Looking at It is common to see names such as “potassium sorbate”, “citric acid” and “L-ascorbic acid (vitamin C)” on ingredient labels on supermarket shelves. These substances are food additives used to prevent spoilage and maintain quality. They are widely used in industrially produced processed foods. According to Open Food Facts, the world’s largest open food database, over 20 percent of processed foods and drinks in its database contain at least one preservative.
In this context, a research team led by scientists from the Sorbonne Paris Nord and Université Paris Cité universities analyzed data from the large-scale NutriNet-Santé cohort testwhich followed 112,395 participants for a median of 7.9 years to examine the association between dietary preservative intake and the risk of developing hypertension and cardiovascular disease.
“Experimental studies suggest that some preservative food additives may be harmful to cardiovascular health, but we do not have enough evidence on the effects of these ingredients in humans,” said Anaïs Hasenböhler, a PhD student who led the study, in press release. “To our knowledge, this is the first study of its kind to examine the links between a wide range of preservatives and cardiovascular health.”
8 preservatives linked to hypertension risk
Scientists have divided preservatives into two broad categories. The first consisted of non-antioxidant preservatives such as sorbates, nitrites and sulfites, which inhibit the growth of molds and bacteria. The second contained antioxidant preservatives including ascorbic acid, citric acid and erythorbatans, which prevent food from oxidizing and discoloring. According to the researchers, almost every participant (99.5%) consumed at least one preservative during the first two years of the study.
The analysis found that participants consuming the highest intake of non-antioxidant preservatives had a 29% higher risk of developing hypertension compared to those consuming the lowest intake. They also had a 16 percent greater risk of overall cardiovascular disease, including heart attack, stroke and angina. Participants who consumed the most antioxidant preservatives also had a 22% higher risk of hypertension.
The researchers also individually examined the 17 most commonly consumed preservatives. Of these, eight were associated with an increased risk of hypertension: potassium sorbate (E202), potassium metabisulfite (E224), sodium nitrite (E250), ascorbic acid (E300), sodium ascorbate (E301), sodium erythorbate (E316), citric acid (E330) and rosemary extract (E392). Among them, ascorbic acid was also associated with an increased risk of cardiovascular disease.
During the observation period, researchers recorded 5,544 cases of hypertension and 2,450 cases of cardiovascular disease, including 1,142 cerebrovascular events and 1,308 cases of coronary artery disease. The study also found that about 16 percent of the association between non-antioxidant preservatives and cardiovascular disease was indirectly mediated by hypertension. In other words, the findings suggest that preservatives may contribute to the development of hypertension, which in turn may enhance the risk of cardiovascular disease.
Calls for a reassessment of food additive regulations
Scientists emphasize that these findings come from observational studies and do not establish a causal relationship between food preservatives and hypertension or cardiovascular diseases. The study also has significant limitations. Women made up 78.7% of participants, and the cohort included a relatively high proportion of people with higher education, meaning it does not perfectly represent the general population.
Nevertheless, the statistical models accounted for a wide range of potential confounders, and the results remained consistent across multiple sensitivity analyses.
“These results suggest that we need a reassessment of the risks and benefits of the use of these food additives by competent authorities such as EFSA in Europe and FDA in the US to better protect consumers,” Mathilde Touvier, research director at France’s National Institute of Health and Medical Research, said in a press release. “In the meantime, these findings support existing recommendations to favor unprocessed and minimally processed foods and avoid unnecessary additives.”
The possibility that preservatives long considered safe and sound could impact cardiovascular health raises significant questions about current regulatory approaches. With additives consumed continuously in many foods without numerical limits on their exploit, the findings suggest it may be time to reopen the debate on whether existing regulations are adequate.
This story originally appeared on WIRED Japan and was translated from Japanese.