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Objective To analyze the combined use of food additives in China, and to assess exposure levels of the common combination of food additives and its cumulative health risks. Methods According to the combined use of food additives in China in the global New Product Database, the maximum allowable amount of food additives of National Food Safety Standards the Use of Food Additives GB 2760-2014, food safety risk monitoring result in China from 2015 to 2019 and the data of the Chinese total dietary study in 2012, a simple distribution method was used to calculate the theoretical and the actual exposure of the common food additives combination in Chinese population and hazard index (HI) method was used to evaluate the cumulative risk. Results Two or more food additives was used in 79.90% of the foods in China, and the highest utilization rate is binary combination, followed by ternary combination and quaternary combination, with a maximum of 29 combination. Through the use of the quaternion combination, the average theoretical daily exposure of sodium benzoate, cyclamate and potassium sorbate in the diet of the general population in China was 1.30, 1.07 and 1.51 mg/kg BW, respectively. The theoretical exposures in the diets of the high food consumption group (P95) were 4.44, 4.69, and 5.19 mg/kg BW, respectively. The proportion of individuals whose average daily theoretical exposure of sodium benzoate, sodium cyclamate and potassium sorbate exceed their corresponding acceptable daily intake (ADI) in the general population was 5.50%. Through cumulative evaluation, it was found that 4 376 individuals had HI≥1, accounting for 13.69% of the surveyed population. According to the actual monitoring data, the average actual daily exposure of sodium benzoate, cyclamate and potassium sorbate in the diet of the general population in China was 0.17, 0.08 and 0.05 mg/kg BW, respectively. The actual exposures in the diets of the high food consumption group (P95) were 0.58, 0.33, and 0.44 mg/kg BW, respectively. The proportion of individuals whose average daily actual exposure of sodium benzoate, sodium cyclamate and potassium sorbate exceed their corresponding ADI in the general population is 0.02%. Through cumulative evaluation, it was found that 12 individuals had HI ≥ 1, accounting for 0.04% of the surveyed population. Conclusion Food additives in China are usually used in multiple forms, the most commonly used additives in binary, ternary and quaternary combinations have low cumulative exposure risks. However, individuals with HI≥1 should adjust their diet. |