Common Food Preservatives Linked to High Blood Pressure Risk

Eating a diet high in common food preservatives may increase your risk for high blood pressure (hypertension) and cardiovascular disease, according to a new analysis of dietary data from more than 112,000 people.

The study, published in the European Heart Journal, found that those who consumed the highest amounts of non-antioxidant preservatives had a 29% higher risk of hypertension, compared to those who ate the lowest amounts. The high-consumption group was also at a 16% higher risk of developing cardiovascular disease, including heart attack, stroke, and angina.

In light of these findings, the researchers believe that a reevaluation of the risks of food additives by regulators is warranted, and advise consumers to follow existing guidance on eating foods that are non- or minimally-processed and that contain fewer additives.

Food additives and heart health

“Food additive preservatives are used in thousands of industrially processed foods. They represent about one item in five on the Open Food Facts database,” study author Anaïs Hasenböhler, a PhD student in the Nutritional Epidemiology Research Team at the Université Sorbonne Paris Nord and Université Paris Cité, told Technology Networks.

Despite their wide use, there are relatively few studies investigating the effects of these additives on heart health, Hasenböhler noted.

“Experimental studies suggest that some preservative food additives may exert adverse cardiovascular effects, yet human data were lacking. Indeed, to our knowledge, this is the first prospective epidemiological study investigating the links between a wide range of preservative food additives and cardiovascular health,” Hasenböhler said.

“This is due to the fact that except for a few preservatives, such as nitrites and nitrates, mainly used in processed meats, previous cohort studies lacked food additive exposure data, due to the absence of brand-specific information and variability in additive composition across products of the same type but different brands.”

Using data from the NutriNet-Santé study, the researchers had previously identified links between food preservative intake and cancer incidence, as well as type 2 diabetes incidence.

The new study uses data from the same cohort to examine any associations between exposure to food preservatives and the incidence of cardiovascular disease (including cerebrovascular disease and coronary heart disease) and hypertension.

The challenge of quantifying exposure to food additives

As a part of the NutriNet-Santé study, volunteer participants record detailed information on exactly what food and drink they have recently consumed. This information is recorded at regular intervals over the course of many years—for the first participants, follow-up has been ongoing for more than 16 years.

But despite this detailed dataset, it can be hard to nail down an individual’s exact exposure to food preservatives. In this case, the team had to make use of several external databases and ad hoc laboratory assays to estimate levels.

“Dietary data are collected through series of 24-hour dietary records every 6 months, in which the commercial name/brand of food products is registered. Linkage with multiple databases (Open Food Facts, Oqali, GNPD) allowed us to identify the specific food additives present in each industrial food consumed. Laboratory assays within food and beverage matrices and linkage to various databases allowed us to estimate food additive doses and then quantify their usual intakes,” Dr. Mathilde Touvier, a research director at INSERM (the French National Institute for Health and Medical Research) and principal director of the NutriNet-Santé cohort, told Technology Networks.

“Such level of detail in dietary data in the NutriNet-Santé cohort, including commercial names and brands of industrial products, is unique in cohort studies globally, and is for the present study, given the huge variability in additive composition from one brand to another.”

Based on these analyses, the team found that, during the first two years of follow-up, 99.5% of participants were exposed to at least one preservative. This extreme prevalence underscores “the importance of examining their long-term impact on health,” Touvier emphasized.

Eight food preservatives linked to increased hypertension risk

From their analysis, the researchers identified increases in hypertension and cardiovascular disease risk that appeared to be associated with food preservative consumption.

Overall, those who ate the most non-antioxidant preservatives had a 29% higher risk of hypertension and 16% high risk of cardiovascular disease. Those who ate the most antioxidant preservatives had a 22% high risk of hypertension compared to those who ate the least.

In total, 58 unique preservative food additives were detected and quantified in the study population. Of these, 17 preservatives were consumed by at least 10% of the participants, and so were selected for additional analysis.

Eight of these common preservatives were individually associated with increased hypertension risk: 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). Additionally, ascorbic acid (E300) was associated with higher cardiovascular disease incidence.

Prioritize minimally-processed food with fewer additives, researchers say

While the NutriNet-Santé cohort is very large, and therefore has significant statistical power, the researchers do note several key limitations on this work that warrant further investigation.

“This study has some limitations inherent to its observational design, which does not allow causal conclusions on its own,” said Hasenböhler. “However, the findings are based on highly detailed data, adjusted for many factors, and remained consistent across multiple analyses.”

“As in many large volunteer-based cohorts, participants may not fully represent the general population, warranting caution when generalizing the results. Finally, although exposure assessment was among the most precise to date, some degree of imprecision is possible, without undermining the overall robustness of the findings.”

Rachel Richardson, methods support unit manager at The Cochrane Collaboration, who was not involved in the study, echoed this sentiment, while noting that the researchers did do “a good job of controlling for other factors that may influence health, such as age, BMI, smoking, physical activity and diet in general.”

“The people in the cohort were predominantly female and had healthier lifestyles than the general French population. The cohort is made up of volunteers, so participants are likely to be more interested in diet and health than the average person,” Richardson said, in comments given to the Science Media Centre. “Although they cannot prove causation, there are signals in the results that warrant further investigation.”

While more experimental research is still needed to investigate the underlying mechanisms behind the associations identified here, Touvier believes that these recent findings should prompt regulators to begin reconsidering their current approaches to food additives.

“These new data call for a reevaluation of the risk/benefit balance of these food additive preservatives by the authorities in charge (the European Food Safety Authority in Europe, the Food and Drug Administration in the USA, etc.) for better consumer protection,” said Touvier.

“In the meantime, these findings support the recommendations to favor non-to-minimally-processed foods and avoid superfluous additives. Healthcare professionals and clinicians could play a key role in disseminating these recommendations to the general population.”

Reference: Hasenböhler A, Javaux G, Payen De La Garanderie M, et al. Preservative food additives, hypertension, and cardiovascular diseases: the NutriNet-Santé study. Eur Heart J. 2026:ehag308. doi: 10.1093/eurheartj/ehag308

About the interviewees:

Anaïs Hasenböhler has been a food science engineer since 2020. After graduating from Oniris VetAgroBio, she worked in nutritional data for a couple of years in the UK. She joined the Nutritional Epidemiology Research Team CRESS-EREN (Inserm/INRAE/CNAM/Sorbonne Paris Nord University/Paris Cité University) in 2023 to start her PhD journey.

 

Recently, she won the Ferenc Bojan Young Investigator Award from the European Public Health 2025 conference for her work on the associations between preservative food additive intakes and the incidence of hypertension and cardiovascular diseases in the NutriNet-Santé cohort.

Dr. Mathilde Touvier is a research professor at the French National Institute for Health and Medical Research (Inserm), and principal investigator of the NutriNet-Santé cohort. She graduated from AgroParisTech with a degree in human nutrition in 2002 and obtained a PhD in epidemiology and public health in 2006. After six years at the French Agency for Food, Environmental and Occupational Health & Safety and one year as a visiting researcher at Imperial College London, she joined the Nutritional Epidemiology Research Team CRESS-EREN ( Inserm/INRAE/CNAM/Sorbonne Paris Nord University/Paris Cité University), of which she became Director in 2019.

She coordinates research on the links between nutrition and health, with >530 publications in this. She codeveloped the front-of-pack logo Nutri-Score, now used in eight countries in Europe. She has been appointed professor of public health at the College de France since 2023. She received the ERC Public Engagement with Research Award 2024. In 2026, she became the president of the French Nutrition and Health Program.