(PTFS10-04-24) Phosphate Food Additives in Ultraprocessed Food (UPF) Categories Positively Associated With Type 2 Diabetes Risk: A Mechanism in UPF Disease Risk?

Objectives: Findings from 3 large U.S. cohort studies with multiple repeated dietary intakes and over 30 years of follow-up reported Nova-characterized Ultraprocessed food (UPF) in specific food categories are positively associated with type 2 Diabetes (T2D) risk. Five food categories that strongly associated with T2D include: refined breads, animal-based products; ready-to-eat mixed dishes; sauces, spreads and condiments, and artificially and sugar-sweetened beverages. Mediation analyses determined that health adverse components of the Nova classification of UPF such as high fat, sugar, and salt accounted for < 30% of the subgroup association with T2D risk, raising the question about the role of chemical food additives--hallmarks of many industrially processed UPF. Widespread use of phosphate additives in UPF have been shown to contribute to excess phosphate intake, which in turn contributes to hormonal dysregulation of the mineral, both providing evidence linking high UPF consumption to cardiorenal disease. We hypothesize that the food groups strongly associated with T2D risk are likely sources of organic and inorganic phosphate additives, which may provide an additional mechanism for the disease.

Methods: To test this hypothesis, we estimated exposure to phosphate additives in these food categories by examining nutrition label information (ingredients list) from products sold by the top 25 largest food and beverage manufacturers in the USA.

Results: Ingredient lists of the approximate 40,000 foods were examined, with 56% containing phosphate additives overall. Even higher percentages were observed in the top T2D associated food categories: baked goods (86%, 3627/4208); processed meat and seafood (50%, 940/1870); ready meals (70%, 3570/5103). These 3 subgroups also represented 88, 59 and 71 % of all product sales in 2020 that contained phosphate additives, respectively.

Conclusions: It is well established that phosphate additives contribute to high phosphate consumption which can promote oxidative stress and inflammation, both recognized underlying mechanisms in chronic disease, including T2D. The extent of exposure to phosphate additives in UPF categories linked to T2D merits further study, as well as the safety of the growing cumulative use of phosphate additives in industrial food processing.

Funding Sources: None