A series of observational studies published in the European Heart Journal, BMJ, and Nature Communications has identified associations between common food preservatives and an increased risk of hypertension, cardiovascular disease, type 2 diabetes, and certain cancers.
The research, based on data from the French NutriNet-Santé study, analyzed the dietary habits and health outcomes of over 100,000 participants. Researchers emphasize that the studies are observational and cannot prove causation, but the findings have prompted calls for regulatory re-evaluation.
Study Methodology and Scope
The research was led by Dr. Mathilde Touvier and Anaïs Hasenböhler from INSERM and the Nutritional Epidemiology Research Team at Université Sorbonne Paris Nord and Université Paris Cité.
- Data Source: The studies analyzed data from the French NutriNet-Santé cohort, a large-scale nutritional epidemiology project tracking over 170,000 participants since 2009.
- Participants: The specific studies included between approximately 105,000 and 112,000 adult volunteers who were free of the target diseases at the start of the follow-up period.
- Dietary Assessment: Participants reported their dietary intake at regular intervals, typically every six months, using detailed 24-hour food records or three-day food diaries.
- Analysis: Researchers analyzed the ingredient lists of all reported food and drink items, including specific preservatives. The total intake of 58 preservatives was assessed, with a detailed analysis of 17 individual preservatives consumed by at least 10% of participants.
- Follow-up: Health tracking lasted an average of seven to eight years for the cardiovascular study and up to 14 years for the cancer study.
- Exposure: 99.5% of volunteers consumed at least one food preservative within the first two years of the study.
Associations with Hypertension and Cardiovascular Disease
A study published in the European Heart Journal on 21 May 2026 found that higher consumption of certain preservative groups was associated with an elevated risk of high blood pressure (hypertension) and cardiovascular disease.
Participants who consumed the largest amounts of non-antioxidant preservatives had a 29% higher risk of hypertension and a 16% higher risk of cardiovascular disease (including heart attacks and stroke) compared to those who consumed the least.
- Non-Antioxidant Preservatives: A 29% higher risk of hypertension and a 16% higher risk of cardiovascular disease.
- Antioxidant Preservatives: A 22% higher risk of hypertension.
- Specific Preservatives Linked to Hypertension: The following eight preservatives were specifically associated with higher blood pressure:
- Potassium sorbate (E202)
- Potassium metabisulphite (E224)
- Sodium nitrite (E250)
- Ascorbic acid (E300)
- Sodium ascorbate (E301)
- Sodium erythorbate (E316)
- Citric acid (E330)
- Extracts of rosemary (E392)
- Ascorbic Acid and Cardiovascular Disease: The additive form of ascorbic acid (E300) was also specifically linked to an increased risk of cardiovascular disease. Researchers noted that naturally occurring ascorbic acid in fruits and vegetables may not have the same effect.
Associations with Type 2 Diabetes
A study published in Nature Communications found that higher intake of food preservatives was associated with an increased incidence of type 2 diabetes.
Higher total preservative intake was associated with a 47% increased incidence of type 2 diabetes.
- Overall Intake: A 47% increased incidence of type 2 diabetes.
- Non-Antioxidant Preservatives: A 49% increased incidence.
- Antioxidant Preservatives: A 40% increased incidence.
- Individual Preservatives: Of the 17 individual preservatives examined, higher consumption of 12 was associated with an increased risk. These included potassium sorbate, potassium metabisulfite, sodium nitrite, acetic acid, sodium acetate, and calcium propionate. Antioxidant additives linked to an increased risk included alpha-tocopherol, sodium ascorbate, rosemary extracts, sodium erythorbate, phosphoric acid, and citric acid.
Associations with Cancer
A study published in the BMJ found no overall link between total preservative consumption and cancer incidence, but several individual preservatives were associated with increased risks.
- Overall Findings: Of the 17 preservatives analyzed in detail, 11 showed no association with cancer. However, higher consumption of six specific preservatives was correlated with increased cancer risk.
- Specific Preservatives and Cancer Risk:
- Sodium nitrite: A 32% increased risk of prostate cancer.
- Potassium nitrate: A 13% increased risk of all cancers and a 22% increased risk of breast cancer.
- Sorbates (e.g., potassium sorbate): A 14% increased risk of all cancers and a 26% increased risk of breast cancer.
- Potassium metabisulfite: An 11% increased risk of all cancers and a 20% increased risk of breast cancer.
- Acetates (e.g., sodium acetate): A 15% increased risk of all cancers and a 25% increased risk of breast cancer.
- Acetic acid: A 12% increased risk of all cancers.
- Erythorbates (e.g., sodium erythorbate): A 12% increased risk of all cancers and a 21% increased risk of breast cancer.
Limitations and Researcher Remarks
The authors of the studies have noted several important caveats to the findings.
- Observational Nature: All studies are observational, meaning they can identify correlations but do not establish direct cause-and-effect relationships.
- Controlled Factors: Researchers stated that they controlled for known risk factors such as age, BMI, smoking, physical activity, alcohol consumption, and overall diet quality. However, the potential influence of unmeasured confounding factors remains.
- Potential Mechanisms: Researchers hypothesized that certain preservatives may cause oxidative stress, affect pancreatic function, or modify immune and inflammatory pathways, which could contribute to disease development.
- Calls for Re-evaluation: Dr. Mathilde Touvier stated that the results suggest a need for re-evaluation of risks and benefits by regulatory authorities such as the European Food Safety Authority (EFSA) and the U.S. Food and Drug Administration (FDA) for better consumer protection.
- Recommendations: Researchers and experts involved in the studies support existing dietary recommendations to favor fresh or minimally processed foods. Frozen options preserved by low temperature were cited as a potential alternative to products preserved with chemical additives.