A Hasenböhler, Guillaume Javaux, M Payen de la Garanderie, Fabien Szabo de Edelenyi, Laurent Bourhis, Cédric Agaësse, Alexandre De, Inge Huybrechts, F Pierre, Xavier Coumoul, Chantal Julia, Emmanuelle Kesse‐Guyot, Benjamin Allès, Leopold Kamedjie Fezeu, Serge Hercberg, Mélanie Deschasaux-Tanguy, E. Cosson, Sopio Tatulashvili, Benoît Chassaing, Bernard Srour, Mathilde Touvier
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).