Eating more foods containing additive emulsifiers may raise risk for type 2 diabetes
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Key takeaways:
- Higher intake of eight types of food additive emulsifiers was linked to an increased risk for type 2 diabetes.
- The most common foods containing emulsifiers included ultra-processed fruits and vegetables.
Adults in France who consumed more food additive emulsifiers had increased risk for type 2 diabetes, according to a study published in The Lancet Diabetes & Endocrinology.
“As with all food additives, the safety of emulsifiers had been previously evaluated by food safety and health agencies based on the scientific evidence that was available at the time of their evaluation,” Bernard Srour, PhD, junior professor at the INRAE – National Research Institute for Agriculture, Food and Environment in France, told Healio. “However, with the recent experimental studies on emulsifiers on gut microbiome, we were expecting to detect some associations with human health. Surprisingly, some of the emulsifiers were present in some foods that are marketed as ‘healthy’ foods, such as plant-based light margarines, some types of bread, plant-based milks and flavored yogurts. Therefore, even participants with more favorable dietary behaviors can be exposed to these substances.”
Srour and colleagues collected data from 104,139 adults in France who enrolled in the NutriNet-Santé cohort study from May 2009 to April 2023 (79.2% women; mean age, 42.7 years). Participants provided lifestyle and sociodemographic data, medical history, dietary habits through three nonconsecutive 24-hour dietary records, anthropometric data and physical activity level at enrollment. Follow-up dietary recalls took place every 6 months. Food additive intake was calculated based on participants’ dietary records. Type 2 diabetes diagnoses were self-reported or obtained from a national health insurance system database.
Of the study group, 99.7% were exposed to at least one food additive emulsifier. The most common foods with emulsifiers were ultra-processed fruits and vegetables, cakes and biscuits and dairy products.
There were 1,056 adults diagnosed with type 2 diabetes during a mean follow-up of 6.8 years. Exposure to each 100 mg of total carrageenans (HR = 1.03; 95% CI, 1.01-1.05; P < .0001), carrageenans gum (HR = 1.03; 95% CI, 1.01-1.05; P < .0001) and acetyl tartaric acid esters of monoglycerides and diglycerides of fatty acids (HR = 1.04; 95% CI, 1-1.08; P = .042) per day increased the risk for type 2 diabetes. Each 500 mg of daily intake of tripotassium phosphate (HR = 1.15; 95% CI, 1.02-1.31; P = .023), sodium citrate (HR = 1.04; 95% CI, 1.01-1.07; P = .008), guar gum (HR = 1.11; 95% CI, 1.06-1.17; P < .0001) and xanthan gum (HR = 1.08; 95% CI, 1.02-1.14; P = .013) was associated with increased risk for type 2 diabetes. Adults also had a higher risk for type 2 diabetes with each 1,000 mg of daily intake of gum arabic (HR = 1.03; 95% CI, 1.01-1.05; P = .013).
In principal component analysis where emulsifiers were grouped into specific intake patterns, each 1 standard deviation increase in exposure to lecithins, carrageenan, carob bean gum, guar gum, xanthan gum, diphosphates, sodium tripolyphosphate, polyphosphates, monoglycerides and diglycerides of fatty acids and sodium bicarbonate was associated with increased risk for type 2 diabetes (HR = 1.14; 95% CI, 1.08-1.2).
“These findings are issued from a single observational study for the moment, and cannot be used on their own to establish a causal relationship,” Srour said. “They need to be replicated in other epidemiological studies worldwide and supplemented with toxicological and interventional experimental studies to further inform the mechanisms linking these food additive emulsifiers and the onset of type 2 diabetes. However, our results represent key elements to enrich the debate on reevaluating the regulations around the use of additives in the food industry in order to better protect consumers.”
Srour said future studies should examine how additives cause variations in blood markers and the gut microbiota to better understand mechanisms of action. More studies are also needed to look at the effects of additive mixtures, according to Srour.
For more information:
Bernard Srour, PhD, can be reached at b.srour@eren.smbg.un.
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