September 3, 2025, 8:55 am | Read time: 6 minutes
Ultra-processed foods have long been the focus of health research, but not the additives and flavors typical of them. A British long-term study involving over 180,000 people examined which additives are linked to mortality. The results show: Some additives are critical—others, however, are harmless or even potentially beneficial. FITBOOK nutrition expert Sophie Brünke presents the study to you.
Until now, research has focused on the consumption of ultra-processed foods in general (called UPFs in English). The question now examined went a step further: Which specific ingredients, serving as markers of ultra-processing (MUPs), are associated with the risk of death? This is crucial because not all additives have the same effect. This study is the first of its kind to compare the intake of MUPs with overall mortality.
How the Scientists Proceeded
The cohort study used data from 186,744 adults aged 40 to 75 from the UK Biobank. Participants were recruited between 2006 and 2010 and followed for an average of eleven years. During this time, 10,203 deaths occurred.
The “Oxford WebQ,” a standardized 24-hour dietary questionnaire, was used to record the foods consumed. Throughout the study period, participants completed this questionnaire up to five times. For each mentioned food, up to ten suitable products from major British supermarket chains were researched. Their ingredient lists were checked to see which of the 57 known MUPs were present. A total of 37 of these additives were included in the analysis and divided into nine categories. A food was considered a UPF if it contained at least one MUP. The goal was to find out which of these additives are particularly critical and should be more regulated or reduced in the future.
The MUP categories examined are:
- Flavors
- Flavor enhancers, such as glutamate, ribonucleotides
- Colorants
- Sweeteners, such as acesulfame, saccharin, and sucralose
- Functional additives, such as anti-caking agents, firming agents, gelling agents, thickeners
- Various sugars: free added sugars like fructose, inverted sugar, lactose, maltodextrin
- Modified oils, such as hydrogenated oils
- Protein sources: isolated/industrially obtained proteins
- Fiber: added isolated fibers
The amount of ultra-processed products consumed was related to the total intake (percent TFI—”percent of total food intake”). This means: Percent TFI indicates what proportion a particular additive or product has of the total amount of food consumed. Example: Someone who eats 2,000 grams of food a day, including 200 grams with sweeteners, has a sweetener share of ten percent TFI. The evaluation was carried out using so-called Cox regressions, which calculated the risk of death in relation to the consumption of various MUPs. For better comparability, the point with the lowest risk was defined as the reference value (percent TFI, where the risk of death was lowest in the evaluation).
Why UPFs Are So Problematic
UPFs are heavily industrially altered products with additives like flavors, colorants, or emulsifiers. They are high in fat, sugar, and salt but low in nutrients like fiber and vitamins. However, they are heavily marketed and their popularity is rising—after all, they save a lot of time in the kitchen and taste good to most people thanks to fat, flavors, and the like. However, they also increase the risk of various diseases, including heart problems, type 2 diabetes, and even lung cancer. They can also hinder weight loss success during a diet.
Most Additives Had a Negative Impact on Mortality—With One Exception
UPFs accounted for an average of 20 percent of the total food intake of the participants. The general consumption of UPFs was clearly linked to an increased risk of death, especially when consumption exceeded 18 percent TFI. However, not all additives were equally associated with the risk of death. Five MUP categories were significantly associated with increased overall mortality at certain intake levels or TFIs:
- Flavors: +20 percent risk of death (40 percent TFI compared to 10 percent TFI)
- Flavor enhancers: +7 percent risk of death (2 percent TFI compared to 0 percent TFI)
- Colorants: +24 percent risk of death (20 percent TFI compared to 3 percent TFI)
- Sweeteners: +14 percent risk of death (20 percent TFI compared to 0 percent TFI)
- Various sugars: +10 percent risk of death (10 percent TFI compared to 4 percent TFI)
In contrast, the scientists found no associations with functional additives, modified oils, protein sources, or fiber.
Which Specific Additives Are Involved
On an individual level, 13 of the 37 analyzed specific MUPs showed a significant association with overall mortality. These include:
- Glutamate, ribonucleotides (flavor enhancers)
- Acesulfame, saccharin, sucralose (sweeteners)
- Fructose, inverted sugar, lactose, maltodextrin (sugars)
- Anti-caking agents, firming agents, thickeners (functional additives)
One Additive Stands Out
Interestingly, only gelling agents showed an inverse association, meaning they were linked to a lower risk of death.
Significance of the Results
The study provides the first concrete evidence of which individual additives in ultra-processed foods affect mortality. This is a significant advancement over previous analyses that only considered overall UPF consumption. For research and healthcare, this means: Future recommendations and regulations could be more specifically targeted at particularly critical additives—such as artificial flavors, certain sweeteners, or colorants. Consumers benefit by being able to pay more attention to the ingredients in processed products.
However, it is also important to note: Not all additives are automatically harmful. Some—like gelling agents (such as pectin)—could even have health benefits. Additionally, the results suggest that it is not solely about industrial processing, but about the interplay of individual ingredients, manufacturing processes, and consumption habits.
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Study Assessment
The study is extensive and methodically conducted with care. The MUP-based classification offers a more objective approach to evaluating UPFs than previous methods, which relied on blanket product lists.
However, there are also limitations. The dietary data collection relied on self-reports, which can lead to inaccuracies. Additionally, some rarer additives could not be reliably analyzed due to a lack of data. It is also possible that unmeasured influencing factors contributed to the result (such as social factors, health awareness). The cohort consists of “healthier” volunteers (Healthy-Volunteer Bias) and is not fully representative of the general population. Nevertheless, extensive sensitivity analyses show that the core results are robust. Even after correcting for possible confounding factors and multiple testing, key associations remained significant.
Not All UPFs May Be Harmful; It Depends on the Additives
We can conclude: Not all ingredients in industrially processed foods are equally dangerous. This study provides the first robust evidence that certain additives like flavors, colorants, and artificial sweeteners increase the risk of death, while others show no or even positive effects. The results enable more targeted health policy measures in the future and provide consumers with guidance for more conscious eating. Future research should focus on the biological mechanisms behind this and other population groups.