The comprehensive research was spearheaded by Dr. Mathilde Touvier, a distinguished research director at INSERM, the French National Institute for Health and Medical Research, alongside Anaïs Hasenböhler, a dedicated PhD student. Both lead investigators operate out of the Nutritional Epidemiology Research Team at Université Sorbonne Paris Nord and Université Paris Cité in France.
Preservatives are widely integrated into the manufacturing of commercial food products for a variety of functional reasons. Primarily, they are utilized to prevent the hazardous growth of bacteria and mold, slow the natural spoilage of perishable ingredients, and help packaged items maintain their original color, flavor, and consumer-facing freshness for much longer periods. Because these chemical agents are so profoundly embedded in the global food supply, researchers sought to better understand whether long-term, cumulative exposure could pose hidden risks to human cardiovascular health over the course of a lifetime.
Ms. Hasenböhler highlighted the sheer scale of exposure in modern diets, noting that food preservatives are routinely deployed across hundreds of thousands of industrially processed foods found on standard grocery store shelves. While previous experimental studies have occasionally suggested that certain preservative food additives might exhibit harmful properties regarding human cardiovascular health, public health officials have historically lacked robust, large-scale epidemiological evidence tracking the real-world impact of these ingredients in human populations. To the knowledge of the research team, this represents the first investigation of its kind to comprehensively examine the epidemiological links between a wide array of chemical preservatives and long-term cardiovascular health outcomes.
Tracking Diet and Heart Health in More Than 112,000 People
The groundbreaking work was conducted as a core component of NutriNet-Santé, a large, ongoing, and highly respected research initiative designed to examine the complex connections between daily nutrition and long-term human health. The rigorous analysis incorporated data gathered from an impressive cohort of 112,395 adult volunteers living across France, representing a diverse cross-section of the population.
To capture dietary habits with exceptional precision, participants were instructed to record every single item they ate and drank during rigorous three-day monitoring periods, repeated systematically every six months. This meticulous methodology provided researchers with unusually detailed information regarding actual dietary intake, moving far beyond the broad and often unreliable estimates of food consumption typically utilized in lesser nutritional studies.
Following the dietary logging phase, the research team conducted a deep compositional analysis of the specific ingredients contained within those recorded foods and beverages, cross-referencing every item with a comprehensive database of food preservatives. Participants were then followed over an average period of seven to eight years. During this extensive follow-up window, researchers carefully tracked medical records to determine whether volunteers developed high blood pressure or serious cardiovascular diseases, including clinical heart attacks, strokes, and angina.
The data revealed that exposure to preservatives was practically universal among the study participants. During the initial two years of participation, an astounding 99.5 percent of the volunteers consumed at least one food preservative through their regular diets.
Higher Preservative Intake Linked to Higher Risk
When the researchers analyzed the correlation between consumption levels and health outcomes, the strongest and most concerning statistical associations appeared among individuals who consumed the largest amounts of specific categories of preservatives.
Participants who reported the highest overall intake of ‘non-antioxidant’ preservatives exhibited a 29 percent higher risk of developing hypertension, commonly known as high blood pressure, compared to those consuming the lowest amounts. Furthermore, this same high-consumption group demonstrated a 16 percent higher risk of developing broader cardiovascular disease, a composite measure that encompassed heart attacks, strokes, and angina episodes.
The data also highlighted risks associated with other chemical classes. Individuals who consumed the greatest amounts of antioxidant preservatives experienced a 22 percent higher risk of developing hypertension over the course of the study.
These two distinct categories of additives protect food products through fundamentally different biochemical mechanisms. Non-antioxidant preservatives are generally deployed by food manufacturers to prevent potentially harmful microorganisms, including destructive bacteria and mold, from colonizing and spoiling the product. Conversely, antioxidant preservatives are utilized to slow down oxidation, a chemical process that can naturally cause foods to turn brown, develop unpleasant off-flavors, or become rancid.
Eight Common Preservatives Stood Out
To drill down into specific ingredients, the research team analyzed 17 of the most commonly consumed preservatives found within the participants’ dietary logs. Out of this broader group, eight specific compounds stood out because they were individually associated with a statistically significant higher risk of high blood pressure.
The compounds linked to elevated hypertension risk included potassium sorbate, chemically designated as E202; potassium metabisulphite, known as E224; sodium nitrite, classified as E250; ascorbic acid, or E300; sodium ascorbate, designated as E301; sodium erythorbate, known as E316; citric acid, classified as E330; and extracts of rosemary, designated as E392. Among these, ascorbic acid, or E300, was also specifically singled out for its independent association with an increased risk of broader cardiovascular disease.
Despite these striking statistical correlations, the study authors emphasize that these findings do not definitively mean that consuming a single serving of any of these common ingredients will directly cause high blood pressure or heart disease. The research was fundamentally observational in nature, meaning it successfully identified clear statistical associations within a large population cohort rather than executing a controlled clinical trial to prove that preservatives were directly and solely responsible for the observed health risks.
Dr. Touvier elaborated on these methodological nuances, noting that while the study carries inherent limitations typical of large-scale observational designs, the findings are nevertheless built upon exceptionally detailed dietary data. She stressed that the research team carefully accounted for a wide array of confounding factors—such as overall lifestyle, socioeconomic status, and other dietary variables—that are known to either increase or lower an individual’s baseline risk of cardiovascular disease. Moreover, she pointed out that experimental research available in the broader scientific literature has consistently suggested that various preservatives may induce oxidative stress within the human body or negatively affect the normal functional capacity of the pancreas.
According to Dr. Touvier, these cumulative results suggest an urgent need for a formal re-evaluation of the risks and benefits associated with these widely used food additives by the relevant regulatory authorities in charge of public health, such as the European Food Safety Authority in Europe and the Food and Drug Administration in the United States, in order to ensure more robust consumer protection. In the meantime, the study’s findings strongly reinforce existing public health recommendations that advise consumers to favor fresh, unprocessed, and minimally processed foods while actively avoiding unnecessary chemical additives wherever possible. Furthermore, the authors note that practicing physicians, dietitians, and other healthcare professionals play a vital frontline role in effectively communicating these nutritional recommendations to the general public.
Why Preservatives Might Affect the Body
To understand the biological mechanisms driving these epidemiological findings, researchers are actively investigating several compelling hypotheses regarding how food preservatives might interact with human physiology. One prominent explanation centers on the concept of oxidative stress. This physiological state occurs when reactive oxygen species and free radicals accumulate within the body at a rate faster than natural protective antioxidant systems can neutralize them, potentially leading to chronic, cumulative damage to cells, blood vessels, and tissues over time.
In addition to oxidative stress, scientific teams are closely investigating whether certain preservatives might directly influence pancreatic function. The pancreas plays a central, indispensable role in regulating human blood sugar levels, insulin production, and broader systemic metabolism, meaning that even subtle alterations in its cellular function could trigger cascading metabolic effects throughout the entire body.
Building upon these current insights, the research team is already expanding their investigative efforts. They are actively studying how various food additives and broader ultra-processed foods may influence systemic inflammation, oxidative stress markers, the metabolic profile circulating in the blood, and the complex ecosystem of the human gut microbiota.
The gut microbiota refers to the vast, intricate community of trillions of bacteria, fungi, and other microorganisms that reside within the human digestive tract. In recent years, these resident microbes have become the focus of intense scientific scrutiny due to their increasingly apparent roles in regulating human metabolism, modulating immune system responses, and influencing long-term cardiovascular health.
By systematically examining these complex biological pathways and cellular changes, researchers hope to gain a much clearer picture of why long-term exposure to certain chemical additives is associated with a heightened risk of chronic disease, and whether the preservatives themselves are actively contributing to those adverse health effects. As nutritional science continues to evolve, findings from large-scale projects like the NutriNet-Santé cohort provide vital data to help guide both future regulatory policies and everyday dietary choices.
