Associations between preservative food additives and type 2 diabetes incidence in the NutriNet-Santé prospective cohort
Experimental studies suggested potential adverse effects of preservative food additives, but epidemiological data are lacking. We aim to investigate associations between exposure to these compounds and type 2 diabetes incidence in the NutriNet-Santé prospective cohort (n = 108,723; 79.2%women; mean age=42.5 (SD = 14.6); France, 2009-2023). Dietary intakes are assessed using repeated 24h-dietary records. Exposure is evaluated through multiple composition databases and ad-hoc laboratory assays in food matrices. Associations between cumulative exposures to preservatives and diabetes incidence are characterised using multi-adjusted Cox models. The sum of total preservatives encompasses 58 substances. Among those, 17 are consumed by at least 10% of the study population and thus individually investigated. Thirteen (12 after multiple test correction) widely used individual preservatives are associated with higher diabetes incidence (n=1131cases): potassium sorbate, potassium metabisulfite, sodium nitrite, acetic, citric and phosphoric acids, sodium acetates, calcium propionate, sodium ascorbate, alpha-tocopherol, sodium erythorbate, and rosemary extracts. These findings call for their safety re-evaluation and support recommendations to favour fresh and minimally processed foods without superfluous additives. Trial registration: The NutriNet-Santé cohort is registered at clinicaltrials.gov (NCT03335644).
Authors
- Bernard Srour (ORCID: https://orcid.org/0000-0002-1277-3380)
- Emmanuelle Kesse‐Guyot (ORCID: https://orcid.org/0000-0002-9715-3534)
- Benoît Chassaing (ORCID: https://orcid.org/0000-0002-4285-769X)
- Laurent Bourhis
- Cédric Agaësse (ORCID: https://orcid.org/0000-0002-6159-4717)
- Fabien Szabo de Edelenyi (ORCID: https://orcid.org/0000-0002-8487-6557)
- Alexandre De
- Sopio Tatulashvili (ORCID: https://orcid.org/0000-0001-7358-8667)
- E. Cosson
- Guillaume Javaux
- Benjamin Allès (ORCID: https://orcid.org/0000-0002-7970-171X)
- F Pierre
- Inge Huybrechts (ORCID: https://orcid.org/0000-0003-3838-855X)
- Leopold Kamedjie Fezeu
- Chantal Julia
- Serge Hercberg
- A Hasenböhler
- M Payen de la Garanderie
- Mélanie Deschasaux-Tanguy
- Xavier Coumoul
Institutions
- Délégation Paris 5 (FR)
- Conservatoire National des Arts et Métiers (FR)
- Centre National de la Recherche Scientifique (FR)
- Université Toulouse III - Paul Sabatier (FR)
- Inserm (FR)
- Institut Pasteur (FR)
- École Nationale Vétérinaire de Toulouse (FR)
- Université Fédérale de Toulouse Midi-Pyrénées (FR)
- Université Paris Cité (FR)
- Pancreatic Cancer Action Network (US)
- Sorbonne Université (FR)
- Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (FR)
- Université Sorbonne Paris Nord (FR)
- Sorbonne Paris Cité (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Toxicologie Alimentaire (FR)
- Hôpital Avicenne (FR)
- Centre international de recherche sur le cancer (FR)
- Centre de Recherche Épidémiologie et Statistique (FR)
Publication Details
- Journal
- Nature Communications
- Published
- 2026-01-07
- DOI
- https://doi.org/10.1038/s41467-025-67360-w
- Citations
- 2
- Primary Topic
- Biochemical Analysis and Sensing Techniques
- Type
- article
- Field-Weighted Citation Impact
- 64.63