Are Food Additives Safe? The Hidden Risks in Modern Diets
By Monika Rau, Trainee Lecturer in Health, LSST Elephant and Castle
In today’s fast-paced world, food consumption patterns have evolved dramatically. While people enjoy the convenience and variety of modern diets, the use of food additives has sparked a global debate about safety and health concerns. This blog explores the role and types of food additives in contemporary consumption, their safety, and the broader implications for global health.
What Are Food Additives?
Many food elements naturally occur as minerals and can be found in some foods in lesser amounts. However, once they are manufactured and intentionally added to foods to achieve specific purposes, such as preserving freshness, enhancing flavour, improving appearance, or modifying texture, these elements become additives. During processing, their proportions are much higher, and they have been assigned E-numbers (Davidson and Singh, 2024). For example, common artificial colours include tartrazine (E102), sunset yellow (E110), and Allura Red (E129). They are used primarily in processed and packaged foods but can also be found in some fresh foods such as jams, jellies, and dairy products. They serve specific technological, sensory, or nutritional purposes during food processing, preparation, packaging, or storage (Lindsay, 2007). One of them is widely used artificial sweeteners such as aspartame (E951), sucralose (E955), saccharin (E954), acesulfame potassium (E950), and neotame (E961). They play a crucial role in maintaining the safety, quality, and appeal of modern food supply. The main roles include spoilage prevention by inhibiting the growth of harmful microorganisms, thereby extending shelf life, and ensuring food safety (Silva and Lido, 2016; Herrera et al., 2020). They improve or modify the taste, smell, colour, texture, and appearance of foods to make them more appealing and consistent for consumers (Downham and Collins, 2000). Additionally, to facilitate food manufacturing and preparation by controlling acidity, aiding leavening, preventing caking, or stabilising emulsions (Ukwo, Udo, and Ndaeyo, 2022).
Key Types of additives and health
Benzoates
Sodium benzoate is a widely used synthetic food preservative derived from benzoic acid, which can occur both naturally and artificially. As the sodium salt of benzoic acid, it is commonly found in various food products, beverages, and personal care items. The U.S. Food and Drug Administration (FDA) recognises sodium benzoate as safe (GRAS) when used in appropriate amounts, and it serves a crucial role in inhibiting the growth of mould, yeast, and bacteria, thereby extending the shelf life of many products (Code of Federal Regulations, no date; Lennerz et al., 2015).
However, concerns have been raised about the potential health risks associated with benzoates, particularly in children. Research links them to behavioural disturbances, including hyperactivity and attention deficit hyperactivity disorder (ADHD) (McCann et al., 2007; Kemp, 2008). Additionally, studies suggest that sodium benzoate may have neurotoxic effects due to toxic metabolites produced by gut microbes (Pedigo, 2019; Yadav et al., 2021). Long-term use has also been associated with cellular damage and potential teratogenic effects, which can disrupt normal foetal development and lead to birth defects (Saatci et al., 2016; Walczak-Nowicka and Herbert, 2022; Stanford Medicine, no date).
While the health risks and toxic effects—such as behavioural disturbances and neurotoxicity—are primarily associated with synthetic benzoates, it is important to recognise the essential role they play in food preservation. Natural benzoic acid is found in some fruits, but the sodium benzoate used in processed foods is typically manufactured synthetically and does not occur in significant amounts in natural food sources (Han, 2020). This dual perspective highlights the importance of careful regulatory oversight and consumer awareness in balancing the benefits of food additives with potential health risks.
Nitrates and Nitrites
Nitrates can be either synthetic or naturally occurring chemicals composed of nitrogen and oxygen. Found in soil, water, and many foods—especially vegetables—they are also used as food additives, primarily as preservatives in processed meats and cheeses. Nitrates and nitrites are effective in preventing the growth of harmful bacteria, particularly Clostridium botulinum, which causes botulism, a serious food-borne illness. Additionally, they help cured meats retain their characteristic pink colour and enhance flavour (Pierson, Smoot, and Robach, 1983; Flores and Toldra, 2021; Shakil et al., 2022; Quansah and Saalia, 2024).
However, excessive exposure to synthetic nitrates can lead to significant health issues, particularly methemoglobinemia. This condition alters haemoglobin, impairing its ability to carry oxygen efficiently and potentially resulting in serious symptoms such as cyanosis (bluish skin), cardiac arrhythmias, and various central nervous system effects, ranging from dizziness to coma (Fewtrell, 2004; Rapaport, 2023). Infants under six months are especially vulnerable, with fatal cases linked to formula prepared with contaminated water (Fewtrell, 2004). Chronic exposure to high levels of nitrates and nitrites may lead to additional health concerns, including frequent urination, abdominal pain, and even death (Harper et al., 2017; United States Environmental Protection Agency, 1999).
Importantly, naturally occurring nitrates in vegetables are generally considered less harmful and may even provide health benefits, thanks to the presence of protective compounds like antioxidants (Rapaport, 2023). In contrast, synthetic nitrates and nitrites found in processed meats are more closely associated with negative health effects, particularly the formation of carcinogenic nitrosamines during cooking or digestion. While acute toxicity, such as methemoglobinemia, is most linked to synthetic nitrates from contaminated water, it can theoretically occur from excessive intake from any source (Rapaport, 2023). Thus, while both natural and synthetic nitrates and nitrites serve essential roles in food preservation and safety, awareness of their potential risks—especially from processed foods and contaminated sources—is crucial for informed dietary choices.
Sulphites
Sulphites are a group of chemical compounds, including sulphur dioxide and various sulphite salts such as sodium sulphite, sodium bisulphite, sodium metabisulphite, potassium bisulphite, and potassium metabisulphite. While they occur naturally in some foods and in the human body, sulphites are predominantly used as food additives to preserve freshness and enhance shelf life in a variety of products, including beverages, dried fruits, wine, jams, seafood, and meats (Grotheer, Marshall, and Simmone, 2005; Quansah and Saalia, 2024). According to the European Food Safety Authority (2016), common sulphites include sulphur dioxide (E220) and sodium bisulfite (E222), which play an essential role in preventing spoilage and maintaining food quality.
However, sulphites can provoke adverse reactions in sensitive individuals. Symptoms can range from mild issues like dermatitis and hives to more severe respiratory problems, such as asthma attacks, particularly in asthmatic individuals, where sensitivity is estimated to be between 3 and 10% (Vally, Misso, and Madan, 2009). Additionally, high dietary intake of sulphites has raised concerns over potential effects on the central nervous system, including delayed nerve cell responses, which may indicate early signs of dysfunction (Dalton-Bunnow, 1985).
In conclusion, while sulphites are valuable as preservatives and antioxidants, ensuring food safety and quality, they pose significant risks for sensitive populations, particularly those with asthma. Adverse reactions can range from mild to severe, emphasising the need for caution among individuals with known sensitivities. Therefore, while sulfites serve essential functions in the food industry, it is crucial for consumers to be aware of their potential risks and read labels carefully when selecting food products.
Food Additives Safety Regulations in the EU and US
The EU regulates food additives primarily under Regulation (EC) No 1333/2008, which lays out strict requirements for the safe use, approval, and labelling of food additives. Only additives that have undergone a rigorous safety assessment by the European Food Safety Authority (EFSA) and have been authorised by the European Commission are permitted for use (European Parliament and Council of the European Union, 2008). The EU regularly re-evaluates approved additives due to new scientific evidence, updating regulations and phasing out substances if safety concerns arise (e.g., the titanium dioxide ban). Novel foods, including new additives, are regulated under Regulation (EU) 2015/2283, requiring a separate safety assessment before market entry (European Commission, 2024; Askew, 2021).
“The Food Additive Amendment (1958) to the FDCA subjected food additives to regulatory scrutiny and gave the Food and Drug Administration (FDA) authority to require premarket approval for new food additives” and that “any substance intentionally added to food is a food additive and is subject to premarket approval by the FDA unless the use of the substance is GRAS (generally recognised as safe) or otherwise excepted.” (Pressman, Clemens, Hayes, and Reddy, 2021).
Global Concerns about Food additives
There is growing international concern about the health impacts of food additives, especially as scientific studies increasingly link certain additives to a range of health problems. Research has associated harmful additives and preservatives with conditions such as asthma, ADHD, heart issues, cancer, obesity, and hormonal disruptions, particularly in children, who are more vulnerable to these exposures (Sambu, Hemaram, Murugan, and Alsofi, 2022). Some additives may interfere with hormones, influence growth and development, and contribute to the rising rates of childhood obesity.
For instance, the International Agency for Research on Cancer (IARC) classifies “ingested nitrate and nitrite under conditions that result in endogenous nitrosation” as probably carcinogenic to humans by 2006 (Group 2A) (IARC Working Group on The Evaluation of Carcinogenic Risks to Human, 2006). Some studies suggest increased risks of childhood diabetes, recurrent diarrhoea, and respiratory infections in children exposed to high nitrate levels (Bahadoran, Ghasemi, Mirmiran, Azizi, and Hadaegh, 2016; United States Environmental Protection Agency, 1999). Epidemiological studies from 2022 have linked high intake of food additive nitrates and nitrites to increased risks of certain cancers, such as breast cancer (nitrates) and prostate cancer (nitrites), particularly from processed meats. Associations with gastric, renal, thyroid, and colorectal cancers have also been reported, though results are sometimes inconsistent and may depend on the source (animal vs. plant) (Chazelas et al., 2022; Xie et al., 2022).
Call for actions
Experts and advocacy groups are calling for more rigorous, independent oversight of food additives, harmonisation of international standards, and greater transparency in regulatory processes (World Health Organization, 2023). There is increasing pressure on governments—especially in the U.S.—to re-evaluate the safety of additives already in use and to close regulatory loopholes that allow potentially harmful substances into the food supply. Meanwhile, nitrates and nitrites themselves are declared to be not directly carcinogenic, but they can react with amines and amides in the body (especially in acidic environments like the stomach) to form N-nitroso compounds (nitrosamines), many of which are known carcinogens (Katwowska and Kononiuk, 2020; de Andrade Junior et al., 2021). Therefore, additives’ safety must be re-evaluated, considering many populations cannot afford to buy only highly processed foods.
Conclusion
In the complex landscape of contemporary food consumption, the role of food additives is both significant and multifaceted. While these substances are essential for ensuring food safety, quality, and longevity, growing concerns regarding their health implications cannot be overlooked. As we navigate this intricate terrain, it is crucial for consumers to remain informed and proactive about their dietary choices.
The increasing awareness of potential risks associated with certain additives—especially among vulnerable populations like children—highlights the need for transparency in food labelling and regulatory practices. As consumers demand greater accountability and seek natural alternatives, the food industry must adapt to foster a safer and more sustainable food system.
The future of food consumption will rely on a collaborative effort between consumers, producers, and regulators to prioritise health, well-being, and environmental sustainability. By making informed choices and advocating for rigorous safety standards, we can collectively shape a food environment that safeguards public health while promoting innovation and quality in food production.
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