Evidence map›Paper›PMID 38663950›Full record

ArticleThe lancet. Diabetes & endocrinology2024

Food additive emulsifiers and the risk of type 2 diabetes: analysis of data from the NutriNet-Santé prospective cohort study.

Clara Salame, Guillaume Javaux, Laury Sellem, Emilie Viennois, Fabien Szabo de Edelenyi, Cédric Agaësse, Alexandre De Sa, Inge Huybrechts, Fabrice Pierre, Xavier Coumoul and 11 more

Registry-linked trialOpen access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in The lancet. Diabetes & endocrinology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03335644 (The NutriNet-Santé Study. A Web-based Prospective Cohort Study of the Relationship Between Nutrition and Health and of Dietary Patterns and Nutritional Status Predictors), which is not on this map. Cited by 32 papers.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed
32.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03335644 recruitingnot on this map

The NutriNet-Santé Study. A Web-based Prospective Cohort Study of the Relationship Between Nutrition and Health and of Dietary Patterns and Nutritional Status Predictors

TypeobservationalSponsorUniversity of Paris 13Ran2009 to 2029Enrolled170,000ConditionsDiet, Food, and Nutrition, Exercise, Diseases Category, Cohort Studies
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 59 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 8 institutions in 1 country.

Clara SalameUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France.
Guillaume JavauxUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France.
Laury SellemUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France; NACRe French Network for Nutrition And Cancer Research, Jouy-en-Josas, France.
Emilie ViennoisINSERM U1149, Center of Research on Inflammation, Université de Paris, 75018 Paris, France.
Fabien Szabo de EdelenyiUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France.
Cédric AgaësseUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France.
Alexandre De SaUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France.
Inge HuybrechtsInternational Agency for Research on Cancer, World Health Organization, Lyon, France.
Fabrice PierreNACRe French Network for Nutrition And Cancer Research, Jouy-en-Josas, France; Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France.
Xavier CoumoulNACRe French Network for Nutrition And Cancer Research, Jouy-en-Josas, France; INSERM UMR-S 1124, Université de Paris, Paris, France.
Chantal JuliaUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France; Public Health Department, Groupe Hospitalier Paris-Seine-Saint-Denis, Assistance Publique-hôpitaux de Paris (AP-HP), Bobigny, France.
Emmanuelle Kesse-GuyotUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France; NACRe French Network for Nutrition And Cancer Research, Jouy-en-Josas, France.
Benjamin AllèsUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France.
Léopold K FezeuUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France.
Serge HercbergUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France; NACRe French Network for Nutrition And Cancer Research, Jouy-en-Josas, France; Public Health Department, Groupe Hospitalier Paris-Seine-Saint-Denis, Assistance Publique-hôpitaux de Paris (AP-HP), Bobigny, France.
Mélanie Deschasaux-TanguyUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France; NACRe French Network for Nutrition And Cancer Research, Jouy-en-Josas, France.
Emmanuel CossonUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France; Diabetology, endocrinology and nutrition Department, Avicenne Hospital, AP-HP, Bobigny, France.
Sopio TatulashviliUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France; Diabetology, endocrinology and nutrition Department, Avicenne Hospital, AP-HP, Bobigny, France.
Benoit ChassaingNACRe French Network for Nutrition And Cancer Research, Jouy-en-Josas, France; INSERM U1016, team "Mucosal microbiota in chronic inflammatory diseases", CNRS UMR 8104, Université de Paris, Paris, France.
Bernard SrourUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France; NACRe French Network for Nutrition And Cancer Research, Jouy-en-Josas, France. Electronic address: b.srour@eren.smbh.univ-paris13.fr.
Mathilde TouvierUniversité Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017 Bobigny, France; NACRe French Network for Nutrition And Cancer Research, Jouy-en-Josas, France.
Inserm · FRConservatoire National des Arts et Métiers · FRInstitut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement · FRSorbonne Paris Cité · FRUniversité Sorbonne Paris Nord · FRCentre international de recherche sur le cancer · FRCentre National de la Recherche Scientifique · FRUniversité Fédérale de Toulouse Midi-Pyrénées · FR

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundExperimental studies have suggested potential detrimental effects of emulsifiers on gut microbiota, inflammation, and metabolic perturbations. We aimed to investigate the associations between exposures to food additive emulsifiers and the risk of type 2 diabetes in a large prospective cohort of French adults.

methodsWe analysed data from 104 139 adults enrolled in the French NutriNet-Santé prospective cohort study from May 1, 2009, to April 26, 2023; 82 456 (79·2%) were female and the mean age was 42·7 years (SD 14·5). Dietary intakes were assessed with three 24 h dietary records collected over three non-consecutive days, every 6 months. Exposure to additive emulsifiers was evaluated through multiple food composition databases and ad-hoc laboratory assays. Associations between cumulative time-dependent exposures to food additive emulsifiers and the risk of type 2 diabetes were characterised with multivariable proportional hazards Cox models adjusted for known risk factors. The NutriNet-Santé study is registered at ClinicalTrials.gov (NCT03335644).

findingsOf 104 139 participants, 1056 were diagnosed with type 2 diabetes during follow-up (mean follow-up duration 6·8 years [SD 3·7]). Intakes of the following emulsifiers were associated with an increased risk of type 2 diabetes: total carrageenans (hazard ratio [HR] 1·03 [95% CI 1·01-1·05] per increment of 100 mg per day, p<0·0001), carrageenans gum (E407; HR 1·03 [1·01-1·05] per increment of 100 mg per day, p<0·0001), tripotassium phosphate (E340; HR 1·15 [1·02-1·31] per increment of 500 mg per day, p=0·023), acetyl tartaric acid esters of monoglycerides and diglycerides of fatty acids (E472e; HR 1·04 [1·00-1·08] per increment of 100 mg per day, p=0·042), sodium citrate (E331; HR 1·04 [1·01-1·07] per increment of 500 mg per day, p=0·0080), guar gum (E412; HR 1·11 [1·06-1·17] per increment of 500 mg per day, p<0·0001), gum arabic (E414; HR 1·03 [1·01-1·05] per increment of 1000 mg per day, p=0·013), and xanthan gum (E415, HR 1·08 [1·02-1·14] per increment of 500 mg per day, p=0·013).

interpretationWe found direct associations between the risk of type 2 diabetes and exposures to various food additive emulsifiers widely used in industrial foods, in a large prospective cohort of French adults. Further research is needed to prompt re-evaluation of regulations governing the use of additive emulsifiers in the food industry for better consumer protection.

fundingEuropean Research Council, French National Cancer Institute, French Ministry of Health, IdEx Université de Paris, and Bettencourt-Schueller Foundation.

Indexed as

Diabetes Mellitus, Type 2Emulsifying AgentsFood AdditivesAdultCohort StudiesFemaleFranceHumansMaleMiddle AgedProspective StudiesRisk FactorsEmulsifying AgentsFood Additives

Identifiers

PMID38663950
OpenAlexW4395026173

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.