Food additive emulsifiers and the risk of type 2 diabetes: analysis of data from the NutriNet-Santé prospective cohort study
Authors' conclusion
We found direct associations between the risk of type 2 diabetes and exposures to various food additive emulsifiers widely used in industrial foods, in a large prospective cohort of French adults. Further research is needed to prompt re-evaluation of regulations governing the use of additive emulsifiers in the food industry for better consumer protection.
Study context
- Population
- French adults in the NutriNet-Santé cohort, 2009–2023; 79.2% female, mean age 42.7 years (SD 14.5)1,056 incident T2D
- Participants
- 104,139 adults
- Exposure
- Exposure to food additive emulsifiers
- Outcome
- Incident T2D
- Follow-up
- Mean 6.8 years (SD 3.7)
Methodological detailsmultivariable proportional hazards Cox models, cumulative time-dependent exposures, Diet assessed by three 24 h dietary records every 6 months; additive exposure via food composition databases and laboratory assays
- Multivariable proportional hazards Cox models
- Cumulative time-dependent exposures
- Diet assessed by three 24 h dietary records every 6 months; additive exposure via food composition databases and laboratory assays
Main finding
As reported in the abstract
Risk of T2D per increment of emulsifier intake
Hazard ratio (95% CI)P value
Total carrageenansper increment of 100 mg per day
1.03(1.01–1.05)
P < 0.0001Carrageenans gum (E407)per increment of 100 mg per day
1.03(1.01–1.05)
P < 0.0001Tripotassium phosphate (E340)per increment of 500 mg per day
1.15(1.02–1.31)
P = 0.023Acetyl tartaric acid esters of monoglycerides and diglycerides of fatty acids (E472e)per increment of 100 mg per day
1.04(1.00–1.08)
P = 0.042Sodium citrate (E331)per increment of 500 mg per day
1.04(1.01–1.07)
P = 0.0080Guar gum (E412)per increment of 500 mg per day
1.11(1.06–1.17)
P < 0.0001Gum arabic (E414)per increment of 1000 mg per day
1.03(1.01–1.05)
P = 0.013Xanthan gum (E415)per increment of 500 mg per day
1.08(1.02–1.14)
P = 0.013Each row per its own increment, as printed
Observational data: associations, not effects.
Original publication
Food additive emulsifiers and the risk of type 2 diabetes: analysis of data from the NutriNet-Santé prospective cohort study. Lancet Diabetes Endocrinol. Published May 2024. doi:10.
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