Overview

• The eClinicalMedicine analysis followed nearly 187,000 German adults aged 40–75 for 11 years, documenting about 10,200 deaths.
• Higher risk was associated with flavor enhancers such as glutamate and ribonucleotides, nonnutritive sweeteners including acesulfame, saccharin and sucralose, and sugars like fructose, inverted sugar, lactose and maltodextrin.
• Several processing aids—caking agents, firming agents and thickeners—were also linked to increased mortality.
• Gelling agents such as pectin were tied to lower risk, contrasting with other additive groups.
• The authors reported no association for modified oils, protein sources or fiber, acknowledged reliance on self-reported diets, and called for mechanistic research to probe these signals.