The prevalence and co-occurrence of emulsifiers, thickeners and stabilizers in food products on the Norwegian market.

Background: As the intake of food that has undergone substantial processing increases, the intake of common additives like Emulsifiers, Thickeners, and Stabilizers (ETSs) also increases. Several ETSs have drawn attention due to potential negative health effects. Objective: This study aimed to map the prevalence and co-occurrence patterns of ETSs across food products on the Norwegian market, examining their distribution across different food groups and products with varying nutritional profiles, including those classified as hyper-palatable. Design: Food product information, including ingredient lists and nutritional information, was obtained from two online databases used by major grocery chains, thus representative of the Norwegian market and analyzed for presence or absence of ETSs. Results: Thirty-two percent of food products contained at least one ETS, 60% of these contained more than one ETS, and many ETSs were found more frequently in combinations with others than individually. ETSs were present in a broad range of food products, with the highest percentage seen in the food groups Bakery, Cakes & Pastries, and Desserts & Ice cream. Mono- and diglycerides of fatty acids (E471) and diphosphates (E450) were the most used food additives. Fifty-eight percent of the food products analyzed were classified as hyper-palatable, though relationships with ETSs were variable across food groups. Conclusion: This is the first comprehensive analysis of its kind, providing a basemap for future research on the potential health effects of modern food products, particularly considering the limited understanding of how multiple ETSs may interact within biological systems.