Food coloring additives are associated with higher incidence of type 2 diabetes

1. Several widely consumed natural and synthetic food coloring additives were associated with higher type 2 diabetes incidence.

Evidence Rating Level: 2 (Good)

Ultraprocessed foods (UPFs) have been linked to increased type 2 diabetes incidence independent of energy intake and adiposity. Food coloring additives are key markers of UPFs and may alter molecular pathways involved in insulin signaling and inflammation. Despite the increase in use of coloring, the relationship between dietary exposures to these additives and diabetes incidence remains unknown. This study thus examined the association between exposure to food coloring additives and type 2 diabetes incidence. The prospective cohort study followed participants from the French NutriNet-Santé cohort (>15 years of age) from 2009–2023 who were not diagnosed with Type 1 or 2 diabetes. Dietary data were assessed using repeated 24-h dietary records. Among the 108,723 participants in the study cohort (mean [SD] age, 42.5 [14.6] years; 86,085 [79.2%] female), 1,131 incident type 2 diabetes cases were diagnosed (median follow-up, 8.05 years). Compared to participants who were non- or low consumers of food coloring additives, intake of the following food coloring additives among higher consumers was associated with higher type 2 diabetes incidence: total food coloring additives (adjusted hazard ratio [aHR] 1.38 [95% CI 1.17–1.63]), total caramel (1.43 [1.21–1.67]), plain caramel (1.46 [1.26–1.70]), sulfite ammonia caramel (1.30 [1.07–1.59]), total carotene (1.27 [1.08–1.48]), carotenoids (1.39 [1.19–1.62]), β-carotene (1.44 [1.23–1.68]), paprika-capsanthin-capsorubin (1.26 [1.08–1.46]), lutein (1.20 [1.02–1.40]), curcumin (1.49 [1.29–1.73]), cochineal-carminic acid-carmines (1.27 [1.10–1.48]), and anthocyanins (1.40 [1.17–1.68]). Unsweetened (49.6%) and sweetened drinks (32.2%) were the main contributors to total food coloring exposure. Overall, this study found that several widely consumed natural and synthetic food coloring additives were associated with higher type 2 diabetes incidence. Future studies are needed to investigate the underlying mechanisms and to determine whether current regulations for food coloring additives should be reevaluated to protect consumer health.

Click here to read this study in Diabetes Care

Image: PD

©2026 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.