Common food additives linked to increased risk of type 2 diabetes
A new study has found a link between consumption of nitrites from drinking water and food and the risk of developing type 2 diabetes. Nitrates and nitrates occur naturally in water and soil and are used as food preservatives to extend shelf life. The research was led by Bernard Srour, and was published in the journal PLOS Medicine.
Some public health officials have suggested limiting nitrites and nitrates as food additives, however, their effects on metabolic problems and type 2 diabetes in humans have not been studied. To study the association, researchers used data from 104,168 participants in the NutriNet-Santé prospective cohort.
The NutriNet-Santé study is an ongoing cohort study launched in 2009. Participants fifteen years of age and older are voluntarily enrolled and self-report medical history, sociodemographics, diet, lifestyle, and major health changes. The researchers used detailed nitrite/nitrate exposure derived from several databases and sources and then developed statistical models to analyze self-reported dietary data with health outcomes.
The researchers found that participants in the NutriNet-Santé cohort who reported higher nitrite intake overall, and specifically from food additives and non-additive sources, had a higher risk of developing type 2 diabetes. There was no association between nitrates and type 2 diabetes risk, and the results did not support any potential benefits of dietary nitrite or nitrate in terms of protection against type 2 diabetes.
The study had several limitations and additional research is needed to confirm the results. Data were self-reported and researchers could not confirm specific nitrite/nitrate exposure using biomarkers due to underlying biological challenges. Additionally, people in the demographics and behaviors cohort may not be generalizable to the rest of the population—the cohort included a larger number of younger individuals, more often women, who exhibited healthier behaviors. Residual confounding may also have affected the outcomes as a result of the study’s observational design.
According to the authors, “These results provide new evidence in the context of current debates about the need to reduce the use of nitrite additives in processed meat by the food industry and may support the need for better regulation of soil pollution through fertilizers.” Meanwhile, several public health authorities around the world are already recommending that citizens limit their consumption of foods containing controversial additives, including sodium nitrite”.
Srour and Touvier add, “This is the first large-scale cohort study to suggest a direct association between additive-derived nitrites and risk of type 2 diabetes. It also confirms previously suggested associations between total dietary nitrites and T2D risk.”
Reference: “Dietary nitrite and nitrate exposure in relation to type 2 diabetes risk: Results from the NutriNet-Santé population-based cohort study” by Bernard Srour, Eloi Chazelas, Nathalie Druesne-Pecollo, Younes Esseddik, Fabien Szabo de Edelenyi, Cédric Agaësse, Alexandre De Sa, Rebecca Lutchia, Charlotte Debras, Laury Sellem, Inge Huybrechts, Chantal Julia, Emmanuelle Kesse-Guyot, Benjamin Allès, Pilar Galan, Serge Hercberg, Fabrice Pierre, Mélanie Deschasaux-Tanguy and Mathilde Touvier, 17 January 2023, PLOS Medicine.