Eating some food additives together may increase diabetes risk, study suggests

From nbcnews.com

Eating combinations of common food additives may be tied to a slightly increased risk of Type 2 diabetes, according to a study published Tuesday in the journal PLOS Medicine. 

                                                    Brandon Bell / Getty Images file

A growing body of evidence has linked certain food additives to cancer, diabetes, heart disease and changes to the gut microbiome. Many of these studies, however, were focused on single ingredients.

“In real life, we ingest a mixture of additives,” said Mathilde Touvier, director of the nutritional epidemiology research team at Université Sorbonne Paris Nord and the French National Institute of Health and Medical Research, who co-authored the new study. 

Touvier and her team looked at about eight years of data from more than 108,000 adults from the French NutriNet-Santé cohort, a long-running study that looks at the links between food and health.  

Poring over the participants’ reported diets, the researchers identified five mixtures of additives people commonly consumed together. The combinations don’t look unlike an ingredient list you might find on the label of an ultra-processed food. 

• Mixture 1: Sodium carbonates; diphosphates; glycerol; ammonium carbonates; potassium carbonates; sorbitol
• Mixture 2: Modified starches; pectins; guar gum; carrageenan; polyphosphates; potassium sorbate; curcumin; xanthan gum
• Mixture 3: Magnesium carbonates; riboflavin; alpha-tocopherol; ammonium carbonates
• Mixture 4: Ammonium carbonates; sodium carbonates; diphosphates; alpha-tocopherol; DATEM; magnesium carbonates; lecithins
• Mixture 5: Citric acid; sodium citrates; phosphoric acid; sulphite ammonia caramel; acesulfame K; aspartame; sucralose; arabic gum; malic acid; carnauba wax; paprika extract, capsanthin, and capsorubin; anthocyanins; guar gum; pectins 

“It’s relatively uncommon for all of them to appear in a single product, however, it’s entirely possible to consume all of them across different foods throughout the day, especially when eating a variety of processed or ultra-processed foods,” said Mengxi Du, a research associate at the Harvard T.H. Chan School of Public Health who studies nutrition and health and wasn’t involved with the study.

Carrageenan and potassium sorbate, two additives in Mixture 2, are found together in sweetened condensed milk. Xanthan gum is commonly found in mayonnaise and gluten-free prepared foods. Pectin is in cream cheese. 

“These are pretty common products in someone’s fridge and a lot of times we combine them,” Du said. 

Two groups — Mixture 2 and Mixture 5 — were linked to an increased risk of Type 2 diabetes, the researchers found. People with more of these combinations in their diet were more likely to develop the disease, regardless of how healthy their diet was overall.

Mixture 2 was heavy in emulsifiers and thickening agents, including carrageenans, which are found in plant-based milks and processed meats, and modified starches, which thicken and stabilize packaged sauces, soups and baked goods. Mixture 5 contained ingredients commonly found in sugary and artificially-sweetened drinks, and included artificial sweeteners, natural dyes and acidifiers.

Still, the study was observational, meaning it doesn’t show cause and effect. Studies that require participants to recall their diets are also notoriously tricky. The limitations make it difficult to draw strong conclusions from the study, which Touvier and her team said will require more research.

“The additives may be markers of something else, rather than causing Type 2 diabetes themselves,” said Dr. Tom Rifai, an internal and lifestyle medicine doctor in Cleveland Clinic’s department of endocrinology, diabetes and metabolism. Rifai owns a lifestyle coaching company that includes nutrition counselling. “These could be a marker for what we call calorie density.”

https://www.nbcnews.com/health/health-news/eating-food-additives-together-may-increase-diabetes-risk-study-sugges-rcna200163cessed food creamy, sugar-free and shelf-stable may work together to increase the risk of Type 2 diabetes

Certain ingredients that make processed food creamy, sugar-free and shelf-stable may work together to increase the risk of Type 2 diabetes

Certain ingredients that make processed food creamy, sugar-free and shelf-stable may work together to increase the risk of Type 2 diabetes

Certain ingredients that make processed food creamy, sugar-free and shelf-stable may work together to increase the risk of Type 2 diabetes 

Food additives in cakes, biscuits may increase type 2 diabetes risk

From medicalnewstoday.com

• About 530 million adults around the world have diabetes, with type 2 diabetes accounting for 98% of cases.
• Certain lifestyle choices, such as following an unhealthy diet and eating ultra-processed foods, can increase a person’s risk for this condition.
• French researchers have now identified seven food additive emulsifiers found in ultra-processed foods that are associated with an increased risk of developing type 2 diabetes.

Researchers estimate that about 530 million adults globally live with diabetes, with 98% of those diagnoses being type 2 diabetes. 

Certain lifestyle choices, such as being sedentaryTrusted Source, following an unhealthy dietTrusted Source, and having overweight or obesityTrusted Source can increase a person’s risk of developing type 2 diabetes.

Previous research also shows that moderate intake of ultra-processed foodsTrusted Source — which generally contain large amounts of sugar, fat, salt, and food additives — can heighten a person’s risk for the condition.

Now, a new study from researchers at the National Research Institute for Agriculture, Food and Environment (INRAE) and the National Institute of Health and Medical Research (INSERM) in France has found that consuming seven specific food additive emulsifiersTrusted Source found in ultra-processed foods may be associated with an increased risk of developing type 2 diabetes.

What are food additive emulsifiers? 

According to Bernard Srour, PhD, junior professor at INRAE and co-lead author of this study, emulsifiers are among the most commonly used additives in processed foods.

Speaking to Medical News Today, he explained where these food additives are typically found:

“They are often added to processed and packaged foods, such as certain industrial cakes, biscuits, and desserts, as well as ice creams, chocolate bars, breads, margarines, and ready meals, to improve their appearance, taste, and texture and lengthen shelf life, and to be able to mix aqueous substances — water-based — with oil-based substances.”

Which food additive emulsifiers are the most unhealthy? 

For this study, Srour and his team analysed medical data from more than 104,000 French citizens who participated in the NutriNet-Santé web-cohort study between 2009 and 2023.

Over 14 years, study participants provided at least 2 days of dietary records every 6 months. Foods consumed were matched against databases to identify the presence and amount of food additives.

After an average follow-up of 7 years, the scientists identified seven food additive emulsifiers associated with an increased risk for type 2 diabetes.

These are:

1. tripotassium phosphate (E340) — 15% increased risk per increment of 500 milligrams (mg )per day
2. guar gumTrusted Source (E412) — 11% increased risk per increment of 500 mg per day
3. xanthan gumTrusted Source (E415) — 8% increased risk per increment of 500 mg per day
4. mono- and diacetyltartaric acid esters of mono- and diglycerides of fatty acids (E472e) — 4% increased risk per increment of 100 mg per day
5. sodium citrate (E331) — 4% increased risk per increment of 500 mg per day
6. carrageenans (total carrageenans and E407) — 3% increased risk per increment of 100 mg per day
7. gum arabicTrusted Source (E414) — 3% increased risk per increment of 1,000 mg per day.

But the most unexpected finding was that these additives came up amongst the ingredients in some foods and beverages that people often think of as healthy.

“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, flavoured yogurts, and therefore, even participants with more favourable dietary behaviours can be exposed to these substances,” Srour told us.

How do food emulsifiers increase type 2 diabetes risk? 

Mathilde Touvier, PhD, research director at INSERM, coordinator of the NutriNet-Santé cohort, and co-lead author of this study, told MNT the research team decided to study the potential impact of food additive emulsifiers on type 2 diabetes risk as a small number of experimental studies — in vitro, animal, and short-term randomised controlled trials — suggested adverse effects of some emulsifiers such as gut microbiota dysbiosisTrusted Source, inflammationTrusted Source, and metabolic perturbationsTrusted Source.

“Two cohort studies from our group showed associations between exposure to various food additive emulsifiers and an increased risk of cardiovascular diseaseTrusted Source and cancerTrusted Source,” Touvier continued.

“No such investigation has, to the best of our knowledge, yet been conducted to assess the risk of type 2 diabetes. We have therefore decided to look into these associations in the NutriNet-Santé cohort, as we have detailed and repeated dietary data — including commercial brands of consumed foods — coupled with a long follow-up,” she told us.

In the future, Touvier said, the team will investigate the potential underlying mechanisms behind this association, as these are currently unclear.

“We will be looking at variations in certain blood markers and the gut microbiota linked to the consumption of these additives, to better understand the underlying mechanisms,” she told us. “We will also look at the health impact of additive mixtures and their potential ‘cocktail effects’.”

After reviewing this study, Monique Richard, MS, RDN, LDN, a registered dietitian nutritionist and owner of Nutrition-In-Sight, told MNT that these findings bring forth an interesting “causation” hypothesis through an observational methodology lens.

“It is well established however that diabetes is a very complex disease often attributed to multiple factors — i.e. genetics, lifestyle, excess of energy-dense foods — that may elevate risk or influence disease manifestation,” Richard explained.

“Certainly, the potential pathways of affecting inflammation, interrupting detoxification and gastrointestinal health are plausible contributions that could increase type 2 diabetes risk,” she hypothsised.

MNT also spoke with Pouya Shafipour, MD, a board-certified family and obesity medicine physician at Providence Saint John’s Health Centre in Santa Monica, CA, not involved in this research, who commented he was not surprised by the study’s findings.

“We know that additives are a big contributing factor to obesity,” Shafipour continued. “It’s not a surprise as that increases fatty liver, and generally weight gain and insulin resistance. It was a good step because now it encourages hopefully more government regulation and also for patients to eat more real, wholesome foods.”

How to avoid food emulsifiers

For those looking to consume less food additive emulsifiers, Shafipour said it is as easy as focusing on eating real whole foods.

“Even a lot of diet supplements, protein bars, protein shakes, anything that pretty much comes with a wrapper, something that’s dried, they have to add […] different preservatives to be able to preserve and make it last longer,” he explained.

“So the more natural sources we eat in terms of food and supplements, the better. Eating more fruits rather than fruit bars, fruit juices, [and] sodas. Instead of protein bars, more natural sources of protein like cheese, meats, or plant-based protein."

– Pouya Shafipour, MD

Richard encouraged everyone to read the ingredients list along with the nutrition facts panelsTrusted Source to understand the composition and nutrient profile of the food they are choosing.

“Monitoring the frequency and amount of those packaged types of food — i.e. chocolate or candy, snack foods, baked goods, pre-packaged meals — is also very important while increasing foods that naturally are free from these additional ingredients such as fruits, vegetables, healthy fats, whole grains and lean protein as often as possible,” she advised.

And “meeting with a registered dietitian nutritionist to further understand how to interpret the ingredients list and possible consequences, as well as understand [individualized advice] for specific dietary recommendations” is also crucial, said Richard.

https://www.medicalnewstoday.com/articles/do-common-food-additives-found-in-cakes-and-biscuits-increase-type-2-diabetes-risk

Could eating local food reduce blood pressure and diabetes risk?

From medicalnewstoday.com

A recent pilot study finds that consuming local foods with fewer additives might reduce abdominal fat, blood pressure, and diabetes risk. The study is small-scale, but the findings are intriguing.
The food that we eat has a huge effect on our overall health — that much is abundantly clear.
The prevalence of both type 2 diabetes and obesity is a clear sign that, overall, the dietary habits of people in the United States need attention.

People crave firm, actionable guidance on their diet.

This need has manifested into a never-ending hunt for the perfect dietary intervention: a diet that will cure all ills, boost well-being, and increase lifespan.

A diet that ticks at least some of these boxes is likely to include fruit, vegetables, whole grains, and limited amounts of sugar, salt, and fat.
However, as many of us are all too aware, sticking to a nutritional diet plan is challenging. And, as one author puts it, "Nutrition and policy science have advanced rapidly, creating confusion."
Popular diet options now include Mediterranean, low carb, no carb, Atkins, ketogenic, and intermittent fasting, all of which jostle for position in the public mind.

A focus on ultra-processed foods

In recent months, Medical News Today have covered several studies focusing on so-called ultra-processed foods. Overall, researchers conclude that they are bad news for health.
The most common explanation for this is the high levels of fat, sugar, and salt in ultra-processed foods.
A recent pilot study, which features in the journal Diabetes & Metabolism, took a different approach and, instead, focused on the food additives in processed foods.
According to the authors, these additives include chemicals that the food industry uses to make food "palatable, durable, and transportable over long distances."
For their study, which they carried out in Italy, the researchers set out to understand the effect of eating locally produced food. Rather than concentrating on fat and sugar content, they were solely interested in the additives.
In particular, the experiment focused on cheese, sausage, pasta, pastries, biscuits, and chocolate, the production of which takes place in distant locations. Rather than asking the participants to cut these products out of their diet, the team asked them to source the foods locally.

Testing additives

In all, 159 healthy participants completed the 6-month study. The scientists assessed a range of parameters, including height, weight, systolic blood pressure (the pressure in the arteries when the heart contracts), and diastolic blood pressure (the pressure in the arteries when the heart rests between beats).
Among other things, they measured the participants' overall fat and abdominal fat, and their levels of anxiety and depression. To assess depression, they used a standard questionnaire called the Beck Depression Inventory.
The scientists took blood samples to measure resting blood glucose and levels of potassium, sodium, insulin, creatine, and C-peptide (a measure of how much insulin someone is producing).
The scientists also calculated homeostasis model assessment (HOMA) scores. The medical community considers HOMA scores to be an indicator of insulin resistance and beta cell (the cells in the pancreas that secrete insulin) function.
At the start of the study, there were no significant differences between the two groups.

Buying local

The researchers randomly split the participants into two groups. They asked the members of the first group to purchase cheese, sausage, fresh pasta, pastries, biscuits, and chocolate from local producers.
As the authors explain, before the study, these producers had undergone vetting by "an expert from the food production industry to ensure that additives were not used" and that all the production had been local.
For instance, cheeses only contained milk, salt, and rennet, while pastries did not contain chemical flavors, antioxidants, or monoglycerides and diglycerides, both of which manufacturers often use to improve the volume and texture of a product.
The participants in the second group bought these products in supermarkets instead. The researchers asked the participants in both groups to follow the Mediterranean diet and keep a detailed food diary.
Overall, both groups consumed a similar number of calories.

After 6 months, the researchers repeated the barrage of tests that they had conducted at the beginning of the study.

A number of differences

Across both groups, body mass index (BMI) and levels of salt in the blood were lower than baseline readings. However, there were differences between the groups too.
The researchers found that at the 6-month mark, the participants in the first group had significantly better HOMA scores and lower fasting glucose levels than those in the second group. Also, compared with their baseline measurements, those in the local food group had lower levels of visceral fat, reduced systolic blood pressure, and improved depression scores.
Those in the second group, however, experienced increases in fasting glucose levels, diastolic blood pressure, and C-peptide compared with their baseline scores.

As the authors explain, the study does have substantial shortcomings. For example, they only designed it as a pilot study, so researchers will need to repeat the findings with a larger group of participants over a longer period.
Aside from the size and length of the study, there were other issues. For instance, it was not possible to "blind" participants. In other words, they were aware of the intervention because it involved them using different shops and changing their diet.
Future studies might avoid this issue by providing biscuits, meat, and the other products to participants so that they remain unaware of their ingredients or origin.

Regarding the improved depression scores, it is worth noting that differences between the groups' experiences during the study might have played a part.
One could argue that visiting independent local sellers might be a more positive experience than visiting a supermarket. Also, local, fresh, additive free food could, theoretically, taste better than additive filled foods, and, because the food we eat can influence our mood, perhaps this difference alone could explain the changes in reported mood.

Even when we take all of the above into account, if just 6 months of choosing additive free versions of a handful of items can improve metabolic factors that relate to disease risk, this line of investigation is worth following up.

https://www.medicalnewstoday.com/articles/325819.php