Currently, in Europe and North America, a substantial portion of adults' dietary energy intake, ranging from 30% to 60%, is derived from ultra-processed foods. Recent epidemiological studies increasingly suggest a correlation between higher consumption levels of these foods and elevated risks of diabetes and other metabolic disorders.
Emulsifiers, commonly used additives, play a significant role in processed and packaged foods, including industrial cakes, biscuits, desserts, yogurts, ice creams, chocolate bars, breads, margarines, and ready-to-eat or ready-to-heat meals. Their addition aims to enhance appearance, taste, texture, and shelf life. Examples of emulsifiers include mono- and diglycerides of fatty acids, carrageenans, modified starches, lecithins, phosphates, celluloses, gums, and pectins.
Although food safety and health agencies previously evaluated the safety of emulsifiers based on available scientific evidence, recent studies suggest potential adverse effects. These studies indicate that emulsifiers may disrupt gut microbiota, leading to inflammation and metabolic disruption, potentially contributing to insulin resistance and diabetes development.
A groundbreaking study conducted by a French research team examined the association between dietary emulsifier intake, evaluated over a maximum 14-year follow-up period, and the risk of developing type 2 diabetes in a large general population cohort.
The study analyzed data from 104,139 French adults (average age 43 years; 79% women) participating in the NutriNet-Santé web-cohort study between 2009 and 2023. Participants provided detailed dietary records, including information on food and beverage consumption and commercial brands, every six months for 14 years. These records were matched with databases to identify food additive presence and quantity, allowing for assessment of chronic emulsifier exposure over time.
During follow-up, 1,056 participants reported diabetes development, with reports validated using a multi-source strategy. Various risk factors for diabetes were considered in the analysis, including age, sex, weight (BMI), education, family history, lifestyle habits, and overall diet quality.
After an average follow-up of seven years, chronic exposure to certain emulsifiers was associated with increased type 2 diabetes risk:
- Carrageenans (total and E407): 3% increased risk per 100 mg/day increment
- Tripotassium phosphate (E340): 15% increased risk per 500 mg/day increment
- Mono- and diacetyltartaric acid esters of mono- and diglycerides of fatty acids (E472e): 4% increased risk per 100 mg/day increment
- Sodium citrate (E331): 4% increased risk per 500 mg/day increment
- Guar gum (E412): 11% increased risk per 500 mg/day increment
- Gum arabic (E414): 3% increased risk per 1,000 mg/day increment
- Xanthan gum (E415): 8% increased risk per 500 mg/day increment
While this study provides valuable insights, it has limitations, including sample characteristics and potential confounding factors. Further research, including epidemiological, toxicological, and experimental studies, is needed to establish causal relationships and inform regulatory measures concerning food additive usage.
The research team plans to investigate blood marker variations and gut microbiota changes associated with emulsifier consumption, as well as potential additive mixture effects. Collaboration with toxicologists for in vitro and in vivo experiments aims to provide additional evidence regarding causal links between emulsifiers and type 2 diabetes.
