Heyndrickxia coagulans IDCC 1201 Alters Gut Microbiome and Metabolome in Patients with Functional Bowel Disorders.

Approximately 589 million adults aged 20–79 years live with diabetes worldwide as of the 2024 IDF estimate, with projections rising to 853 million by 2050 []; type 2 diabetes mellitus (T2D) accounts for the majority of these cases. While excess energy intake, refined carbohydrate load, and physical inactivity remain the dominant modifiable risk factors, they do not fully account for the accelerating prevalence observed across socioeconomically diverse populations over recent decades []. An underexplored dietary exposure dimension concerns food additives—substances intentionally incorporated into processed foods during manufacture for purposes of texturisation, emulsification, preservation, acidification, or sweetening—that are consumed daily at dose levels and in combinations that have no precedent in traditional diets. Ultra-processed foods (UPFs), defined within NOVA—a food-processing classification system based on the nature, extent, and purpose of processing—as industrially formulated products characterised by minimal whole-food ingredients and a distinctive additive profile [], are now linked to T2D by consistent epidemiological evidence. A 2024 umbrella review of 45 meta-analyses identified Class I evidence for a dose–response relationship between UPF consumption and T2D incidence, with a relative risk of 1.12 per 10% increment in dietary UPF share []. Three large US prospective cohorts—the Nurses’ Health Study, Nurses’ Health Study II, and the Health Professionals Follow-up Study—reported a hazard ratio (HR) of 1.46 (95% CI 1.39–1.54) comparing the highest with the lowest UPF quintile []. A parallel systematic meta-analysis reached concordant conclusions []. Yet a persistent methodological obstacle has limited progress: UPF classification conflates at least four biologically distinct exposure types—excess energy density, fibre and micronutrient displacement, processing-derived contaminants, and the additive load itself. Separating the additive contribution from these concurrent attributes has, until recently, been methodologically intractable. UPFs and additive mixtures are related but non-equivalent exposure concepts. NOVA classifies foods according to the nature and extent of industrial processing, whereas mixture analysis estimates correlated intakes of named additives across foods. A mixture score may therefore identify co-exposure patterns within or across product categories, but it does not remove the energy density, nutrient profile, physical structure, or other matrix characteristics of the foods that deliver those additives.