The research was conducted by scientists from Inserm, INRAE, Sorbonne Paris Nord University, Paris Cité University and CNAM within the Nutritional Epidemiology Research Team (CRESS-EREN). Their findings were published in the journals Diabetes Care, European Journal of Epidemiology and European Heart Journal.

The studies analysed data from the French NutriNet-Santé cohort, involving more than 100,000 participants, and provide some of the first large-scale epidemiological evidence connecting exposure to specific food additives with chronic disease risk.

Additives Widespread Across Global Food Supply

Among the 3.5 million food and beverage products listed in the Open Food Facts World database in 2024:

More than 139,000 products contained at least one food colouring additive

Over 700,000 products contained at least one preservative

Food colourings are generally labelled under European additive codes E100–E199, while preservatives are classified under E200–E299, with antioxidant preservatives under E300–E399.

Despite their widespread use, population-based studies on the long-term health impact of these additives have been limited due to the lack of precise exposure data.

To address this gap, a team led by Mathilde Touvier, Research Director at Inserm, conducted detailed large-scale analyses tracking additive exposure over time.

Key Findings

Food Colourings Linked to Type 2 Diabetes
Researchers found that overall consumption of food colouring additives was associated with a 38% higher risk of type 2 diabetes among high consumers compared with those with the lowest exposure.

Specific additives showed even stronger associations:

Caramel colours: +43%

Carotenoid colours (E160): +39%

Beta-carotene (E160a): +44%

Ordinary caramel (E150a): +46%

Curcumin (E100): +49%

Anthocyanins (E163): +40%

Higher Cancer Risks Observed

Overall exposure to food colouring additives was associated with:

14% higher risk of overall cancer

21% higher risk of breast cancer

32% higher risk of post-menopausal breast cancer

Notable individual additives included:

Beta-carotene (E160a):

+16% overall cancer risk

+41% breast cancer risk

Ordinary caramel (E150a):
+15% overall cancer risk

Preservatives Linked to Hypertension and Cardiovascular Disease

High preservative consumption was associated with:

24% higher hypertension risk


29% higher hypertension risk for non-antioxidant preservatives


16% higher cardiovascular disease risk for non-antioxidant preservatives

22% higher hypertension risk for antioxidant preservatives

Among specific preservatives:

Potassium sorbate (E202): +39% hypertension risk

Citric acid (E330): +25% hypertension risk

Ascorbic acid (E300): +15% cardiovascular disease risk

Strategic Public Health Importance

Researchers say these findings are highly significant because exposure to these additives is both widespread and potentially preventable.

The results align with earlier NutriNet-Santé studies published in early 2026, which also linked preservatives to increased risks of cancer and type 2 diabetes.

They are further supported by experimental and mechanistic studies conducted in cellular and animal models that have shown harmful biological effects from several of these compounds.

How the Research Was Conducted

Between 2009 and 2024, NutriNet-Santé participants regularly submitted detailed 24-hour dietary records, including brand-specific information on industrial food products consumed.

Researchers matched this data with multiple databases, including:

Open Food Facts

Oqali

GNPD

Additive concentration measurements

Exposure dose estimates from the European Food Safety Authority

The analysis also adjusted for numerous potential confounding factors, including:

Age and socio-demographic background

Smoking and alcohol use

Physical activity

Overall dietary quality

Intake of sugar, salt, saturated fat and fibre

The final participant sample sizes included:

105,260 participants for cancer analysis

108,723 participants for diabetes analysis

112,395 participants for cardiovascular and hypertension analysis

Call for Regulatory Reassessment

The researchers conclude that health authorities should reassess the safety of food additives using this new evidence to better protect public health.

For preservatives, they say future evaluations should also include risk-benefit analyses.

In the meantime, the findings support recommendations from France’s National Nutrition and Health Program, which advises consumers to limit exposure to non-essential additives and prioritise unprocessed or minimally processed foods.