January/February 2026
Food preservatives: higher consumption may be linked with cancer, type 2 diabetes risk
By Rebecca Jenkins
Higher intake of certain food preservatives is associated with an increased risk of type 2 diabetes and cancer, according to two analyses of a large prospective cohort study.
The French NutriNet-Santé study ran from 2009 to 2023 and included more than 100,000 participants who provided regular 24-hour brand-specific dietary records in addition to information about their medical history, health and lifestyle.
In one analysis, published in Nature Communications, researchers examined associations between food preservatives intake and type 2 diabetes, noting there were 1131 cases of diabetes among the 108,723 participants included in the analysis.
Researchers identified 58 food preservatives in total but individually investigated 17 of these that were consumed by at least 10% of the population.
Higher consumption of preservatives overall, nonantioxidant preservatives and antioxidant preservatives were all associated with an increased incidence of type 2 diabetes (a 47%, 49% and 40% increased risk, respectively), compared with the lowest levels of consumption.
Higher consumption of 12 of the 17 studied preservatives was associated with an increased risk of type 2 diabetes; these included widely used nonantioxidant food preservatives (potassium sorbate, potassium metabisulfite, sodium nitrite, acetic acid, sodium acetates and calcium propionate) and antioxidant additives (sodium ascorbate, alphatocopherol, sodium erythorbate, citric acid, phosphoric acid and rosemary extracts).
In another analysis, published in The BMJ, researchers studied the dataset to examine any associations with cancer incidence, noting 4226 of the 105,260 participants included in the analysis received a diagnosis of incident cancer (1208 breast, 508 prostate, 352 colorectal and 2158 other cancers).
Of the 17 individually studied preservatives, 11 were not associated with cancer incidence, and there was no link between total preservative intake and cancer incidence.
However, higher intakes of several preservatives (mostly nonantioxidants, including potassium sorbate, potassium metabisulfite, sodium nitrite, potassium nitrate and acetic acid) were associated with higher risk of cancers when compared with nonconsumers or lower consumers.
As an example, total sorbates, specifically potassium sorbate, was associated with a 14% increased risk of overall cancer and a 26% increased risk of breast cancer, and total sulfites were associated with a 12% increased risk of overall cancer.
In other findings, sodium nitrite was associated with a 32% increased risk of prostate cancer, and potassium nitrate was associated with an increased risk of overall cancer (13%) and breast cancer (22%).
Commenting on the findings, Professor Mark Wahlqvist AO, Emeritus Professor of Medicine at Monash University, Melbourne, said since clinical trials in this field were ethically unacceptable, we were dependent on multisectoral and multimodal lines of evidence for policy direction.
‘The findings of NutriNet-Santé are indicative of how difficult and late in the day it has been to learn about the risks posed for diabetes and cancer incidence value, let alone how to manage the risk,’ he told Medicine Today.
He added that the quest for food preservation, extended storage and globalisation of the food system, along with a dramatic increase and change in population size and demographics, had encouraged major shifts in food characteristics, especially its structure and formulation and in unsustainable packaging, notably with plastic.
‘There is a need for healthcare practitioners and consumers to have ready access – e.g. by QR codes – to not only nutrient but physicochemical and system information about the food they are consuming,’ he said. Nat Commun 2026; https://doi.org/10.1038/s41467-025-67360-w and BMJ 2026; doi: https://doi.org/10.1136/bmj-2025084917.