Walk down any grocery store aisle, and you’re surrounded by brightly packaged convenience foods, from creamy desserts to bubbly diet sodas. Behind those tempting labels, however, lies a hidden cocktail of food additives—chemical agents designed to preserve, color, flavor, and texturize what we eat. These additives are staples in ultra-processed foods, and until recently, they’ve been evaluated for safety one by one, as if we only consumed them in isolation.
But a new large-scale study by French researchers is turning that assumption on its head.
In what is the first of its kind, scientists from Inserm, INRAE, Sorbonne Paris Nord University, Paris Cité University, and Cnam have uncovered compelling evidence that mixtures of commonly used food additives may be significantly increasing the risk of developing type 2 diabetes. This multi-institutional team, working within the Nutritional Epidemiology Research Team (CRESS-EREN), has now published their eye-opening findings in PLOS Medicine, revealing a previously underexplored dimension of dietary health risks.
Beyond the Label: What’s Lurking in Processed Foods?
Food additives are nothing new. From the stabilizers that keep sauces creamy to the sweeteners that make diet sodas taste good without sugar, these chemical compounds have long been part of our daily lives. In Europe alone, more than 300 food additives are approved for use. What’s been missing from food safety regulation, however, is a serious look at what happens when these substances are consumed in combination—something that, thanks to the prevalence of ultra-processed foods, happens all the time.
Until now, regulatory agencies like the European Food Safety Authority (EFSA) or the U.S. Food and Drug Administration (FDA) have conducted evaluations substance by substance. That means no one was really asking: what happens when emulsifiers, colorants, and sweeteners are ingested together, meal after meal, day after day?
The French researchers took up that question—and their findings could have sweeping implications.
The NutriNet-Santé Cohort: A Unique Data Goldmine
To dig into the effects of additive combinations, researchers leveraged the NutriNet-Santé cohort, one of the largest ongoing nutritional studies in the world. This study, launched in 2009, involves over 170,000 French adults who regularly self-report their dietary habits, health updates, and lifestyle patterns through detailed online surveys.
For this particular investigation, the team zeroed in on 108,643 adults who had submitted at least two to fifteen days’ worth of detailed food diaries, including exact brands and product types consumed. That depth of data allowed researchers to cross-reference food records with commercial ingredient lists and laboratory analyses to determine not just which additives were present—but how often and in what combinations they were consumed.
And that’s where things got very interesting.
Five Common Additive Mixtures—and Two Red Flags
Using advanced mixture modeling techniques, the team identified five primary clusters or “cocktails” of food additives that tend to be consumed together. These were not arbitrarily grouped; they reflect real-world consumption patterns driven by the co-occurrence of additives in industrially manufactured foods or in food items often eaten together.
Of the five mixtures studied, two were associated with a significantly higher incidence of type 2 diabetes over the average 7.7-year follow-up period. What was striking is that these risks remained independent of other known dietary and lifestyle risk factors—including total sugar intake, fiber, calorie consumption, body weight, and socioeconomic status.
Let’s break down these two culprit mixtures:
1. The Emulsifier-Rich Mix
This first risky blend was dominated by emulsifiers like modified starches, guar gum, pectin, carrageenans, xanthan gum, and polyphosphates. It also included the preservative potassium sorbate and the coloring agent curcumin.
Where are these found? Think stocks, creamy sauces, processed fats, and milky desserts. Emulsifiers are used to create that uniform, stable texture that consumers expect—but they may also interfere with gut health, as emerging research on the microbiome suggests.
2. The Sweet & Colorful Combo
The second problematic mixture was found in artificially sweetened beverages and processed drinks. It featured acidifiers like citric and phosphoric acid, colorants like sulfite ammonia caramel and anthocyanins, and a variety of sweeteners—acesulfame-K, aspartame, and sucralose.
This colorful medley also included the coating agent carnauba wax and some additional emulsifiers.
In both cases, these mixtures showed a statistically significant correlation with new diagnoses of type 2 diabetes over the study period.
What’s Happening Inside the Body?
One of the most fascinating aspects of the study is its suggestion that these food additives may not act alone. Instead, they might be engaging in complex biochemical interactions—some potentially amplifying each other’s effects (a phenomenon known as synergy), others perhaps mitigating them (antagonism). This “cocktail effect” is something researchers are only beginning to unravel.
Preliminary experimental studies in lab settings have indicated that some additives can impair glucose tolerance, increase insulin resistance, promote low-grade chronic inflammation, and disrupt the gut microbiota. When several of these compounds are consumed together, those effects might compound in ways that are hard to predict with current safety models.
“This study is the first to estimate exposure to food additive mixtures in a large cohort of the general population and to analyze their link to the incidence of type 2 diabetes,” said lead author Marie Payen de la Garanderie, a Ph.D. student at Inserm.
Her mentor, Dr. Mathilde Touvier, added: “Our findings suggest that several emblematic additives present in many products are often consumed together and that certain mixtures are associated with a higher risk of this disease. These substances may therefore represent a modifiable risk factor, paving the way for strategies to prevent type 2 diabetes.”
What Does This Mean for You?
Let’s be clear: this is an observational study. It cannot, by design, prove direct causation. However, its sheer scale and rigorous methodology lend weight to its conclusions. Coupled with growing lab-based evidence and earlier NutriNet-Santé findings linking specific additives to cancer and cardiovascular diseases, the study strengthens the call for a new, more holistic approach to food safety regulation.
As consumers, it might be time to rethink our relationship with ultra-processed foods. While individual additives may pass safety checks in isolation, we almost never consume them that way. From the sweeteners in your “diet” soda to the thickeners in your favorite ready-to-eat soup, it’s the combinations that matter—and we’re only beginning to understand how.
Toward a Safer Food Future
This study adds fuel to the growing debate over ultra-processed foods and the need for modernized regulations that consider real-world dietary habits. Experts are now calling for:
- Broader risk assessments that evaluate additive interactions, not just isolated exposures.
- Transparent labeling that helps consumers understand what they’re eating.
- More public education on the risks associated with high intake of ultra-processed foods.
As science continues to uncover the intricate relationships between diet and chronic disease, one thing becomes clear: convenience shouldn’t come at the cost of long-term health. And the cocktail of chemicals in your next snack might be a bigger deal than we ever thought.
Reference: Food additive mixtures and type 2 diabetes incidence: Results from the NutriNet-Santé prospective cohort, PLOS Medicine (2025). DOI: 10.1371/journal.pmed.1004570