Food additives continue to be a controversial and confusing topic in health. The Environmental Working Group (EWG) states that over 10,000 chemicals are allowed in food sold in the U.S., such as preservatives like BHA or even heavy metals that contaminate food during processing. These additives have been associated with health issues such as increased risk of cancer and hormone disruption. Yet, the U.S. Food and Drug Administration (FDA) states that "all food additives are carefully regulated by federal authorities and various international organizations to ensure that foods are safe to eat and are accurately labeled." So, why is there a disconnect? This article aims to help you decipher this often confusing information with the latest research on this topic.

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Understanding Food Additives

A food additive is any ingredient added to food. These additives can be considered direct and indirect food additives. Direct additives are added for a specific purpose. An example is xanthan gum used for salad dressing to add texture. Indirect additives indirectly become a part of the food in trace amounts due to its processing, storage, or packaging.

Some of the most commonly used additives are nitrates/nitrites and Butylated hydroxyanisole (BHA) found in cured meats, potassium bromate added to flour, propylparaben used in pastries, Butylated hydroxytoluene (BHT) in cereals, titanium dioxide in candy, and artificial colors and artificial sweeteners in beverages. These food and color additives are used to maintain freshness and nutritional value or improve taste, texture, and appearance.

Currently, the FDA is the primary governing body responsible for determining the use and safety of food and color additives in the U.S. In order to introduce a new food or color additive or use an already approved additive differently, the manufacturer or sponsor must seek FDA approval through a petition. The petition should include evidence demonstrating the substance's safety for its intended use. Since 1999, indirect additives have been approved through a premarket notification process, which now requires the same data previously required by a petition. The gray area or what has been considered a loophole in these regulations is the implementation of the classification of Generally Recognized as Safe (GRAS), which has enabled manufacturers to decide the safety of the additives we consume instead of the FDA.

Exploring the Cancer Risk of Food Additives

There is a growing body of evidence that is linking certain food additives and cancer. In this section, we will explore the research on some commonly used food additives under scrutiny for potential carcinogenic properties and discuss their possible mechanisms of cancer promotion. The EWG reports that over 99% of food additives introduced since 2000 were approved by food and chemical companies rather than thoroughly reviewed by the FDA, with many additives linked to significant health risks, such as increased cancer risk, developmental harm, and hormone disruption.

This allowance is due to a loophole in the law that allows food to be classified as GRAS. Some of these potentially carcinogenic additives include nitrates/nitrites, potassium bromate, BHA, BHT, PFAS, and heavy metals such as mercury, lead, cadmium, and arsenic. A carcinogen is an organism, substance, or agent capable of causing cancer. Potassium bromate, BHA, BHT, and PFAS have all been associated with being potential human carcinogens, some of which have been banned in other countries (Brazil, Canada, EU, and U.K.), such as potassium bromate.

‍Nitrates and nitrites are typically in processed foods like cured meats and have also been found in tap water. These additives can form cancer-causing compounds called nitrosamines in the body associated with stomach, esophageal, and possibly brain and thyroid cancers. PFAS, known as the "forever chemical," is used in products such as cooking pans and can create long-term exposure in humans through being leached from those products.

Chronic exposure to elevated levels of heavy metals such as arsenic and cadmium has been shown to lead to oxidative stress, DNA damage, cell death, and increased cancer risk. Some of these metals, including arsenic, have been found in baby food and are being prompted by groups like the EWG to be removed and to have strict limitations set on heavy metals in foods by the FDA.

What Food Additives Are Banned in Europe vs. the USA?

Here is a list of some food additives and an overview of these additives that are banned in Europe but not in the U.S.:

Potassium Bromate

This food additive is typically found in baked goods from the flour added to make the dough rise higher. It has been found in over 130 different food products in the U.S. Potassium bromate is a potential human carcinogen and has been banned in the European Union, the U.K., Brazil, and Canada. The FDA has yet to review this food additive since 1973.

Brominated Vegetable Oil (BVO)

BVO is an additive primarily found in soft drinks with a citrus flavoring to keep the flavors from separating. This additive has been associated with an increased risk for nervous system issues from drinking these drinks that contain this additive over a long period of time. BVO is currently banned in Europe and Japan and is classified by the FDA as GRAS, allowing the use of this ingredient without a safety review.

Titanium Dioxide

This additive is found in many processed foods, such as candies for texture and bright coloring. The European Food Safety Authority (EFSA) determined in 2021 that particles of this food additive could accumulate in the body and potentially cause chromosomal damage in the DNA, thereby making this not safe for consumption in Europe. Titanium Dioxide is still allowed in the U.S. and has not been reassessed for over 50 years.

Propylparaben

Propyl parabens are often found in products such as cosmetics and also in pastries. Although these parabens are being removed from cosmetics, they are still found in 49 various processed foods. Parabens have been linked to being an endocrine disruptor and, according to the CDC, have been found in the urine of 92.7 percent of Americans. Propyl parabens have been removed from the list of food additives in the Europen Union since 2006.

Current Regulatory Measures and Consumer Awareness

Although most developed countries have their own jurisdiction for food additives, such as the Europen Food Safety Authority (EFSA), an international regulatory body called the Joint FAO/WHO Expert Committee on Food Additives (JECFA) exists. This organization is made up of an international scientific expert committee. It is administered by the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO). The JECFA has assessed more than 2600 food additives taking into account their exposure risks and safety utilizing scientific assessments such as toxicology, epidemiology, and biotechnology. Some of the guidelines set forth by the JECFA include, what additives may be used, which may not be used, maximum use levels, acceptable daily intake, safety, justification of the use, good manufacturing practices, and purity of food additives.

Regarding labeling requirements, currently, the FDA requires manufacturers to list all ingredients on the food label in order of predominance with the greatest amount first. However, some ingredients can be listed collectively as "spices," "flavors," "artificial flavoring," or, in the case of color additives exempt from certification, "artificial colors" without having to name each ingredient under these collective terms. This collective terming on labels can be misleading to consumers and can impact their awareness of the specific ingredient in the foods they consume.

The good news is that there is an effort to educate and raise consumer awareness regarding the potential risks of food additives by non-profit groups like the EWG, who are advocates for the general public. Their mission is to empower people to make informed choices through research to live healthy lives in a healthy environment. They aim to raise our awareness of outdated legislation that may pose a risk to our health and environment. They provide educational information and consumer guides on various chemicals, food additives, and agricultural practices.

Functional Medicine Labs That Test for Food-Additive Exposure

Functional medicine labs can help practitioners assess for food-additive exposure in their patients. Here are some common labs used by functional medicine doctors. 

Food Additives

This food additive test assesses 30 food additives and measures their immune reactions to these additives. Some food additives include BHA, BHT, various food colorings, and artificial sweeteners. Analyzing these additives can help assess which of these additives may be creating a reaction in your body.

Hair Elements

This hair sample test analyzes various heavy metals such as arsenic, lead, and cadmium that may be present in our foods. This test can aid people in determining which metals they are exposed to and at which levels allowing for proper treatments or detoxification if necessary.

Functional Medicine Labs That Help Detect and Individualize Treatment for Patients at Risk for Cancer

Here are some functional medicine labs that can help detect a patient's risk for cancer to allow for appropriate management or referral: 

Cancer Panels

This cancer panel for women and men can assess various cancer markers. These markers can help detect early signs of cancer, allowing for monitoring and possible treatment options. However, it is essential to note that these markers can have some limitations as they are not always definitive signs of cancer, and there may be some false negatives in some cases.

Hs-CRP

The hs-CRP test measures C-reactive protein levels in the body. C-reactive proteins can indicate inflammation in the body. Inflammation is often associated with elevated toxins or heavy metals in the body, and elevated levels of these proteins have also been shown to increase the risk of cancer development. This test can help assess cancer risk.

Toxin Screening

This panel is a comprehensive toxic screen that assesses levels of toxins and chemicals that you may have been exposed to. Toxin exposure can contribute to an increased risk of cancer, and this test can help identify and reduce exposure to these toxins and chemicals, thus reducing the cancer risk.

Nutrition Options That Help Avoid Food Additives

The best nutritional option for food additives is to avoid the top additives that have been associated with contributing to health issues. Consumers can read product labels and look under the ingredients for these food additives. The EWG is an excellent source for the most updated list of food additives with potentially harmful effects and which foods they are often found in. They have a list called the "Dirty Dozen Guide To Food Chemicals" that can help people navigate through these additives. This list includes nitrates, potassium bromate, propyl parabens, BHA, BHT, TBHQ, Titanium Dioxide, BVO, PFAs, artificial colors and sweeteners, and heavy metals. Being aware of these various food additives, which foods they are found in, and reading labels is essential in avoiding them as part of a healthy nutritional plan.

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Summary

With food additives such as BHA, Nitrates, and Potassium Bromate still being allowed in food products in the U.S., it is imperative to be aware of the potentially unsafe effects of these chemicals and their possibility of being human carcinogens. Therefore, ongoing research is needed to ensure that we have proper regulations for these food additives to mitigate the potential health hazards of these substances. Organizations such as the EWG are a great example of a company that continues to explore these topics to promote safer food environments for the general public allowing for further public dialogue, investigation, and awareness.