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 randomized 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 hypothsized.

MNT also spoke with Pouya Shafipour, MD, a board-certified family and obesity medicine physician at Providence Saint John’s Health Center 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.”

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.

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.