EFSA Reviews Study Linking Phosphate Additives to Cardiovascular Risk

The European Food Safety Authority (EFSA) has issued a statement finding that a published review of observational studies ultimately failed to establish a causal relationship between high intakes of phosphate additives in food and increased cardiovascular risk in the general population. In addition to considering the data on the association between serum phosphate levels and cardiovascular disease, the review in question apparently proposed a mechanism by which the metabolism of inorganic phosphate could contribute to vascular calcification, in the process suggesting that “intake of phosphate as a food additive, especially through consumption of processed and ready-to-eat food, is of particular concern.” Additional details about the review, which was initially published in the January 2012 edition of Deutsches Ärzteblatt International, appear in Issue 428 of this Update.

After assessing these findings at the request of the European Commission,
EFSA concluded that (i) the limitations of the observational studies included
in the review made it impossible “to make causal inferences for serum
phosphate levels and the observed adverse effects,” and (ii) the evidence
did not make it clear “whether the increased cardiovascular risk observed in
these observational studies is attributable to differences in the dietary intake
of phosphorus in general or in the form of phosphate additives and serum
phosphate levels.” As a result, the agency suggested that “a meta-analysis of
a systematic review of the available literature” could help resolve the current
inconsistencies in studies examining the link between phosphate additives
and cardiovascular disease.

“As set out by Regulation (EU) No 257/2010, phosphates for use as food additives will be re-evaluated by EFSA with high priority by 31 December 2018,” concludes EFSA’s statement. “In the context of this re-evaluation all relevant toxicological information will be collated and evaluated. A dedicated call for data aimed at gathering information on usage levels of phosphates in food will be launched in preparation for the re-evaluation.”