Nitrites and nitrates from food additives and natural sources and cancer risk: results from the NutriNet-Santé cohort

Author:

Chazelas Eloi12ORCID,Pierre Fabrice23,Druesne-Pecollo Nathalie12ORCID,Esseddik Younes1,Szabo de Edelenyi Fabien1,Agaesse Cédric1,De Sa Alexandre1,Lutchia Rebecca1,Gigandet Stéphane4,Srour Bernard12ORCID,Debras Charlotte12ORCID,Huybrechts Inge25,Julia Chantal16ORCID,Kesse-Guyot Emmanuelle12ORCID,Allès Benjamin1ORCID,Galan Pilar12ORCID,Hercberg Serge126,Deschasaux-Tanguy Mélanie12ORCID,Touvier Mathilde12ORCID

Affiliation:

1. Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS) , Bobigny, France

2. French Network for Nutrition and Cancer Research (NACRe Network) , Jouy-en-Josas, France

3. Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS , Toulouse, France

4. Open Food Facts , Saint-Maur-des-Fossés, France

5. International Agency for Research on Cancer, World Health Organization , Lyon, France

6. Public Health Department, Avicenne Hospital, AP-HP , Bobigny, France

Abstract

Abstract Background Nitrates and nitrites occur naturally in water and soil. They are also used as food additives (preservatives) in processed meats. They could play a role in the carcinogenicity of processed meat. The objective was to investigate the relationship between nitrate and nitrite intakes (natural food, water and food additive sources) and cancer risk in a large prospective cohort with detailed dietary assessment. Methods Overall, 101    056 adults from the French NutriNet-Santé cohort (2009–ongoing, median follow-up 6.7 years) were included. Nitrites/nitrates exposure was evaluated using repeated 24-h dietary records, linked to a comprehensive composition database and accounting for commercial names/brands of industrial products. Associations with cancer risk were assessed using multi-adjusted Cox hazard models. Results In total, 3311 incident cancer cases were diagnosed. Compared with non-consumers, high consumers of food additive nitrates had higher breast cancer risk [hazard ratio (HR) = 1.24 (95% CI 1.03–1.48), P = 0.02], more specifically for potassium nitrate. High consumers of food additive nitrites had higher prostate cancer risk [HR = 1.58 (1.14–2.18), P = 0.008], specifically for sodium nitrite. Although similar HRs were observed for colorectal cancer for additive nitrites [HR = 1.22 (0.85–1.75)] and nitrates [HR = 1.26 (0.90–1.76)], no association was detected, maybe due to limited statistical power for this cancer location. No association was observed for natural sources. Conclusion Food additive nitrates and nitrites were positively associated with breast and prostate cancer risks, respectively. Although these results need confirmation in other large-scale prospective studies, they provide new insights in a context of lively debate around the ban of these additives from the food industry.

Funder

Ministère de la Santé, Santé Publique France

Institut National de la Santé et de la Recherche Médicale

Institut National de la Recherche Agronomique

Conservatoire National des Arts et Métiers

University Sorbonne Paris Nord

University Sorbonne Paris Nord—Galilée Doctoral School

French National Cancer Institute

European Research Council

European Union’s Horizon 2020

French Ministry of Health

Publisher

Oxford University Press (OUP)

Subject

General Medicine,Epidemiology

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