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

Eloi Chazelas (1, 2) , Fabrice H.F. Pierre (3, 2) , Nathalie Druesne-Pecollo (4, 2) , Younes Esseddik (4) , Fabien Szabo de Edelenyi (4) , Cédric Agaësse (1) , Alexandre de Sa (1) , Rebecca Lutchia (1) , Stéphane Gigandet (5) , Bernard Srour (1, 2) , Charlotte Debras (1, 2) , Inge Huybrechts (6, 2) , Chantal Julia (1, 7) , Emmanuelle Kesse-Guyot (1, 2) , Benjamin Allès (1) , Pilar Galan (1, 2) , Serge Hercberg (1, 2, 7) , Mélanie Deschasaux-Tanguy (1, 2) , Mathilde Touvier (1, 2)

1 EREN [CRESS - U1153 / UMR_A 1125] - Nutritional Epidemiology Research Team | Equipe de Recherche en Epidémiologie Nutritionnelle
2 Réseau National Alimentation Cancer Recherche (réseau NACRe)
3 ToxAlim-PPCA - Prévention et promotion de la cancérogénèse par les aliments
4 CRESS (U1153 / UMR_A 1125) - Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques
5 Open Food Facts [Saint-Maur-des-Fossés]
6 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
7 Hôpital Avicenne [AP-HP]

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 model. 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.

Keywords: Nitrites; cancer risk; food additives; nitrates; prospective cohort

Domains: Life Sciences [q-bio]

Eloi Chazelas, Fabrice H.F. Pierre, Nathalie Druesne-Pecollo, Younes Esseddik, Fabien Szabo de Edelenyi, et al.. Nitrites and nitrates from food additives and natural sources and cancer risk: results from the NutriNet-Santé cohort. International Journal of Epidemiology, 2022, 51 (4), pp.1106-1119. ⟨10.1093/ije/dyac046⟩. ⟨hal-03624104⟩