A study from France has found that common preservatives used in a number of store-bought foods to kill bacteria and mould were linked to a 29% greater risk of elevated blood pressure and a 16% higher risk of heart attacks and stroke, reports CNN.
Even so-called “natural” antioxidant preservatives used to stop discolouration, like citric acid and ascorbic acid (widely known as vitamin C), led to a 22% greater risk of high blood pressure in people who ate more foods with those ingredients, the research, published in the European Heart Journal, found.
While antioxidants such as citric and ascorbic acid are found naturally in fruits, for example, they are “not exactly natural” when used as preservatives, senior author Mathilde Touvier said. Touvier is the principal investigator of the NutriNet-Santé study used to conduct the research.
“Naturally occurring ascorbic acid and added ascorbic acid, which may be chemically manufactured, might have different impacts on health,” said Touvier, who is also director of research at France’s National Institute of Health and Medical Research in Paris.
“Thus, the results observed here for these food additives are not true for natural substances found in fruits and vegetables,” she added.
Not only ultra-processed foods
The study sheds light on how different additives in ultra-processed foods, or UPFs, could play a role in cardiovascular risk, and “echo the recent European Society of Cardiology consensus, which highlights UPFs as a global public health concern”, said Tracy Parker, nutrition lead at the British Heart Foundation in London. Parker was not involved in the study.
Ultra-processed foods have been linked to a 50% higher risk of cardiovascular disease-related death, and may boost the risk of obesity by 55%, sleep disorders by 41% and the development of type 2 diabetes by 40%. Obesity, diabetes and poor sleep are closely connected to poor heart health.
“This is one of the first large studies to look at individual preservatives rather than treating ultra-processed foods as a single category,” Parker said. “UPFs have long raised concerns due to their high levels of sugar, salt and fat, but these factors alone have never fully explained why they appear more harmful than their nutrient profile suggests. These findings help fill part of that gap.”
However, previous research by Touvier and her team found ultra-processed foods make up only 35% of foods with preservatives people consumed. “That means preservatives are ubiquitous,” said lead author Anaïs Hasenböhler, a doctoral student at the Nutritional Epidemiology Research Team at the Université Sorbonne Paris Nord.
“There is no food group/item to remove from the diet in order to fix things,” Hasenböhler said. “These results also support the recommendations for consumers to favour non-to-minimally-processed foods.”
Choose fresh, uncooked, unprocessed items, or if looking for the fastest to prepare and eat, choose frozen options which are preserved through a low temperature, not necessarily through the addition of food additive preservatives, she recommended
More ‘natural’ preservatives associated with risk
The study investigated the impact of 58 preservatives on the cardiovascular health of more than 112 000 people over 15. All are participating in NutriNet-Santé, which has analysed the diets of volunteers from across France since 2009.
To be in the study, each participant tracks every bite of their food and drink by brand name for three days every six months. Researchers then use a database of product ingredients to identify common preservatives and compare levels of consumption over years with medical data stored in the French national healthcare system.
Researchers scrutinised 17 preservatives consumed by at least 10% of the participants and found eight were associated with higher blood pressure over the next decade. Three of those – potassium sorbate, potassium metabisulphite and sodium nitrite – are “non-antioxidant” preservatives, which means they kill bacteria, moulds and yeast that spoil foods.
Potassium sorbate is often used in wine, baked goods, cheeses and sauces. Potassium metabisulphite, which releases sulphur dioxide when dissolved, is found in wine, juice, cider, beer and other fermented beverages. Sodium nitrite is a chemical salt commonly used in processed meats like bacon, ham and deli meats.
Nitrates and sulphur-based compounds are found in foods like red and processed meats, already known to increase the risk of heart disease. Therefore, that finding should not be surprising, some experts say.
In addition, preservatives are needed if consumers want to continue to buy foods they can store and eat later, according to Gunter Kuhnle, a Professor of Food and Nutritional Science at the University of Reading, England. He was not involved in any of the studies.
“Preservatives have an important role in the food system, not only by preventing food-borne diseases, but also by preventing spoilage, reducing food waste and extending shelf life,” he said.
The remaining preservatives linked to high blood pressure in the study – ascorbic acid, sodium ascorbate, sodium erythorbate, citric acid and extracts of rosemary – are so-called natural “antioxidant” preservatives, used to reduce oxidation that turns foods brown and rancid.
Ascorbic acid, or vitamin C, was also specifically linked to cardiovascular disease, the study found. Similar preservatives also linked to cancer, type 2 diabetes
The results support the findings of two other studies by Touvier and her team which found similar links between preservatives and a much higher risk of cancer and type 2 diabetes.
Six preservatives – sodium nitrite, potassium nitrate, sorbates, potassium metabisulphite, acetates and acetic acid – were linked to up to a 32% higher risk of prostate cancer, breast cancer and cancer of all kinds.
All but one of those same preservatives also boosted the risk of developing type 2 diabetes by 49%.
While the findings of the new research are observational and cannot prove cause and effect, the study did a good job of controlling for other factors that may influence health, such as age, body mass index or BMI, smoking, physical activity and diet in general, said Rachel Richardson, a methods support unit manager for The Cochrane Collaboration, an international non-profit highly respected for its scientific approach to research. She was not involved in the study.
“Other strengths of this study include the way in which they assessed people’s diets and their comprehensive approach to identifying hypertension and cardiovascular disease,” said Richardson.
“Although they cannot prove causation, there are signals in the results that warrant further investigation.”
Study details
Preservative food additives, hypertension, and cardiovascular diseases: the NutriNet-Santé study
Anaïs Hasenböhler, Guillaume Javaux, Marie Payen de la Garanderie et al.
Published in European Heart Journal on 20 May 2026
Abstract
Background and Aims
Experimental studies suggest that some preservative food additives may exert adverse cardiovascular effects, yet human data are lacking. The associations between exposure to these compounds and incidence of hypertension and cardiovascular diseases (CVD) were investigated in the NutriNet-Santé cohort (France, 2009–2024).
Methods
Dietary intakes were assessed using repeated 24-h dietary records (up to 96), including commercial brands. Exposure to food additives was evaluated through multiple composition databases and ad hoc laboratory assays in food matrices. Associations between cumulative time-dependent exposures to preservative food additives during follow-up and outcomes were characterised using multi-adjusted Cox models.
Results
Overall, 112 395 participants were included (78.7% women, mean age 42.8 ± 14.7 years) with a median follow-up of 7.9 years. The sum of total preservatives encompassed 58 substances consumed by at least one participant. Total non-antioxidant preservatives were positively associated with higher incidences of hypertension [n = 5544; hazard ratio (HR) higher vs. lower consumers: 1.29, 95% confidence interval (CI) 1.20–1.39] and CVD (n = 2450; HR 1.16, 95% CI 1.04–1.29), while total antioxidant preservatives were associated with higher incidence of hypertension (HR 1.22, 95% CI 1.13–1.31). Out of the 17 individual preservative food additives consumed by at least 10% of the study population, eight were associated with higher incidence of hypertension and one with higher incidence of CVD, after multiple test correction.
Conclusions
Multiple associations between exposure to preservative food additives widely used in industrial foods and higher incidence of hypertension or CVD were observed in this large prospective cohort. Experimental research is needed to gain insight into underlying mechanisms. If confirmed, these new data call for the re-evaluation of regulations governing the use of these additives to improve consumer protection.
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