Are you having plant-based milk, flavoured yogurt or the low-fat mayonnaise, thinking they are healthy? Or taking diet supplements, protein bars and protein shakes? They could be raising your blood sugar.
Anything that comes in a wrapper or packet, or something that’s dried, has added preservatives to make it last longer. All of them have emulsifiers, compounds that help mix two substances that typically separate when they are combined (for example oil and water) and are used to improve the appearance, taste, texture and lengthen shelf life of food. Examples of processed foods that contain chemical emulsifiers are commercially available cakes, biscuits, desserts, ice creams, chocolate bars, breads, and ready-to-eat meals.
How can emulsifiers increase the risk for diabetes?
Recent experimental studies have shown that emulsifiers modify the composition and function of the gut microbiota (micro-organisms, including bacteria, fungi and viruses that live in the digestive tracts). They then enter the gut lining, a mucus layer that keeps them away from the host cells, and cause inflammation. This leads to insulin resistance.
This year’s study from France, published in the Lancet -Diabetes and Endocrinology, tracked 104,000 adults between 2009 and 2024 and identified seven food additive emulsifiers associated with an increased risk of Type 2 diabetes. Participants with the highest exposure to emulsifiers in commercial food products were up to 15 per cent more likely to have Type 2 diabetes.
Among the emulsifiers that increased diabetes risk was tripotassium phosphate (15 per cent), which is used in dry cereals, meat, sauces, and cheeses. Guar gum, used in breakfast cereals, dairy products, gravy, processed vegetables, and baked goods, increased risk by 11 per cent. Xanthan gum, used for thickening gravies, raised risk by eight per cent. Mono- and diacetyltartaric acid esters of mono- and diglycerides of fatty acids, used in biscuits, ice cream and salad dressings, upped diabetes chances by four per cent. Sodium citrate, which is used in club soda, ready-to-drink beverages, drink mixes and preservatives, increased diabetes risk by four per cent; carrageenans, a thickening agent, by three per cent and gum Arabic, used in confectionery and chocolates, by another three per cent.
What diet changes are needed after this study?
This study adds to mounting evidence against the widespread consumption of processed food. While it can be challenging to avoid such food items completely, we can start making an effort to reduce their consumption. People should focus on eating real, whole foods.
Monitoring the frequency and amount of packaged food, i.e. chocolate or candy, packed snacks, baked goods, pre-packaged meals, is therefore advisable. Sticking to fresh or home-made food will eliminate emulsifiers from your diet.
Increasing foods that are free from these additional ingredients such as fruits, vegetables, healthy fats, whole grains and lean protein will help to keep you healthy. If you are looking to prevent or manage metabolic syndrome/ diabetes, meeting a nutritionist to understand how to interpret the ingredients list can be helpful.
The findings from this study could prompt regulatory agencies and policy makers to reconsider the rules governing the use of emulsifiers and other additives by the food industry. The Food Standards and Safety Authority of India has a list of permitted emulsifiers, and may need to take a relook at their regulations at some point in the future. More clear disclosure and labelling of food items will help consumers make informed choices.
(Dr Mithal is Chairman, Diabetes and Endocrinology, Max Healthcare)
