There was a recent article in the Journal of Nature published by Anaïs Hasenböhler et al on January 7, 2026 titled “Associations between preservative food additives and type 2 diabetes incidence in the NutriNet-Santé prospective cohort.” The lengthy article is attached in three parts in a PDF format for your information, and below is a summary for your convenience.
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 characterized 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 reevaluation and support recommendations to favor fresh and minimally processed foods without superfluous additives.
Preservatives are widely used to extend the shelf life of industrially processed foods, but previous research has suggested that some of these additives may have adverse metabolic effects. Out of 17 preservatives used by at least 10% of the study population, 12 were associated with a higher incidence of type 2 diabetes. Among the three and a half million foods and beverages listed in the Open Food Facts World database in 2024, more than 700,000 contain at least one of these additives. Preservatives are added to prolong the shelf-life of foods. They protect them against deterioration caused by micro-organisms and/or growth of pathogenic microorganisms, and by oxidation, such as fat rancidity and color changes.
The analysis included repeated 24-hour diet records of nearly 109 000 adults in France. Between 2009 and 2023, about 1100 people among the larger group were diagnosed with type 2 diabetes. Researchers found that participants who were exposed to more preservative food additives were more likely to develop type 2 diabetes, even after adjusting for nutritional content.
Many mechanisms may underpin the associations detected in this study, including metabolic and inflammatory disruption and/or altered insulin signaling pathway. Mouse model studies showed that coadministration of sorbate and fructose (monosaccharide naturally found in many foods and drinks) leads to altered liver function (steatosis, inflammation, fibrosis) associated with altered expression of genes involved in lipid metabolism. These observations are associated with disturbances in intestinal myco- and microbiota, while other studies have confirmed sorbate’s potential proinflammatory effects at hepatic and microbiota levels. Investigating the impact of potassium sorbate on pancreatic inflammation, related to type 2 diabetes onset, would be interesting.