An analysis of more than 112,000 adults found higher consumption of several widely used food preservatives was associated with increased rates of high blood pressure and cardiovascular disease, although researchers cautioned that the observational findings do not prove the additives caused those conditions.
By yourNEWS Media Newsroom.
Eight preservatives commonly used in processed foods were individually associated with a higher risk of developing high blood pressure in a large French study that tracked more than 112,000 adults for as long as several years, adding to research examining whether food additives may have health effects beyond their intended role in preserving products.
The study, published Sept. 20, 2026, in the European Heart Journal, found that participants consuming the greatest amounts of non-antioxidant preservatives had a 29% higher risk of hypertension and a 16% higher risk of cardiovascular disease than participants with the lowest consumption. Cardiovascular outcomes examined included heart attack, stroke and angina.
People with the highest intake of antioxidant preservatives had a 22% greater risk of developing hypertension.
Researchers stressed that the results show associations rather than proof that preservatives directly cause hypertension or cardiovascular disease. Eating a food containing one of the identified additives does not mean a person will develop either condition.
The research was led by Dr. Mathilde Touvier, research director at INSERM, the French National Institute for Health and Medical Research, and doctoral student Anaïs Hasenböhler of the Nutritional Epidemiology Research Team at Université Sorbonne Paris Nord and Université Paris Cité, according to the European Society of Cardiology.
Detailed Food Records Followed More Than 112,000 Adults
Researchers analyzed 112,395 adults participating in NutriNet-Santé, an ongoing French project designed to examine relationships between nutrition and long-term health.
Participants were followed for an average of approximately seven to eight years.
Rather than relying solely on general questionnaires asking people how often they ate particular types of food, volunteers repeatedly submitted detailed accounts of everything they consumed over three-day periods. Those dietary records were collected every six months.
Researchers then examined the foods and beverages for specific preservatives and estimated participants’ exposure to individual additives.
Preservative consumption was nearly universal. During their first two years in the study, 99.5% of participants consumed at least one preservative.
The researchers followed participants over time to determine who subsequently developed hypertension or cardiovascular conditions including heart attack, stroke and angina.
“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,” Hasenböhler said.
The findings add to broader research examining industrially formulated foods. Previous studies involving millions of adults have associated greater consumption of ultra-processed foods with higher risks of cardiovascular disease, cancer, premature death and digestive disorders. One analysis found that each additional 100 grams consumed daily was associated with a 6% increase in cardiovascular risk and a 19.5% increase in digestive disorders.
Eight Individual Additives Stood Out in the Analysis
Researchers evaluated 17 of the preservatives most frequently consumed by NutriNet-Santé participants.
Eight were individually associated with greater hypertension risk: potassium sorbate, identified on European ingredient labels as E202; potassium metabisulphite, or E224; sodium nitrite, E250; ascorbic acid, E300; sodium ascorbate, E301; sodium erythorbate, E316; citric acid, E330; and extracts of rosemary, E392.
Ascorbic acid was also specifically associated with increased cardiovascular disease risk in the analysis.
The additives fall into categories that perform different functions in foods.
Non-antioxidant preservatives are commonly used to inhibit microorganisms such as bacteria, yeast and mold that can cause food to spoil or potentially become unsafe.
Antioxidant preservatives are designed to slow oxidation. That process can alter a food’s appearance, flavor and chemical composition, causing products to brown, become rancid or develop undesirable tastes.
The findings do not establish that every use of the eight preservatives is harmful or that all preservatives carry the same risk. Researchers examined differences in exposure across a large population and compared those exposure levels with subsequent health outcomes.
The study also arrives amid wider research into other additives and highly processed foods.
A review covering more than a decade of research and published in Nutrients associated diets high in industrially formulated foods with an increased risk of Crohn’s disease.
Animal research published in Food Research International has separately examined xanthan gum, finding mild inflammation in the colon, changes in inflammatory markers and alterations in proteins involved in maintaining the intestinal barrier.
Those findings involve different additives, study designs and health outcomes and do not establish that all food additives have similar biological effects.
Researchers Examine Oxidative Stress and Metabolic Effects
The authors adjusted their statistical analysis for other factors that could influence cardiovascular risk, but they emphasized that the study’s observational design prevents researchers from establishing cause and effect.
“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,” Touvier said.
Oxidative stress occurs when reactive molecules accumulate faster than the body’s antioxidant defenses can control them. Persistent oxidative stress can damage cells and tissues and has been investigated as a contributor to numerous chronic diseases.
Researchers are also studying whether certain additives can alter pancreatic function.
The pancreas is central to glucose regulation and metabolism because it produces hormones including insulin. Changes affecting pancreatic function could therefore have consequences extending beyond digestion.
Touvier’s research group is now examining several biological pathways that might help explain observed associations between processed foods, additives and disease. Areas under investigation include inflammation, oxidative stress, blood metabolic profiles and the gut microbiota.
The gut microbiota consists of bacteria and other microorganisms inhabiting the digestive system. Researchers increasingly are studying whether changes to that microbial community can affect inflammation, metabolism and disease risk.
The authors again cautioned that identifying possible biological mechanisms does not prove those mechanisms explain the cardiovascular associations found in their population study.
Other Additives Have Drawn Metabolic Scrutiny
Previous research has examined whether individual food preservatives may affect glucose metabolism.
Scientists in Israel and the United States studied propionate using both animal experiments and human clinical research and reported that exposure could promote insulin resistance, a metabolic condition strongly associated with Type 2 diabetes.
Other research has focused on combinations of additives rather than single ingredients.
Studies of additive mixtures found in ultra-processed foods have reported associations with increased Type 2 diabetes risk, including among people whose broader diets otherwise contained healthful foods.
Researchers have also investigated whether combinations of additives can alter intestinal bacteria, interfere with cellular processes or damage DNA at exposure levels intended to reflect real-world consumption patterns.
Those studies do not establish that every processed food or additive produces those outcomes, but they have contributed to increased scientific attention on the cumulative effects of multiple ingredients consumed repeatedly over time.
Researchers Call for Regulatory Review
Touvier said the new cardiovascular findings warrant additional examination by food-safety regulators.
She said the results suggest authorities including the European Food Safety Authority and U.S. Food and Drug Administration should reassess the balance of risks and benefits associated with the additives to strengthen consumer protection.
The researchers also said their findings reinforce existing dietary recommendations favoring unprocessed or minimally processed foods and limiting unnecessary food additives.
Health professionals have a role in helping consumers understand those recommendations without interpreting the observational evidence as proof that an individual preservative will cause disease, according to Touvier.
That distinction is particularly important because several substances identified in the research have familiar nutritional or food-related uses in addition to functioning as preservatives.
Ascorbic acid, for example, is vitamin C, while citric acid occurs naturally in citrus fruits and numerous other foods. The study examined exposure to those compounds when used and recorded as food additives rather than concluding that naturally occurring vitamin C or citric acid in whole foods produces the same risk.
The amount, source, formulation and broader dietary context of an ingredient can affect exposure and make conclusions about individual foods more complicated than the additive names alone suggest.
Findings Reinforce Focus on Minimally Processed Diets
The preservative study adds to a larger body of nutritional research examining the differences between diets centered on whole foods and those containing substantial quantities of heavily processed products.
Traditional nutrition guidance has generally favored increasing foods in their whole or minimally processed forms while reducing highly refined foods and products containing numerous artificial or chemical additives.
Guidance cited in the source material likewise recommends choosing more traditionally prepared foods and fewer artificially or chemically processed products while increasing consumption of foods in their whole form.
Cardiovascular nutrition recommendations have also frequently emphasized minimizing highly processed foods because many contain substantial amounts of sodium, added sugars and certain fats in addition to preservatives.
Sinatra has similarly argued that whole foods are preferable for people attempting to control hypertension because highly processed products can contain combinations of sodium, sugar, chemical preservatives, trans fats and polyunsaturated vegetable oils.
The new French findings do not demonstrate that avoiding the eight preservatives will prevent hypertension, nor do they establish preservatives as the explanation for cardiovascular disease among individual participants.
Instead, the study found statistically higher rates of hypertension and cardiovascular disease among people with greater exposure to certain preservative categories and identified eight individual additives associated with hypertension.
Researchers said additional studies are needed to determine whether those relationships are causal, establish the biological mechanisms involved and clarify whether regulatory limits or dietary recommendations should change.
Until that evidence develops, the authors said their findings support an existing recommendation rather than a new treatment: favor foods that are unprocessed or minimally processed and avoid unnecessary additives where practical.
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