How Everyday Food Additives May Be Fuelling T2D
TOPLINE: Exposure to certain food additive mixtures was associated with a higher incidence of type 2 diabetes (T2D), with two specific mixtures containing emulsifiers, preservatives, and artificial sweeteners showed significant associations. METHODOLOGY: Food additives are widely used in processed foods to enhance texture, shelf life, and taste; however, previous research has focused on individual additives
TOPLINE:
Exposure to certain food additive mixtures was associated with a higher incidence of type 2 diabetes (T2D), with two specific mixtures containing emulsifiers, preservatives, and artificial sweeteners showed significant associations.
METHODOLOGY:
- Food additives are widely used in processed foods to enhance texture, shelf life, and taste; however, previous research has focused on individual additives, while real-life exposure involves additive mixtures, raising concerns about potential interactions.
- Researchers analysed data of 1src8,643 adults (median age, 41.2 years; 79.2% women) from the French NutriNet-Santé e-cohort to assess associations of main food additive mixtures with the incidence of T2D; participants provided detailed lifestyle, health, and dietary information through five comprehensive questionnaires.
- Dietary intakes were assessed at baseline and every 6 months using three non-consecutive 24-hour dietary records, and daily dietary intakes for food additives, nutrients, energy, and food groups were calculated.
- Exposure to food additives was evaluated using multiple food composition databases and laboratory assays, and the incidence of T2D was assessed over a mean follow-up duration of 7.7 years.
- Five main food additive mixtures were identified, primarily characterised by leavening agents; emulsifiers, preservatives, and colouring agents; source of minerals; and acidifiers and acid regulators, dyes, and artificial sweeteners.
TAKEAWAY:
- A total of 1131 patients with incident T2D were reported. Exposure to a mixture containing emulsifiers, preservatives, and colouring agents, which were mostly correlated with broths, dairy desserts, and fats and sauces, was positively associated with a higher incidence of T2D (hazard ratio [HR] per increment of 1 SD, 1.src8; P=.srcsrc6).
- Moreover, exposure to another mixture primarily found in sweetened beverages was significantly associated with a higher incidence of T2D (HR per increment of 1 SD, 1.13; P <.srcsrc1).
- No significant association was observed between the incidence of T2D and the other three mixtures that were correlated with cakes, biscuits, savoury snacks, tabletop salt, chocolate cookies, or cocoa powder.
- The mixture, characterised by acidifiers and acid regulators, sweeteners, colouring agents, and emulsifiers, mediated 42% of the association between sugary drinks and T2D (P <.srcsrc1) and 52% of the association between artificially sweetened beverages and T2D (P=.src3).
IN PRACTICE:
“[The study] results suggest that it may be of interest to consider potential interaction/synergistic/antagonist effects when assessing the safety of food additives and call for a reevaluation of regulations governing their use by the food industry, with the aim of enhancing consumer protection. In the meantime, these findings provide support for the public health recommendation to limit exposure to UPF [ultraprocessed foods] and their nonessential food additives,” the authors wrote.
SOURCE:
This study was led by Marie Payen de la Garanderie, Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and Statistics, Paris, France. It was published online on April src8, 2src25, in PLOS Medicine.
LIMITATIONS:
The observational design of the study limited the ability to establish causality. Despite adjustments for various confounders, unmeasured and residual confounding may still exist. The intake of food additives may have varied over time. Demographic characteristics of the cohort, such as a higher proportion of women, may have limited the generalisability of the findings.
DISCLOSURES:
The NutriNet-Santé study was supported by various public institutions, including the French Ministry of Health, Institut National de la Santé et de la Recherche Médicale, Institut National de la Recherche pour l’agriculture, I’alimentation et l’environnement, and others. This study received funding from the European Research Council, the French National Cancer Institute, the French Ministry of Health and the IdEx Université de Paris, and a Bettencourt-Schueller Foundation Research Prize 2src21. The authors reported having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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