Common food preservatives found ubiquitously across the modern processed food supply may be associated with a significantly greater risk of developing high blood pressure and cardiovascular disease, according to a sweeping new study published in the prestigious European Heart Journal.
The comprehensive research was led by Dr. Mathilde Touvier, a research director at INSERM, the French National Institute for Health and Medical Research, alongside Anaïs Hasenböhler, a PhD student. Both researchers operate out of the Nutritional Epidemiology Research Team at the Université Sorbonne Paris Nord and Université Paris Cité in France, where they investigate the long-term public health implications of modern dietary habits and food industrialization.
Preservatives are routinely added to a vast array of commercial food products for several crucial technological reasons. These include preventing the proliferation of dangerous bacteria and mold, slowing down natural spoilage, and helping manufactured products maintain their visual appeal, distinct flavor profiles, or perceived freshness for much longer periods on supermarket shelves. Because these chemical ingredients have become so deeply integrated into the global food supply, researchers sought to better understand whether long-term, cumulative exposure could be silently connected to broader cardiovascular health complications over a person’s lifetime.
Ms. Hasenböhler elaborated on the motivations behind the investigation, noting the historical lack of human data regarding these widely consumed additives. "Food preservatives are used in hundreds of thousands of industrially processed foods," she said. "Experimental studies suggest that some preservative food additives may be harmful to cardiovascular health, but we have not had enough evidence on the impact of these ingredients in humans. As far as we know, this is the first study of its kind to investigate the links between a wide range of preservatives and cardiovascular health."
Tracking Diet and Heart Health in More Than 112,000 People
The ambitious research initiative was conducted as part of NutriNet-Santé, a large and ongoing public health research project designed to closely examine the complex connections between nutrition, dietary patterns, and long-term health outcomes. To ensure a robust dataset, the comprehensive analysis included 112,395 adult volunteers living across various regions of France who committed to detailing their daily habits over several years.
To capture dietary intake with high precision, every six months, participants meticulously recorded everything they ate and drank during a rigorous three-day reporting period. This methodology provided researchers with unusually detailed, granular information regarding individual diets, avoiding the common pitfalls of relying solely on broad, retrospective estimates of food consumption.
Armed with this dietary data, the research team then meticulously examined the complex ingredient lists of those specific foods and beverages, cataloging every chemical preservative they contained. Participants were followed for an average duration of seven to eight years. Throughout this extended monitoring period, researchers could accurately track whether volunteers developed high blood pressure, known clinically as hypertension, or severe cardiovascular diseases such as heart attacks, strokes, or angina.
Exposure to food preservatives proved to be nearly universal among the study population. During the initial two years of participation, an overwhelming 99.5 percent of the volunteers consumed at least one food preservative through their regular diets, illustrating just how difficult it is for modern consumers to completely avoid these additives in the contemporary marketplace.
Higher Preservative Intake Linked to Higher Risk
When analyzing the statistical relationships between consumption levels and health outcomes, the researchers discovered that the strongest associations consistently appeared among individuals who consumed the largest amounts of certain categories of preservatives.
Specifically, participants who reported the highest intake of what scientists classify as ‘non-antioxidant’ preservatives faced a 29 percent higher risk of developing hypertension compared to those consuming the lowest amounts. Furthermore, this same high-consumption group experienced a 16 percent higher risk of developing broader cardiovascular disease, a composite category that encompassed heart attacks, strokes, and angina.
Meanwhile, individuals who consumed the greatest amounts of antioxidant preservatives were not entirely unaffected, displaying a 22 percent higher risk of developing high blood pressure themselves.
These two distinct categories of additives protect food in fundamentally different ways. Non-antioxidant preservatives are generally deployed by manufacturers to prevent potentially harmful microorganisms, including bacteria and mold, from multiplying within food products. Antioxidant preservatives, on the other hand, serve a different chemical purpose: they slow down oxidation, a natural chemical process that can cause foods to brown, develop unpleasant off-flavors, or become rancid over time.
Eight Common Preservatives Stood Out
Beyond broad categories, the research team performed a granular analysis of 17 of the specific preservatives most commonly consumed by the study participants during their daily routines. Out of these, eight individual compounds were specifically associated with a heightened risk of developing high blood pressure.
The flagged additives included potassium sorbate, cataloged as E202; potassium metabisulphite, designated as E224; sodium nitrite, known as E250; ascorbic acid, or E300; sodium ascorbate, listed as E301; sodium erythorbate, designated as E316; citric acid, cataloged as E330; and extracts of rosemary, known as E392. Among these, ascorbic acid, commonly recognized as vitamin C when used as an additive, was also specifically associated with an increased risk of broader cardiovascular disease.
Researchers emphasize that these observational findings do not mean that consuming a single item containing one of these ingredients will automatically or directly cause high blood pressure or heart disease. Because the research was observational in nature, it successfully identified important statistical associations, but it could not definitively prove that the preservatives themselves were solely and directly responsible for the increased cardiovascular risks observed in the population.
Dr. Touvier addressed these methodological boundaries while underscoring the strength of the underlying data. "This study has some limitations inherent to its observational design," she explained. "However, the findings are based on highly detailed data, and we have taken account of other factors that can increase or lower the risk of cardiovascular disease. Experimental research in the literature consistently suggested that preservatives may cause oxidative stress in the body or affect the way the pancreas works."
Looking toward regulatory implications, Dr. Touvier suggested that these insights should prompt a thorough reassessment by public health authorities. "These results suggest we need a re-evaluation of the risks and benefits of these food additives by the authorities in charge, such as the EFSA in Europe and the FDA in the USA, for better consumer protection," she stated. "In the meantime, these findings support existing recommendations to favor non-processed and minimally processed foods, and avoid unnecessary additives. Doctors and other healthcare professionals play a key role in explaining these recommendations to the public."
Why Preservatives Might Affect the Body
To make sense of these epidemiological findings, scientists are actively exploring the biological mechanisms through which food additives might negatively impact human health. One prominent hypothesis involves oxidative stress. This physiological state occurs when unstable, reactive molecules accumulate within the body faster than natural protective antioxidant systems can neutralize them, potentially leading to cumulative cellular and tissue damage over time.
In addition to oxidative stress, researchers are investigating whether certain preservatives could directly influence pancreatic function. The pancreas plays a central regulatory role in managing blood sugar levels, insulin production, and overall metabolic processes, meaning that any disruption to its normal functioning could trigger wide-ranging systemic effects throughout the human body.
To deepen this understanding, the research team is currently expanding its investigations to explore how various food additives and ultra-processed foods may influence systemic inflammation, oxidative markers, blood metabolic profiles, and the composition of the gut microbiota.
The gut microbiota refers to the massive, complex community of bacteria, fungi, and other microorganisms that reside within the human digestive tract. These microscopic residents are receiving intense scientific attention for their critical roles in human metabolism, immune system regulation, and cardiovascular health. By examining these complex biological changes and pathways, researchers hope to clarify why exposure to certain chemical additives is associated with higher disease risk and whether the preservatives are actively driving those pathological changes.