processed foods, so they can also be avoided by sticking to fresh produce, meats and whole foods.

Diacetyl Concerns about food additives are not limited to consumers;

some have been associated with serious workplace diseases. Diacetyl, used as a butter fl avoring in microwave popcorn, is associated with a severe and irreversible respiratory condition called bronchiolitis obliterans, which leads to infl ammation and permanent scarring of the airways. Diacetyl is also used to fl avor dairy products such as yogurt and cheese as well as in “brown fl avorings” such as butterscotch and maple and in fruit fl avorings such as strawberry and raspberry (OSHA 2010). Several fl avor-related respiratory disease clusters have been

identifi ed, beginning with an investigation in 2000 of former workers at a microwave popcorn plant (NIOSH 2004). In one case, the National Institute for Occupational Safety and Health found compromised lung function in 11 of 41 production work- ers – two-to-three times the expected number. There was little or no response to medical treatment, and workers with severe forms of the disease, some only in their 30s, ended up on waiting lists for lung transplants. Occupational health concerns associated with fl avoring

chemicals go beyond diacetyl. The federal Centers for Disease Control and Prevention and the Occupational Safety and Health Administration have identifi ed other fl avoring chemicals that may pose a risk to workers, including 2,3-pentanedione and acetal- dehyde. NIOSH emphasizes that safety evaluations of fl avoring chemicals are largely based on consumer exposure, and there are

no occupational exposure guidelines for most. This means that workers could face much higher risks that are poorly understood.

What you should do Be aware of foods that contain the non-specifi c ingredient

“fl avor.” It’s hard to know what kinds of compounds this term may be hiding. Use EWG’s Food Scores to fi nd foods without question- able fl avorings.


Phosphates are among the most common food additives, found in more than 20,000 products in EWG’s Food Scores da- tabase. They can be used to leaven baked goods, reduce acid and improve moisture retention and tenderness in processed meats. Phosphates are frequently added to unhealthy highly processed foods, including fast foods. In people with chronic kidney disease, high phosphate levels in the body are associated with heart disease and death (Ritz 2012).

In people without kidney disease, one study has linked higher phosphorus levels in the blood to increased cardiovascu- lar risk (Dhingra 2007). Another study that followed more than 3,000 people for 15 years also found an association between dietary phosphorus and heart disease. Other research has re- ported similar fi ndings (Foley 2009; Cancela 2012). The jury is still out about whether there is truly a link between the consump- tion of phosphate food additives and health problems. More re- search is clearly needed. Meanwhile, the issue is being taken


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