A high intake of certain agents used in ultra-processed food (UPF) has been linked to an increased risk of heart problems such as heart attacks, angina and strokes, according to a new study.

French researchers said their findings, published in The BMJ, could be used to help re-evaluate regulations in the food industry “to protect consumers”.

They explored the health implications of certain emulsifiers, which are used to preserve and add texture to packaged foods such as cakes, ice cream, bread, margarine and ready meals.

Some scientists have already suggested the agents can impact gut bacteria and increase inflammation, potentially adding to a risk in heart problems.

The team looked at a cohort of 95,442 French adults with no history of heart disease, who were taking part in the NutriNet-Sante study between 2009 and 2021.

The average age of those involved was 43 and 79% were women.

During a two-year follow-up, they were asked to complete between three and 21 24-hour food diaries online.

Each item consumed was then matched by brand to three databases to pinpoint the presence and amount of additives.

Those in the cohort were also asked to report any major cardiovascular event such as a heart attack or stroke.

Deaths linked to cardiovascular disease were recorded using the French national death register, taking into account other risk factors such as age, weight, family history and smoking status.

After an average follow-up period of seven years, a higher intake of celluloses E460, 2468 and E460, which are used to improve the texture of food, were linked to a higher risk of cardiovascular disease and coronary heart disease, along with the thickener carboxymethylcellulose, also known as E466, acidity regulator E339 and binding agent E472c.

The emulsifier E472b, which is used as an airing agent in pastries and cakes, was associated with a risk of cardiovascular disease and cerebrovascular disease, which includes strokes and aneurysms.

While it would be hard to avoid UPF entirely in our diets, cutting down on food like cakes and biscuits and cooking more from scratch are already things we know can help improve our diets and, in doing so, lower our cardiovascular disease risk

The team said there was “no evidence of an association between the other studied emulsifiers and any of the cardiovascular outcomes”.

They also acknowledged the single observational study can not “establish cause” but stressed the findings should be replicated in other large-scale studies and could “contribute to the re-evaluation of regulations around food additive usage in the food industry to protect consumers.”

Tracy Parker, heart health dietitian at the British Heart Foundation (BHF), said this type of study “can only show an association” between a high intake of certain emulsifiers and cardiovascular disease.

She added: “We need more research to properly understand the link between UPF and heart disease.

“While it would be hard to avoid UPF entirely in our diets, cutting down on food like cakes and biscuits and cooking more from scratch are already things we know can help improve our diets and, in doing so, lower our cardiovascular disease risk.

“It is also essential to create an environment that supports this, by implementing delayed policies that are already on the table to restrict the advertising and promotion of often highly processed foods which are high in fat, sugar and salt.”

Dr Gavin Stewart, senior lecturer in evidence synthesis at Newcastle University, said that while the “study demonstrates a potential effect” there is a need for “cautious interpretation”.

“The strength of evidence from a single observational study is inherently low because of uncertainty about confounders and causal relationships.

“Further studies and evidence synthesis are required to reduce this uncertainty.”

Last month, two pieces of research presented at the European Society of Cardiology Congress in Amsterdam also linked the consumption of UPF, such as cereals and fast food, to cardiovascular disease.

A team from the University of Sydney studied more than 10,000 middle-aged women over 15 years, finding that 39% were more likely to develop high blood pressure compared to those with the lowest intake of ultra-processed foods.

The second study, presented by Yang Qu on behalf of the researchers at China’s Fourth Military Medical University, found those who ate the most UPF were nearly 25% more likely to suffer from a heart attack, stroke, or angina.

Speaking at the time, campaigner Henry Dimbleby said the results should be a “wake-up call” as “Britain is particularly bad” when it comes to UPF.

He told The Guardian: “It is storing up problems for the future.

“If we do nothing, a tidal wave of harm is going to hit the NHS.”