Food additives are a diverse group of substances added to foods for various purposes, such as colorants, preservatives, sweeteners, and emulsifiers. Preservatives, commonly identified by European codes within the E200s and E300s ranges, are widely used to extend shelf life by protecting foods against microbial deterioration and oxidation-related changes, such as fat rancidity and color alteration.
Owing to their extensive use, a substantial proportion of food additive re-evaluations were conducted by the European Food Safety Authority (EFSA) between 2004 and 2024. These studies resulted in the establishment of Acceptable Daily Intake (ADI) values based on experimental toxicological data, including carcinogenicity, developmental and reproductive toxicity, metabolic disturbances, and increased mortality. In vivo and in vitro studies have also suggested the potential adverse metabolic effects of preservatives on pancreatic tissue, insulin signalling, inflammatory pathways, and advanced glycation end product activation, raising concerns regarding their potential contribution to metabolic disorders such as type 2 diabetes.
A recent large prospective analysis published in Nature Communications within the NutriNet-Santé cohort addressed these gaps. This study quantified the time-dependent exposure to preservative food additives and examined their association with incident type 2 diabetes. In this population, nearly all participants consumed preservative additives, and 13 (12 after multiple testing correction) widely used individual preservatives were associated with a higher incidence of type 2 diabetes (n = 1,131 cases), with a proportion of the association between ultra-processed food consumption and diabetes risk being mediated by preservative exposure (see Graphic).
Source: Hasenböhler A, Javaux G, Payen de la Garanderie M, Szabo de Edelenyi F, Bourhis L, Agaësse C, De Sa A, Huybrechts I, Pierre F, Coumoul X, Julia C, Kesse-Guyot E, Allès B, Fezeu LK, Hercberg S, Deschasaux-Tanguy M, Cosson E, Tatulashvili S, Chassaing B, Srour B, Touvier M. Associations between preservative food additives and type 2 diabetes incidence in the NutriNet-Santé prospective cohort. Nat Commun. 2026,7;16(1):11199. Doi: 10.1038/s41467-025-67360-w.