Researchers Linked These 8 Food Ingredients to Higher Heart Disease Risk

Food additives are used for a reason—they help keep products shelf-stable and safe to eat. But new research ties eight common food preservatives to high blood pressure.

The study, which was published in the European Heart Journal, tracked more than 112,000 participants in France over several years. Every six months, the participants answered questions about what they ate and drank during a three-day period, so the researchers could determine which preservatives they consumed, and in what amounts. At the same time, the participants’ health was also monitored for cardiovascular complications, including high blood pressure.

When they drilled into the data, researchers found that participants who ingested the highest levels of non-antioxidant preservatives—ingredients used to prevent the growth of microbes—had a 29% higher risk of being diagnosed with high blood pressure compared to those who took in the lowest levels of these preservatives. These participants also had a 16% higher risk of heart attack and stroke.

Meet the experts: Cheng-Han Chen, M.D., interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center; Scott Keatley, R.D., co-owner of Keatley Medical Nutrition Therapy; Katherine N. Balantekin, Ph.D., R.D., assistant professor in the Department of Exercise and Nutrition Sciences at the University at Buffalo; Anaïs Hasenböhler, lead study author and Ph.D. student with the Nutritional Epidemiology Research Team at the French National Institute for Health and Medical Research; Mathilde Touvier, Ph.D., study co-author and head of the Nutritional Epidemiology Research Team at the French National Institute for Health and Medical Research

Meanwhile, those who consumed the highest levels of antioxidant preservatives—ingredients designed to keep food from spoiling or turning brown—had a 22% higher risk of developing high blood pressure.

Researchers also learned that preservatives were remarkably common in participants’ diets. During their first two years in the study, 99.5% of participants consumed something with at least one preservative.

While this new research doesn’t prove that the preservatives caused the increased risk of developing high blood pressure, experts say the link is worth exploring further. Here’s why.

Which food preservatives are concerning?

The study linked eight common food preservatives with a higher risk of high blood pressure:

• potassium sorbate
• potassium metabisulphite
• sodium nitrite
• ascorbic acid
• sodium ascorbate
• sodium erythorbate
• citric acid
• rosemary extract

The study also flagged ascorbic acid for its link to cardiovascular disease.

What’s behind the link?

Experts believe there are likely a few things going on here. It’s possible that both the preservatives themselves and the foods they’re in are raising the risk of high blood pressure, says Katherine N. Balantekin, Ph.D., R.D., assistant professor in the Department of Exercise and Nutrition Sciences at the University at Buffalo. “These preservatives tend to be found in shelf-stable, ultra-processed foods, which tend to be higher in added fats, sugar, and sodium,” she says. Those ingredients in and of themselves are associated with a higher risk of high blood pressure and cardiovascular disease.

But certain preservatives may raise inflammation levels, increase oxidative stress (an imbalance of unstable molecules in the body linked to chronic conditions), impact the function of blood vessels, or alter the gut microbiome. Any of those effects would impact blood pressure regulation, says Scott Keatley, R.D., co-owner of Keatley Medical Nutrition Therapy. “Nitrites, for example, have been linked to oxidative damage in laboratory studies,” he says.

Regularly eating ultra-processed foods, which often contain these preservatives, is also linked to a higher risk of type 2 diabetes. And as Anaïs Hasenböhler—lead study author and Ph.D. student with the Nutritional Epidemiology Research Team at the French National Institute for Health and Medical Research—notes, “Type 2 diabetes is indeed also a risk factor for cardiovascular health [issues].”

“But, ultimately, we don’t really know what’s behind this association,” says Cheng-Han Chen, M.D., interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, California. “It’s probably a combination of all of these factors.”

What does a heart-healthy diet look like?

“The practical takeaway isn’t that consumers need to memorize additive names,” Keatley says. “This study adds to growing evidence that diets centered on minimally processed foods are associated with better cardiovascular health.”

To support your heart health through diet, Dr. Chen suggests limiting your intake of highly processed foods and focusing on whole foods. “We recommend plenty of fruits and vegetables, whole grains, lean proteins, and less saturated fats,” Dr. Chen says, adding that those particularly concerned with high blood pressure could try a lower-sodium diet. (The American Heart Association recommends that most adults have no more than 2,300 milligrams of sodium a day, with an ideal limit of no more than 1,500 milligrams per day, especially if you have high blood pressure.)

While you’re at it, Keatley recommends loading up on potassium-rich fruits and vegetables like bananas, oranges, potatoes, leafy greens, beans, and lentils, since potassium has blood pressure-lowering effects.

“If you are to purchase vegetables, it is recommended for you to look for fresh, uncooked, unprocessed items, or if you are looking for the fastest to prepare and eat, to favor frozen options which are preserved through a low temperature, not necessarily through the addition of food additive preservatives,” says Mathilde Touvier, Ph.D., study co-author and head of the Nutritional Epidemiology Research Team at the French National Institute for Health and Medical Research.