TOPLINE:
Various food additive emulsifiers, including total carrageenans, carrageenan gum, tripotassium phosphate, sodium citrate, and guar gum, can increase the risk for type 2 diabetes (T2D), showed a recent study.
METHODOLOGY:
- Food emulsifiers, which are extensively used to enhance the texture and improve the shelf life of various ultraprocessed food items, have been shown to increase the risk for cardiovascular disease and cancer.
- In this study, the dietary intake data of 104,139 adults (79.2% women; mean age, 42.7 years) enrolled in the French NutriNet-Santé prospective cohort study from May 2009 to April 2023 were assessed for 24 hours on 3 nonconsecutive days at inclusion and every 6 months thereafter to determine the risk for T2D.
- The dietary records of participants, which were linked to food composition databases, were used to quantify the food additive intake.
- T2D cases were identified using a multisource approach encompassing self-reports, health questionnaires, national health insurance system databases, and/or mortality registries.
TAKEAWAY:
- During a mean follow-up period of 6.8 years, 1056 incident cases of T2D were reported.
- Almost all (99.7%) participants were exposed to at least one food additive emulsifier, with the main contributors being ultraprocessed fruits and vegetables (18.5%), cakes and biscuits (14.7%), and dairy products (10.0%).
- The intake of the following emulsifiers increased the risk for T2D:
- Total carrageenans and carrageenan gum (3% increased risk per increment of 100 mg/d; P < .001)
- Tripotassium phosphate (15% increased risk per increment of 500 mg/d; P = .023)
- Acetyl tartaric acid esters of monoglycerides and diglycerides of fatty acids (4% increased risk per increment of 100 mg/d; P = .042)
- Sodium citrate (4% increased risk per increment of 500 mg/d; P = .008)
- Guar gum (11% increased risk per increment of 500 mg/d; P < .0001)
- Gum arabic (3% increased risk per increment of 1000 mg/d; P = .013)
- Xanthan gum (8% increased risk per increment of 500 mg/d; P = .013)
IN PRACTICE:
In an accompanying commentary, experts postulated that “findings from this and other studies could prompt regulatory agencies and policymakers to reconsider the rules governing the use of emulsifiers and other additives by the food industry such as setting limits and requiring better disclosure of food additive contents to help consumers make more informed choices.”
SOURCE:
Clara Salame, PhD, Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and Statistics, Nutritional Epidemiology Research Team, Paris, France, led this study, which was published online in The Lancet Diabetes & Endocrinology.
LIMITATIONS:
The observational nature of this study is not sufficient to establish causality relationships. There may have been measurement errors in emulsifier exposure, particularly in products exempted from labeling requirements. This cohort’s demographics, which included a higher percentage of women and a health-conscious population, may affect the generalizability of the study’s findings.
DISCLOSURES:
This study received funding from the European Research Council, and the NutriNet-Santé study was supported by many public institutions such as the Ministère de la Santé, Santé publique France, Université Sorbonne Paris Nord, and others. The authors declared no conflicts of interest.
A version of this article appeared on Medscape.com.