Common food additives tied to increased cancer and diabetes risks

medwireNews: Data from a large prospective cohort study has revealed a significant association between higher consumption of certain food preservatives and increased incidences of cancer and type 2 diabetes.

The findings were reported by Mathilde Touvier (Université Sorbonne Paris Nord and Université Paris Cité, France) and colleagues in The BMJ and Nature Communications, respectively.

“If confirmed, these new data call for the re-evaluation of regulations governing the food industry’s use of these additives, to improve consumer protection. In the meantime, the findings support recommendations for consumers to favour freshly made, minimally processed foods,” they write in The BMJ.

The researchers analyzed data covering the period between 2009 and 2023 from the French NutriNet-Santé cohort, which comprised individuals aged 15 years and older “who regularly answered questionnaires on dietary intakes, health, anthropometric measures, physical activity, lifestyle, and sociodemographic factors.”

The current analyses included participants with at least two 24-hour dietary records in the first 2 years of follow-up. Of the 58 preservatives investigated, 17 that were consumed by at least 10% of participants were individually evaluated for association with cancer and diabetes.

A link with cancer

Among 105,260 individuals (mean age 42.0 years, 78.7% women) without prevalent cancer at the time of enrollment, 4226 received a cancer diagnosis over a mean follow-up of 7.6 years, consisting of 1208 breast, 508 prostate, 352 colorectal, and 2158 other cancers.

After adjusting for a broad spectrum of sociodemographic, anthropometric, lifestyle, and dietary confounding factors, higher intake of several preservatives was associated with a significantly increased risk for overall cancer as well as for breast and prostate cancer relative to no or lower intake.

For instance, high consumption of total non-antioxidant preservatives was associated with a significant 16% higher risk for overall cancer and a 22% higher risk for breast cancer versus low consumption, while the corresponding risks were increased by a significant 14% and 26% for high versus no consumption of potassium sorbate.

Similarly, there was a significant association between high intake of total nitrites and sodium nitrite and the risk for prostate cancer, which rose by a respective 34% and 32% compared with low consumption.

“Most associations were observed for non-antioxidant preservatives,” highlight the investigators, noting that “[a]mong antioxidant preservatives, only total erythorbates and specific sodium erythorbate were found to be associated with higher incidence of [overall and breast] cancer.”

They continue: “Additional studies are needed to better understand mechanisms linking food preservatives to the development of cancer, the differences in susceptibility to cancer location, and why erythorbates were the only preservative antioxidant associated with higher cancer incidence in this study.”

The authors of an accompanying editorial say that “[a]djustment for nutritional profiles, preservatives from natural sources, and other food additives associated with cancer enabled a clearer assessment of the independent association of preservative additives.”

But “given the modest increased risk estimates, causality cannot be established and unmeasured or residual confounding cannot be ruled out, especially considering the strong correlations between some preservatives and their food vectors,” they write.

“For example, nitrites and nitrates were consumed mainly through processed meats, whereas sulfites were consumed predominantly from alcoholic beverages—both classified as carcinogenic to humans.”

Xinyu Wang and Edward Giovannucci, both from the Harvard TH Chan School of Public Health in Boston, Massachusetts, USA, conclude: “From a policy perspective, preservatives offer clear benefits by extending shelf life and lowering food costs, which can be particularly important for populations with lower incomes.

“However, the widespread and often insufficiently monitored use of these additives, with uncertainties of their long term health effects, call for a more balanced approach.”

A link with diabetes

During a median follow-up of 8.1 years, 1131 cases of incident type 2 diabetes were identified among 108,723 individuals (mean age 42.5 years, 79.2% women) without prevalent type 2 or type 1 diabetes at baseline.

The researchers found that high intake of total preservatives versus low intake was associated with a significant 47% increased risk for type 2 diabetes after accounting for a raft of confounders. And this was also the case for total non-antioxidants and total antioxidants, with respective increases in risk with high consumption of 49% and 40%.

Similar to the cancer analysis, there were significant associations for individual preservatives too. For example, high versus low intake of the non-antioxidant sodium nitrite correlated with an 50% increased risk for type 2 diabetes, while high intake of potassium sorbate more than doubled the risk compared with no intake.

In this case, several antioxidants were found to be significantly associated with an elevated risk, namely, sodium ascorbate, tocopherol-rich extract, alpha-tocopherol, sodium erythorbate, citric acid, phosphoric acid, and extracts of rosemary.

Touvier and colleagues write: “In practice, to reduce exposure to certain food additive preservatives such as sulfites or nitrites, for which the primary sources are specific food groups that, in addition, have no particular nutritional value (i.e., alcoholic beverages and processed meats, respectively), it is advisable to limit consumption of these food/ beverage groups.

“However, several preservative food additives (e.g., potassium sorbate, calcium propionate, erythorbates) are ubiquitously used across many food groups, with a huge variability in ingredient lists depending on the brands for the same generic food item.”

And therefore, they stress that “measures targeting individuals (such as disseminating recommendations) will not be sufficient and that policy actions must be implemented in parallel to deeply transform the food supply and reduce exposure.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2026 Springer Healthcare Ltd, part of Springer Nature

BMJ 2026; 392: e084917
BMJ 2026; 392: r2613
Nat Commun 2026; 16, 11199