Cohort studyindependent cross-checkabstract checked I-UPF-118 standard review

Food preservatives and type 2 diabetes

Associations between preservative food additives and type 2 diabetes incidence in the NutriNet-Santé prospective cohort.

Overview

Hasenböhler A et al.. Nat Commun 2026 · PMID 41501013 · DOI 10.1038/s41467-025-67360-w

In the same French cohort, 12 widely used preservatives were linked to more type 2 diabetes.

Does the study support the specific claim? No · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: To link preservatives with diabetes.
How was the study done?: Cohort study.
How many people, animals or samples were studied?: 108,723 adults.
What was actually found?: 12 preservatives linked to more diabetes.
How large was the observed effect?: Not in abstract.
What do the results mean in everyday life?: A signal worth checking.
What are the study's limitations?: Observational; same cohort.
What does it say about Elawady's specific claim?: Contradicts C-UPF-11.
Do the results apply to Germany and Europe?: High.
What can explicitly not be concluded from this study?: Cannot prove causation.

Authors: Hasenböhler A et al.
Journal: Nat Commun
Year: 2026
Identifier: PMID 41501013 DOI 10.1038/s41467-025-67360-w · PMC12780003
Verification: verified – PubMed efetch 2026-10-26; Crossref works API 2026-10-26
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: COI statement in record: Competing interests: The authors declare no competing interests.; funding listed: EC | Horizon 2020 Framework Programme (EU Framework Programme for Research and Innovation H2020), Fondation Bettencourt Schueller (Bettencourt Schueller Foundation), Institut National Du Cancer (French National Cancer Institute), Institut National de la Santé et de la Recherche Médicale (National Institute of Health and Medical Research), World Health Organization

Is exposure to preservative food additives associated with type 2 diabetes incidence?

Study design: Cohort study – Prospective cohort (NutriNet-Sante)
Population: French adults (79.2% women; mean age 42.5)
Country: France
Period: 2009-2023
Sample size: 108,723; 1,131 T2D cases
Inclusion and exclusion criteria: NutriNet-Sante participants with repeated 24-h records

Exposure / intervention: Cumulative preservative intake (58 substances; 17 individually)
Comparator: Lower exposure
Endpoints: Incident T2D
Statistical methods: Multi-adjusted Cox models; multiple-testing correction

Results: Thirteen (12 after multiple-test correction) individual preservatives associated with higher diabetes incidence: potassium sorbate, potassium metabisulfite, sodium nitrite, acetic, citric and phosphoric acids, sodium acetates, calcium propionate, sodium ascorbate, alpha-tocopherol, sodium erythorbate and rosemary extracts (effect sizes not in abstract).
Absolute risks: not reported in abstract
Authors' conclusion: Findings call for safety re-evaluation and support favouring fresh, minimally processed foods.

Observational; effect sizes not in abstract
Associations include antioxidants such as ascorbate and tocopherol, suggesting possible confounding by food matrix

Not recalculable.

Further challenges a blanket dismissal of preservatives.

Same cohort as I-UPF-117; not independent.

High.

Signal; needs replication.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	not applicable
Directness	direct
Reproducibility	not replicated
Consistency with the overall evidence	unknown
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable

Replication.