Food processing/contact materials and hypertension/type 2 diabetes risk – NutriNet-Santé cohort
Abstract
Background: Food items are contaminated by various substances (e.g. Per- and polyfluoroalkyl substances – PFAS, Polycyclic aromatic hydrocarbons – PAHs, Brominated Flame Retardants – BFRs) throughout their lifecycle. This study investigated the associations between exposure to contaminants originating from food processing/contact materials and hypertension and type 2 diabetes (T2D) risk in the NutriNet-Santé cohort.
Methods: We assessed cumulative time-dependent exposures to 51 food contaminants using repeated 24h-dietary records from 108,758 participants (78.6% women, mean age=42.8y (SD = 14.7)) of the NutriNet-Santé cohort (2009-2024), and quantitative analyses in food matrices from the French total diet study 2 (2006-2009). Associations between contaminant exposures (sex-specific tertiles) and hypertension/T2D incidence were characterized using multivariable Cox proportional hazards models adjusted for known risk factors. Mixtures effects were explored using sparse PLS-Cox models.
Results: During a median 8y follow-up, 1,958 incident hypertension and 1,202 incident T2D cases were ascertained. 12 BFRs (e.g. total BDEs: HRT3 vs. T1=1.12,95%CI[1.04–1.21],ptrend= 0.005), 7 PAHs and 10 PFAS (e.g. PFOS: HRT3 vs. T1=1.15 [1.06-1.25], poverall<0.001) were associated with increased risk of hypertension. 5 BFRs, 2 PAHs (e.g. benzo[b]fluoranthene: HRT3 vs. T1=1.20[1.03-1.39],ptrend=0.02) and 1 PFAS (e.g. PFDS: HRT3 vs. T1=1.30 [1.04-1.63], ptrend=0.03) were associated with higher T2D incidence. Sparse PLS-Cox models identified contaminants mixtures most associated with each outcome.
Conclusions: This large prospective cohort study suggests a potential role for food contaminants such as BFRs, in hypertension and T2D etiology, which is consistent with their metabolic disrupting potential suggested by previous in vivo/in vitro studies. If replicated and confirmed in other epidemiological studies, our findings advocate for stronger regulations on these food contaminants.
Key messages: • Some substances found in food contact material and/or generated during food processing might be associated with a higher risk of hypertension and type 2 diabetes.
• If corroborated by further studies, our study underscores the necessity for stricter regulations on food contaminants.
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BibTeX
@article{folcalvez2026food,
title = {{Food processing/contact materials and hypertension/type 2 diabetes risk – NutriNet-Santé cohort}},
author = {X Le Folcalvez and A Hasenböhler and M Payen de la Garanderie and S Shah and X Coumoul and JB Fini and J Muncke and M Deschasaux-Tanguy and B Srour and M Touvier},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.554},
url = {https://doi.org/10.1093/eurpub/ckag169.554},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Food processing/contact materials and hypertension/type 2 diabetes risk – NutriNet-Santé cohort
AU - X Le Folcalvez
AU - A Hasenböhler
AU - M Payen de la Garanderie
AU - S Shah
AU - X Coumoul
AU - JB Fini
AU - J Muncke
AU - M Deschasaux-Tanguy
AU - B Srour
AU - M Touvier
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.554
UR - https://doi.org/10.1093/eurpub/ckag169.554
AB - Background: Food items are contaminated by various substances (e.g. Per- and polyfluoroalkyl substances – PFAS, Polycyclic aromatic hydrocarbons – PAHs, Brominated Flame Retardants – BFRs) throughout their lifecycle. This study investigated the associations between exposure to contaminants originating from food processing/contact materials and hypertension and type 2 diabetes (T2D) risk in the NutriNet-Santé cohort. Methods: We assessed cumulative time-dependent exposures to 51 food contaminants using repeated 24h-dietary records from 108,758 participants (78.6% women, mean age=42.8y (SD = 14.7)) of the NutriNet-Santé cohort (2009-2024), and quantitative analyses in food matrices from the French total diet study 2 (2006-2009). Associations between contaminant exposures (sex-specific tertiles) and hypertension/T2D incidence were characterized using multivariable Cox proportional hazards models adjusted for known risk factors. Mixtures effects were explored using sparse PLS-Cox models. Results: During a median 8y follow-up, 1,958 incident hypertension and 1,202 incident T2D cases were ascertained. 12 BFRs (e.g. total BDEs: HRT3 vs. T1=1.12,95%CI[1.04–1.21],ptrend= 0.005), 7 PAHs and 10 PFAS (e.g. PFOS: HRT3 vs. T1=1.15 [1.06-1.25], poverall<0.001) were associated with increased risk of hypertension. 5 BFRs, 2 PAHs (e.g. benzo[b]fluoranthene: HRT3 vs. T1=1.20[1.03-1.39],ptrend=0.02) and 1 PFAS (e.g. PFDS: HRT3 vs. T1=1.30 [1.04-1.63], ptrend=0.03) were associated with higher T2D incidence. Sparse PLS-Cox models identified contaminants mixtures most associated with each outcome. Conclusions: This large prospective cohort study suggests a potential role for food contaminants such as BFRs, in hypertension and T2D etiology, which is consistent with their metabolic disrupting potential suggested by previous in vivo/in vitro studies. If replicated and confirmed in other epidemiological studies, our findings advocate for stronger regulations on these food contaminants. Key messages: • Some substances found in food contact material and/or generated during food processing might be associated with a higher risk of hypertension and type 2 diabetes. • If corroborated by further studies, our study underscores the necessity for stricter regulations on food contaminants.
SN - 1101-1262
SN - 1464-360X
ER -