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Review Articles

Evidence and hypotheses on adverse effects of the food additives carrageenan (E 407)/processed Eucheuma seaweed (E 407a) and carboxymethylcellulose (E 466) on the intestines: a scoping review

ORCID Icon, ORCID Icon & ORCID Icon
Pages 521-571 | Received 13 Jun 2023, Accepted 02 Oct 2023, Published online: 30 Nov 2023

Figures & data

Figure 1. Structural formulas of κ-, ι- and λ-CGN. The names κ-, ι- and λ-CGN do not reflect definitive chemical structures but only general differences in the composition and degree of sulfation at specific locations in the polymer (EFSA Citation2018a, reused with permission from EFSA).

Figure 1. Structural formulas of κ-, ι- and λ-CGN. The names κ-, ι- and λ-CGN do not reflect definitive chemical structures but only general differences in the composition and degree of sulfation at specific locations in the polymer (EFSA Citation2018a, reused with permission from EFSA).

Figure 2. The chemical structure of CMC, in which R = H or CH2COOH (EFSA Citation2020, reused with permission from EFSA).

Figure 2. The chemical structure of CMC, in which R = H or CH2COOH (EFSA Citation2020, reused with permission from EFSA).

Table 1. Inclusion and exclusion criteria used for selection of publications obtained from the literature searches.

Figure 3. PRISMA flow chart of literature identification, selection and inclusion for the scoping review, guided by Tricco et al. (Citation2018), Page et al. (Citation2021a, Citation2021b).

Figure 3. PRISMA flow chart of literature identification, selection and inclusion for the scoping review, guided by Tricco et al. (Citation2018), Page et al. (Citation2021a, Citation2021b).

Figure 4. The number of all types of publications studying CGN or CMC per 5-year-periods.

Figure 4. The number of all types of publications studying CGN or CMC per 5-year-periods.

Figure 5. The number of research publications studying degraded or native CGN per 5-year-periods.

Figure 5. The number of research publications studying degraded or native CGN per 5-year-periods.

Figure 6. The number of research publications studying the various types of CGN as specified in the publications. Modified CGN was only mentioned in one review publication and one abstract.

Figure 6. The number of research publications studying the various types of CGN as specified in the publications. Modified CGN was only mentioned in one review publication and one abstract.

Figure 7. The distribution of various types of publications on CGN (degraded and native). The human studies (without studies of exposure), experimental animal studies and in vitro studies are original research publications. Exposure studies comprise all types of publications that contain information on levels in food, exposure etc., including from review publications and conference abstracts. In addition, publications on CGN containing information on ADME and risk assessments were included.

Figure 7. The distribution of various types of publications on CGN (degraded and native). The human studies (without studies of exposure), experimental animal studies and in vitro studies are original research publications. Exposure studies comprise all types of publications that contain information on levels in food, exposure etc., including from review publications and conference abstracts. In addition, publications on CGN containing information on ADME and risk assessments were included.

Figure 8. Hypotheses on adverse effects on the intestines of degraded and native CGN in the research publications.

Figure 8. Hypotheses on adverse effects on the intestines of degraded and native CGN in the research publications.

Figure 9. The number of research publications studying non-modified or modified CMC per 5-year periods.

Figure 9. The number of research publications studying non-modified or modified CMC per 5-year periods.

Figure 10. Distribution of various types of publications on CMC. The human studies (without studies of exposure), experimental animal studies, in vitro studies and other types of studies (one toxicokinetic study), are original research publications. Exposure studies comprise all types of publications that contain information on levels in food, exposure etc., including from review publications and conference abstracts. In addition, publications on CMC containing information on toxicokinetics and ADME, and risk assessments, were included.

Figure 10. Distribution of various types of publications on CMC. The human studies (without studies of exposure), experimental animal studies, in vitro studies and other types of studies (one toxicokinetic study), are original research publications. Exposure studies comprise all types of publications that contain information on levels in food, exposure etc., including from review publications and conference abstracts. In addition, publications on CMC containing information on toxicokinetics and ADME, and risk assessments, were included.

Figure 11. Hypotheses on adverse effects of CMC in the research publications.

Figure 11. Hypotheses on adverse effects of CMC in the research publications.

Figure 12. Image of the interactive research map showing various types of CGN and CMC in the columns, type of publications in the rows and hypotheses on the adverse effects on the intestines as bubbles. The size of the bubbles indicates the number of studies in each square. From this map, available and missing data in the various categories can be easily seen. The map can be downloaded from Supplementary materials Figure 1 be used interactively.

Figure 12. Image of the interactive research map showing various types of CGN and CMC in the columns, type of publications in the rows and hypotheses on the adverse effects on the intestines as bubbles. The size of the bubbles indicates the number of studies in each square. From this map, available and missing data in the various categories can be easily seen. The map can be downloaded from Supplementary materials Figure 1 be used interactively.

Figure 13. Image of the interactive research map showing various types of CGN and CMC in the columns, human populations (healthy general population or patients) in the rows and hypotheses on the adverse effects on the intestines as bubbles. The size of the bubbles indicates the number of studies in each square. From this map, available and missing data in the various categories can be easily seen. The map can be downloaded from Supplementary materials Figure 2 to be used interactively.

Figure 13. Image of the interactive research map showing various types of CGN and CMC in the columns, human populations (healthy general population or patients) in the rows and hypotheses on the adverse effects on the intestines as bubbles. The size of the bubbles indicates the number of studies in each square. From this map, available and missing data in the various categories can be easily seen. The map can be downloaded from Supplementary materials Figure 2 to be used interactively.