Food Preservatives: New Study Links Higher Intake to Increased Hypertension Risk

Food preservatives play an important role in today’s food supply, helping extend shelf life, maintain freshness and reduce food waste. They’re found in everything from packaged breads and cured meats to ready-made meals, condiments and snack foods. While many preservatives have been evaluated for safety at approved levels, researchers continue to investigate whether regularly consuming foods high in preservatives may have long-term health effects.

One area receiving growing attention is cardiovascular health, particularly blood pressure.

Hypertension affects nearly half of U.S. adults and is one of the leading risk factors for heart disease, stroke and kidney disease. Although excess sodium, obesity, inactivity and genetics are well-established contributors, scientists are increasingly examining whether other components of processed foods may also influence blood pressure.

A new study published in the European Heart Journal adds to this conversation by exploring whether people who consume more food preservatives have a greater likelihood of developing hypertension over time. Rather than examining just one preservative, researchers evaluated overall exposure to multiple commonly consumed food preservatives using detailed dietary data and followed participants for years to determine whether higher intake was associated with increased hypertension risk.

Here’s what the study found and what it may mean for your health.

Ad

Preservatives in food and hypertension study

Researchers conducted a large prospective cohort study to investigate whether dietary exposure to food preservatives was associated with the future development of hypertension.

The analysis included adults participating in the French NutriNet-Santé cohort, an ongoing population-based nutrition study designed to examine relationships between diet and long-term health. Participants completed repeated 24-hour dietary records throughout follow-up, allowing investigators to estimate exposure to food additives, including preservatives, from thousands of commercially available foods.

Rather than relying on broad estimates of processed food consumption, the researchers linked detailed dietary information with extensive food composition databases to calculate individual intake of specific preservatives. They then followed participants over time to identify new cases of hypertension.

The goal was to determine whether higher consumption of certain food preservatives, or combinations of preservatives, was associated with an increased risk of developing high blood pressure.

Researchers analyzed data from 112,395 adults participating in the French NutriNet-Santé cohort between 2009 and 2024. Participants had an average age of 42.8 years, 78.7 percent were women and they were followed for a median of 7.9 years.

During the study period, researchers documented:

• 5,544 new cases of hypertension
• 2,450 new cardiovascular disease (CVD) events, including:
  • 1,308 coronary heart disease cases
  • 1,142 cerebrovascular disease cases

Unlike many nutrition studies that estimate processed food intake, this investigation estimated exposure to 58 different preservative food additives using repeated 24-hour dietary records (up to 96 dietary recalls per participant), commercial brand information, food composition databases and laboratory analyses. Researchers focused on the 17 preservatives consumed by at least 10 percent of participants, allowing them to evaluate individual additives rather than simply grouping all processed foods together.

How the researchers measured preservative intake

To estimate preservative exposure as accurately as possible, investigators combined multiple sources of information, including:

• Participants’ repeated 24-hour dietary records
• National food composition databases
• Ingredient lists from branded food products
• Laboratory analyses when available

This approach enabled researchers to estimate intake of numerous approved food preservatives consumed through everyday foods rather than relying solely on food frequency questionnaires or assumptions based on processed food intake.

Participants were then categorized according to their estimated preservative intake, and statistical models accounted for numerous potential confounding factors, including demographic characteristics, lifestyle habits, overall diet quality, body weight and other variables known to influence blood pressure risk.

What the study found

During follow-up, researchers observed that greater exposure to several commonly consumed food preservatives was associated with a higher risk of developing hypertension.

Importantly, the associations differed among preservatives. Rather than suggesting that every approved preservative carries the same level of risk, the findings indicated that certain preservatives appeared to have stronger associations with incident hypertension than others.

The researchers also found that these associations remained after adjusting for many established hypertension risk factors, suggesting that preservative exposure itself may contribute independently to blood pressure risk, although additional research is needed.

Overall, the results support the possibility that long-term dietary exposure to specific food preservatives may play a role in hypertension development.

More specifically, participants with the highest intake of total food preservatives had a 24 percent higher risk of developing hypertension compared to those with the lowest intake.

Ad

When researchers separated preservatives into categories, the associations became even more pronounced.

Those consuming the greatest amounts of non-antioxidant preservatives had:

• 29 percent higher risk of hypertension
• 16 percent higher risk of cardiovascular disease
• 26 percent higher risk of coronary heart disease

Participants with the highest intake of antioxidant preservatives also experienced a significantly greater hypertension risk (22 percent higher risk of hypertension).

Key findings

Among the study’s major observations:

• Higher dietary exposure to certain food preservatives was associated with an increased risk of developing hypertension.
• Not all preservatives demonstrated the same associations, indicating that health effects may differ depending on the preservative.
• The relationships remained statistically significant after accounting for numerous dietary and lifestyle factors.
• The findings suggest that examining individual food additives, not simply ultra-processed foods as a whole, may provide additional insight into cardiovascular risk.

The researchers note that food additives have traditionally been evaluated individually for toxicological safety. However, people consume mixtures of additives every day, often over many years, and relatively little research has examined how long-term exposure to these substances may influence chronic diseases such as hypertension.

Which preservatives were associated with hypertension?

After adjusting for numerous dietary, lifestyle and cardiovascular risk factors (and correcting for multiple statistical comparisons), the researchers identified eight preservative groups or individual preservatives that remained significantly associated with a higher incidence of hypertension.

These included:

One preservative was also associated with cardiovascular disease after multiple-comparison correction: Ascorbic acid was associated with a 15 percent higher CVD risk.

Study strengths

The investigators highlighted several strengths of the research:

• Large prospective cohort with long-term follow-up
• Repeated dietary assessments over time
• Detailed estimation of preservative exposure using multiple databases
• Careful adjustment for many known hypertension risk factors
• Evaluation of real-world dietary exposure rather than isolated laboratory doses

These strengths help provide a more realistic picture of how preservative intake may relate to blood pressure risk in everyday life.

Study limitations

Like all observational research, this study cannot prove that food preservatives directly cause hypertension.

Other limitations include:

• Dietary intake was self-reported.
• Participants may have changed eating habits during follow-up.
• Residual confounding cannot be completely excluded despite extensive statistical adjustments.
• The findings show an association rather than a cause-and-effect relationship.

The authors emphasize that additional research, including mechanistic studies and further prospective investigations, is needed to better understand how specific preservatives might influence blood pressure regulation.

Researchers’ conclusion

The researchers concluded that higher dietary exposure to certain food preservatives was associated with an increased risk of developing hypertension.

They suggested these findings support continued investigation into the cardiovascular effects of food additives and indicate that considering specific food preservatives, not only overall processed food consumption, may help improve understanding of dietary factors that contribute to hypertension.

What this means for health

This study doesn’t prove that food preservatives directly cause high blood pressure, but it does add to a growing body of evidence suggesting that certain preservatives commonly found in processed foods may play a role in cardiovascular health.

Perhaps the most important takeaway is that researchers didn’t simply compare people who ate more ultra-processed foods with those who ate less. Instead, they estimated participants’ exposure to specific preservative additives using detailed dietary records, commercial food brands, ingredient databases and laboratory analyses.

This allowed them to examine whether individual preservatives were associated with hypertension independent of many other lifestyle and dietary factors.

Another notable finding is that not all preservatives were associated with increased risk. Of the 17 preservative additives consumed by at least 10 percent of participants, eight were linked with a higher incidence of hypertension, while one (ascorbic acid) was associated with a higher incidence of cardiovascular disease after statistical correction.

This suggests that evaluating preservatives individually may be more informative than treating all food additives as a single group.

It’s also worth noting that several additives identified in the study, including ascorbic acid (vitamin C) and citric acid, are compounds that naturally occur in fruits and vegetables. That does not mean eating oranges, lemons or other produce raises blood pressure.

Instead, the study evaluated these substances when used as food additives in industrially processed foods, where they may be consumed alongside sodium, refined carbohydrates, saturated fats and numerous other additives. The study was not designed to determine whether the observed associations were caused by the preservative itself, the foods containing it or another factor associated with higher preservative intake.

The authors cautioned that this was an observational cohort study, meaning it can identify associations but cannot establish cause and effect. Although the researchers adjusted for numerous confounding variables (including age, sex, body mass index, smoking, physical activity, alcohol intake, education, family history, energy intake, sodium intake and overall diet quality), it’s still possible that other unmeasured factors contributed to the results.

For consumers, the findings reinforce a practical message that many health organizations already recommend: Prioritize a diet centered on minimally processed foods while limiting heavily processed products that often contain multiple preservatives and other additives.

Even if future research ultimately determines that the preservatives themselves are not directly responsible, eating fewer highly processed foods generally supports better cardiovascular health.

The researchers also emphasized that experimental and mechanistic studies are now needed to determine whether these preservatives directly influence blood pressure regulation and, if so, how they do so. If future research confirms these findings, they suggest that current regulations governing preservative use may warrant re-evaluation.

Other potential issues with food preservatives

While the European Heart Journal study focused specifically on hypertension and cardiovascular disease, other research has investigated how certain food preservatives may affect different aspects of health. It’s important to remember that preservatives are a broad category of additives, and they don’t all behave the same way. Some have been studied extensively, while others have relatively limited long-term human data.

Here are several areas scientists continue to investigate.

1. May influence gut microbiome health

The trillions of bacteria that live in your digestive tract play important roles in digestion, immune function, metabolism and even cardiovascular health. Emerging research suggests that some food preservatives may alter the balance of beneficial and harmful microbes in the gut.

Laboratory and animal studies have found that certain preservatives, including sorbates, benzoates and sulfites, can inhibit bacterial growth. While that’s precisely why they’re effective at preventing food spoilage, researchers are also exploring whether regular dietary exposure could affect beneficial gut bacteria.

More human research is needed to determine whether typical dietary intake significantly alters the gut microbiome and whether any changes translate into meaningful health effects.

2. Some preservatives may promote oxidative stress

Oxidative stress occurs when the production of unstable molecules called free radicals exceeds the body’s antioxidant defenses. Chronic oxidative stress has been linked to aging and numerous chronic diseases.

Experimental research suggests that certain preservatives may increase markers of oxidative stress or inflammation under some conditions. However, these findings often come from laboratory or animal studies using doses that may not reflect typical human consumption.

Additional well-designed human studies are needed before firm conclusions can be drawn.

3. Some people are sensitive to sulfites

Sulfites are preservatives commonly used in foods, such as:

• Wine
• Dried fruit
• Shrimp
• Some condiments
• Certain baked goods

Most people tolerate sulfites without difficulty, but some individuals, particularly those with asthma, may experience sensitivity reactions, and some people may even have a sulfite allergy.

Possible symptoms can include:

• Wheezing
• Coughing
• Chest tightness
• Difficulty breathing
• Flushing
• Headache

Because of this known risk, sulfites must be declared on food labels when present above certain levels in many countries.

4. Nitrites and nitrates remain an area of active research

Nitrites are commonly added to processed meats, such as bacon, hot dogs, deli meats and sausages, to inhibit bacterial growth and preserve color.

Researchers have long studied nitrites because they can contribute to the formation of N-nitroso compounds, some of which have been associated with cancer risk under certain conditions.

It’s important to distinguish between:

• Added nitrites used as preservatives in processed meats
• Naturally occurring nitrates found in vegetables like spinach, arugula and beets

Vegetables provide numerous beneficial nutrients, antioxidants and phytochemicals that appear to counteract many of the concerns associated with processed meats. In fact, vegetable-derived nitrates have been associated with cardiovascular benefits in many studies.

5. Food preservatives often signal a more processed dietary pattern

Perhaps one of the biggest concerns isn’t any single preservative but rather what foods they typically appear in.

Many foods containing multiple preservatives are also more likely to be:

• High in sodium
• Rich in refined carbohydrates
• Lower in fiber
• Lower in potassium
• More calorie-dense
• Lower in vitamins, minerals and phytonutrients

This makes it difficult for researchers to completely separate the effects of preservatives from the overall nutritional quality of the foods they’re added to.

For this reason, most nutrition experts recommend focusing on your overall dietary pattern rather than trying to eliminate every preservative individually.

Ways to support blood pressure

Although no single food can prevent or treat hypertension, everyday dietary and lifestyle habits can have a meaningful impact on maintaining healthy blood pressure.

1. Eat more minimally processed foods

One of the simplest ways to reduce exposure to food preservatives is to build more meals around whole and minimally processed foods (aka eat a high blood pressure-friendly diet).

Examples include foods that help lower blood pressure, such as:

• Fresh vegetables
• Fresh fruit
• Beans and lentils
• Whole grains
• Plain yogurt
• Eggs
• Fish
• Poultry
• Nuts and seeds

These foods naturally provide fiber, potassium, magnesium and antioxidants that support overall cardiovascular health.

2. Increase potassium-rich foods

Potassium helps balance the effects of sodium and supports healthy blood pressure regulation.

Good potassium-rich foods include:

• Sweet potatoes
• White potatoes
• Bananas
• Avocados
• Spinach
• Swiss chard
• Beans
• Lentils
• Winter squash
• Coconut water (unsweetened)

People with kidney disease should speak with a healthcare provider before significantly increasing potassium intake.

3. Limit excess sodium

Many preserved and processed foods are also high in sodium, making label reading especially important.

Common high-sodium foods include:

• Processed meats
• Frozen meals
• Canned soups
• Fast food
• Salty snack foods
• Packaged sauces

Preparing more meals at home makes it easier to control sodium intake.

4. Prioritize regular physical activity

Exercise helps support healthy blood vessel function and overall cardiovascular health.

Aim for at least 150 minutes of moderate-intensity aerobic activity per week, along with muscle-strengthening exercises at least twice weekly.

5. Maintain a healthy weight

Even modest weight loss in people who are overweight can help support healthier blood pressure levels.

Rather than focusing on restrictive diets, aim for sustainable eating habits that emphasize nutrient-dense foods.

6. Get enough sleep

Poor sleep has been associated with elevated blood pressure and poorer cardiovascular health.

Adults should generally aim for seven to nine hours of quality sleep each night.

7. Manage chronic stress

Long-term stress may contribute to unhealthy lifestyle habits and temporary increases in blood pressure.

Helpful stress-management techniques include:

• Walking outdoors
• Meditation
• Deep breathing
• Yoga
• Journaling
• Spending time with friends and family

8. Read ingredient labels

If you’re trying to reduce preservative intake, checking ingredient lists can help.

Some commonly used food preservatives include:

• Potassium sorbate
• Sodium nitrite
• Sodium benzoate
• Potassium metabisulfite
• Calcium propionate
• Sorbic acid
• BHA
• BHT

Keep in mind that the presence of a preservative doesn’t necessarily mean a food is unhealthy. Looking at the overall nutrition facts and ingredient quality provides a more complete picture than focusing on one ingredient alone.

Frequently asked questions

What are food preservatives?

Food preservatives are natural or synthetic substances added to foods to help prevent spoilage caused by bacteria, mold, yeast or oxidation. They help extend shelf life, maintain food quality, and improve safety during storage and transportation. Common food preservatives include potassium sorbate, sodium benzoate, sodium nitrite, calcium propionate and sulfites.

Are food preservatives bad for you?

Not necessarily. Many food preservatives have been evaluated by regulatory agencies and are considered safe when used within approved limits. However, emerging research suggests that some preservatives may be associated with long-term health outcomes, including hypertension, although more studies are needed to determine whether these additives directly contribute to disease risk.

Which foods contain the most food preservatives?

Foods that commonly contain preservatives include:

• Processed meats
• Packaged breads and baked goods
• Frozen meals
• Chips and crackers
• Bottled sauces and dressings
• Soft drinks
• Candy
• Shelf-stable desserts
• Dried fruit
• Wine
• Some cheeses

The specific preservatives used vary depending on the product.

Can eating fewer processed foods reduce preservative intake?

Yes. Choosing more fresh or minimally processed foods naturally reduces exposure to many food preservatives. Examples include fresh fruits, vegetables, legumes, whole grains, plain dairy products, eggs, seafood and fresh meats instead of heavily processed packaged alternatives.

Should I avoid foods with preservatives altogether?

For most people, eliminating every food containing preservatives isn’t necessary or realistic. Instead, aim for an overall dietary pattern centered on minimally processed foods while treating heavily processed convenience foods as occasional choices. This approach not only reduces preservative intake, but also typically increases fiber, vitamins, minerals and beneficial plant compounds that support overall health.

Are natural preservatives healthier than artificial preservatives?

Not always. A preservative’s safety depends on its chemical properties, the amount consumed and how it’s used … not simply whether it’s considered “natural” or “synthetic.”

Some naturally derived preservatives have been associated with health concerns in certain contexts, while many synthetic preservatives have been extensively evaluated for safety. Researchers continue to study individual preservatives because their biological effects may differ.

Conclusion

• Food preservatives help keep many foods safe, fresh and shelf-stable, making them an important part of today’s food supply. At the same time, scientists continue to investigate whether long-term exposure to some preservatives may have unintended effects on health.
• The new European Heart Journal study adds important evidence to this discussion. After following more than 112,000 adults for nearly eight years, researchers found that higher dietary exposure to several commonly used food preservatives, including certain sorbates, sulfites, nitrites, ascorbates and erythorbates, was associated with an increased risk of developing hypertension. However, the study also showed that not every preservative was associated with increased risk, highlighting the importance of evaluating individual additives rather than treating all preservatives the same.
• Because the research was observational, it doesn’t prove that preservatives directly cause high blood pressure. Still, the findings support continued investigation into how specific food additives may influence cardiovascular health over time.
• For now, one of the most practical takeaways is also one of the simplest: Build your diet around whole and minimally processed foods whenever possible. Doing so naturally reduces exposure to many preservatives while increasing your intake of nutrients known to support heart health, including fiber, potassium, magnesium and antioxidants.
• As researchers continue to learn more about individual food preservatives, maintaining an overall healthy dietary pattern remains one of the best-supported strategies for promoting healthy blood pressure and long-term cardiovascular wellness.