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.
French Network for Nutrition and Cancer Research (NACRe Network), Jouy-en-Josas, France.
Int J Epidemiol. 2022 Aug 10;51(4):1106-1119. doi: 10.1093/ije/dyac046.
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.
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.
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.
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.
硝酸盐和亚硝酸盐自然存在于水和土壤中。它们也被用作加工肉类中的食品添加剂（防腐剂）。它们可能在加工肉类的致癌性中发挥作用。本研究的目的是在一个具有详细饮食评估的大型前瞻性队列中，调查硝酸盐和亚硝酸盐摄入量（天然食物、水和食品添加剂来源）与癌症风险之间的关系。
总体而言，共有 101056 名来自法国 NutriNet-Santé 队列的成年人（2009 年开始至今，中位随访 6.7 年）被纳入本研究。通过反复的 24 小时饮食记录来评估亚硝酸盐/硝酸盐的暴露情况，这些记录与一个综合的成分数据库相关联，并考虑了商业名称/工业产品的品牌。使用多因素调整的 Cox 风险模型评估与癌症风险的关联。
共诊断出 3311 例新发癌症病例。与非消费者相比，高消费食品添加剂硝酸盐的人群乳腺癌风险更高[风险比（HR）=1.24（95%CI 1.03-1.48），P=0.02]，特别是对于钾硝酸盐。高消费食品添加剂亚硝酸盐的人群前列腺癌风险更高[HR=1.58（1.14-2.18），P=0.008]，特别是对于亚硝酸钠。尽管对于结直肠癌，添加剂亚硝酸盐[HR=1.22（0.85-1.75）]和硝酸盐[HR=1.26（0.90-1.76）]的 HR 相似，但未检测到相关性，可能是因为该癌症部位的统计效力有限。天然来源与癌症风险之间没有关联。
食品添加剂硝酸盐和亚硝酸盐分别与乳腺癌和前列腺癌风险呈正相关。尽管这些结果需要在其他大规模前瞻性研究中得到证实，但它们在食品工业中禁止这些添加剂的激烈争论背景下提供了新的见解。
