8 common food additives linked to high blood pressure and heart disease

The study was led by Dr. Mathilde Touvier, a research director at INSERM (the French National Institute for Health and Medical Research), and Anaïs Hasenböhler, PhD student, both from the Nutritional Epidemiology Research Team at the Université Sorbonne Paris Nord and Université Paris Cité, France.

Preservatives are added to foods for several reasons, including preventing the growth of bacteria and mold, slowing spoilage, and helping products maintain their color, flavor, or freshness for longer. Because these ingredients are so widely used, researchers wanted to better understand whether long-term exposure could be connected to cardiovascular health.

Ms. Hasenböhler said: "Food preservatives are used in hundreds of thousands of industrially processed foods. 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 work was conducted as part of NutriNet-Santé, a large ongoing research project examining the connections between nutrition and health. The analysis included 112,395 volunteers living across France.

Every six months, participants recorded everything they ate and drank during a three-day period. This gave researchers unusually detailed information about their diets rather than relying only on broad estimates of food consumption.

The research team then examined the ingredients in those foods and beverages, including the preservatives they contained. Participants were followed for an average of seven to eight years so researchers could track whether they developed high blood pressure or cardiovascular diseases such as heart attack, stroke, or angina.

Preservative exposure was nearly universal. During the first two years of participation, 99.5% of the volunteers consumed at least one food preservative.

Higher Preservative Intake Linked to Higher Risk

The strongest associations appeared among people consuming the largest amounts of certain preservatives.

Participants with the highest intake of 'non-antioxidant' preservatives had a 29% higher risk of hypertension than those consuming the lowest amounts. They also had a 16% higher risk of cardiovascular disease, which included heart attack, stroke and angina.

People who consumed the greatest amounts of antioxidant preservatives had a 22% higher risk of hypertension.

The two categories protect food in different ways. Non-antioxidant preservatives are generally used to prevent potentially harmful microorganisms, including bacteria and mold, from growing. Antioxidant preservatives instead slow oxidation, a chemical process that can cause foods to brown, develop unpleasant flavors, or become rancid.

Eight Common Preservatives Stood Out

Researchers also analyzed 17 of the preservatives most commonly consumed by participants.

Eight were specifically associated with a higher risk of high blood pressure: potassium sorbate (E202), potassium metabisulphite (E224), sodium nitrite (E250), ascorbic acid (E300), sodium ascorbate (E301), sodium erythorbate (E316), citric acid (E330) and extracts of rosemary (E392).

Ascorbic acid (E300) was also specifically associated with cardiovascular disease.

These findings do not mean that consuming one of these ingredients will necessarily cause high blood pressure or heart disease. The research was observational, meaning it identified statistical associations rather than proving that preservatives were directly responsible for the increased risks.

Dr. Touvier added: "This study has some limitations inherent to its observational design. 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.

"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. 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

One possible explanation involves oxidative stress. This occurs when reactive molecules build up faster than the body's protective systems can neutralize them, potentially damaging cells and tissues over time.

Researchers are also investigating whether preservatives could influence pancreatic function. The pancreas plays a central role in regulating blood sugar and metabolism, so changes in its function could have broader effects throughout the body.

The team is now studying how food additives and ultra-processed foods may influence inflammation, oxidative stress, the metabolic profile of the blood, and the gut microbiota.

The gut microbiota refers to the enormous community of bacteria and other microorganisms living in the digestive tract. These microbes are increasingly being studied for their possible roles in metabolism, immune function, and cardiovascular health.

By examining these biological changes, researchers hope to better understand why exposure to certain additives may be associated with a higher risk of disease and whether the preservatives themselves are contributing to those effects.