By analysing nationally representative diet data, researchers show that food additives rarely occur alone, with children and teenagers experiencing the highest exposure to complex additive mixtures largely driven by ultra-processed foods.
Study: Food additive mixtures in French children and adults: the nationally representative Esteban study. Image Credit: nau2018 / Shutterstock
A recent study in the journal Scientific Reports evaluated exposure to food additives and their mixtures among adults and children in France.
Widespread Use of Food Additives in Modern Diets
Food additives are substances that, when added to foods, improve their appearance, shelf life, texture, or taste. They are ubiquitous in modern diets and found in a range of food products, including expected items like industrial cookies, as well as less-anticipated products, such as prepackaged bread and yogurt. In France, food products containing additives account for more than 50% of the market.
Emerging Health Concerns From Additive Mixtures
Growing evidence suggests that chronic exposure to certain food additives may have adverse effects, raising public health concerns, particularly for children. Further, experimental and human studies indicate that these substances may have synergistic effects when consumed in mixtures. However, these cumulative effects are generally not accounted for in current safety assessments, plausibly due to the lack of real-world exposure data and the fact that regulatory thresholds are largely derived from single-additive toxicological studies.
Nationally Representative Assessment of Additive Intake
In the present study, researchers investigated exposure to food additives and their mixtures in French children and adults. This study was part of the cross-sectional Esteban study. Participants aged 3–74 were recruited between 2014 and 2016. Sociodemographic and physical activity data were collected using questionnaires. Height and weight were measured, and body mass index (BMI) was calculated. Dietary data were collected using three 24-hour dietary recalls or records.
The daily average dietary intake was calculated based on these dietary data. Nutrient intake was determined using a comprehensive food composition database. The NOVA classification was used to identify ultra-processed foods (UPFs) and estimate their contribution to energy intake. Additive intake was assessed by merging dietary intake information, including commercial brand details, with food composition databases and laboratory assays in food matrices.
For each additive, the mean and median intakes were calculated both in absolute terms (g/day) and relative to body weight (mg/kg/day). Additives were ranked based on the proportion of consumers. Food additive mixtures were identified using non-negative matrix factorization based on additives consumed by more than 5% of participants, with the resulting mixtures explaining most of the variability in additive exposure profiles. Their associations with lifestyle, dietary, and sociodemographic factors were assessed using regressions.
High Additive Exposure and UPF Consumption
The study included 2,177 adults aged 18–74 years and 1,279 children aged 6–17 years. UPFs accounted for an average of 34.2% and 49.3% of daily energy intake in adults and children, respectively. Overall, 125 and 122 food additives were found in the diets of at least one adult and child participant, respectively. On average, the daily intake of food additives was 5.1 g/day for children and 4.4 g/day for adults, with body-weight–adjusted exposure approximately twice as high in children as in adults.
Seventy-one food additives were consumed by more than 5% of children, compared to 60 among adults. Acceptable Daily Intake (ADI) exceedances were observed for rosemary extract (E392) in both children and adults, and for sucralose (E955) in a small proportion of adults. Three food additive mixtures were identified for adults and four for children, together accounting for approximately three-quarters of exposure variability in adults and more than four-fifths in children.
Adult Exposure Patterns Across Additive Mixtures
In adults, mixture 1 was characterized by acidity regulators, food colors, and emulsifiers and thickeners, which are commonly found in industrial cakes, biscuits, salty and highly processed foods, savory snacks, and sweetened soft drinks. Adults exposed to mixture 1 were more likely to be younger, male, and have higher education, and less likely to be manual laborers.
Mixture 2 included a flavor enhancer, preservative, food colors, and emulsifiers. Ready-to-eat dishes, highly processed foods, fats and sauces, dairy products, savory snacks, and dairy desserts were the foods most representative of this mixture. Greater exposure to mixture 2 was noted in adults with higher BMI.
Mixture 3 was characterized by emulsifiers, food colors, acidity regulators, a glazing agent, and two sweeteners. Pastries and both sweetened and artificially sweetened beverages were representative of this mixture. Most adults exposed to mixture 3 were aged 30–50, smokers, males, and manual laborers.
Distinct Additive Mixtures Among Children
In children, mixture 1 contained acidity regulators, a texture agent, and emulsifiers and thickeners, which are commonly found in cakes and biscuits, highly processed foods, and savory snacks. Children most exposed to mixture 1 were more likely to be aged 6–10 and to come from households with incomes ranging from €1,900 to €3,100.
Mixture 2 was characterized by an acidity regulator, preservative, flavor enhancer, and emulsifiers, which are commonly found in fats and sauces, dairy desserts, highly processed foods, and ready-to-eat dishes. Females aged 15–17 who never smoked and those with BMI > 97th percentile were most exposed to this mixture, with higher exposure also observed in certain parental occupational and educational groups.
Mixture 3 included an emulsifier, acidity regulator, glazing agent, sweetener, antioxidants, and food colors, which are commonly found in sweetened soft drinks, confectionery, and cakes and biscuits; females aged 11–14 who never smoked and whose parents had a lower educational background were most exposed to this mixture.
Food additive mixture 4 included an emulsifier and intense and bulk sweeteners, which are commonly found in pastries and artificially sweetened beverages. Exposure to mixture 4 was more likely in children whose referent parent had an intermediate profession.
In general, food additive mixtures were inversely associated with protein, dietary fiber, β-carotene, and vitamin C intakes. Nevertheless, positive associations were observed with energy intake, saturated fats, and added sugars.
Public Health Implications for Dietary Additive Mixtures
In sum, most additives characterizing mixtures were markers of UPFs, although some additives also occur in less processed food matrices. Consumption of food additive mixtures increased with age in children but decreased in adults, suggesting that young adults and teenagers are the most exposed to additives. Higher intake of additive mixtures was associated with less favorable sociodemographic and health profiles, with some heterogeneity across mixtures and population subgroups.
Further studies are needed to explore the health effects and possible antagonistic or synergistic interactions between additives, particularly given that the Esteban data were collected nearly a decade ago and dietary patterns may have since evolved, and in light of emerging evidence from other French cohorts linking certain additive mixtures to cardiometabolic outcomes such as type 2 diabetes.
Journal reference:
de La Garanderie MP, Dechamp N, Verdot C, et al. (2025). Food additive mixtures in French children and adults: the nationally representative Esteban study. Scientific Reports. DOI: 10.1038/s41598-025-27819-8, https://www.nature.com/articles/s41598-025-27819-8
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