Eight preservatives associated with higher risk of hypertension. Why is vitamin C also on the list?

Preservatives in processed foods, including some perceived as harmless, may have a greater impact on cardiovascular health than previously thought. The researchers point out that the problem is not limited to cured meats or ultra-processed foods, as risky substances can also be found in seemingly ordinary products, from packaged bread and sliced ​​cheeses to sauces, juices or wine.

According to a study recently published in the European Heart Journal, people who consume the highest amounts of antibacterial preservatives have a 29% higher risk of developing high blood pressure and a 16% higher risk of having a heart attack or stroke compared to people with the lowest consumption.

The research, made public on May 21, 2026, included 112,395 volunteers who were followed for almost eight years and revealed that including preservatives considered natural, such as ascorbic acid, known to the public as vitamin C, or citric acid, were associated with a 22% higher risk of hypertension.

The participants, aged over 15, wrote down everything they ate and drank for three days every six months. The team then analyzed the composition of the products and measured the consumption of 58 different preservatives, comparing it with medical data from the French health system.

According to the results, 99.5% of the volunteers had consumed at least one food preservative in the first two years of participation.

Eight Preservatives That Raise Blood Pressure

The researchers analyzed 17 preservatives consumed by at least 10% of the participants. Eight of them were associated with hypertension that occurred during the nearly eight years of follow-up:

• E202 (potassium sorbate): used in wine, cheeses, sauces, pastries;
• E224 (potassium metabisulphite): used in wine, juices, cider, beer and other fermented beverages;
• E250 (sodium nitrite): used in sausages, ham, bacon, salamis;
• E300 (ascorbic acid – vitamin C): used in various processed products, sausages, beverages;
• E301 (sodium ascorbate): used in sausages, processed meats;
• E316 (sodium erythorbate): used in processed meat, canned fish;
• E330 (citric acid): used in soft drinks, sweets, preserves;
• E392 (rosemary extracts): used in oils, fats, snacks.

Of the additives analyzed, industrially used ascorbic acid was specifically linked to cardiovascular disease, not just hypertension. The authors point out, however, that this observation is not related to vitamin C naturally present in foods such as oranges, bell peppers or kiwis.

“Ascorbic acid naturally present in food and added ascorbic acid, which can be produced chemically, may have different effects on health. The results observed here for these food additives do not apply to natural substances in fruits and vegetables,” emphasized Dr. Mathilde Touvier, director of research at the French National Institute of Health and Medical Research (INSERM) and study coordinator.

The same additives, also associated with diabetes and cancer

The new study adds to two other analyzes previously published by the same French team, based on data from the NutriNet-Santé cohort. Both looked at the link between food preservatives and the risk of chronic diseases.

In one study, six preservatives, including sodium nitrite, potassium nitrate, sorbates, potassium metabisulfite and acetates, were associated with up to a 32% higher risk of prostate cancer, breast cancer and cancer in general. Another analysis, performed on the same cohort, indicated an association between the same group of preservatives and a 49% higher risk of type 2 diabetes.

Rachel Richardson, manager in the methodological support unit of The Cochrane Collaboration, an organization known for the rigor of its scientific analyses, said the research “cannot prove causality, but there are signals in the results that merit further investigation”. The specialist appreciated the fact that the French team took into account factors such as age, body mass index, smoking, physical activity and the general quality of the diet.

How substances considered safe could affect blood pressure

Preservatives used in the food industry can be grouped into two categories. The first includes preservatives with no antioxidant effect, such as sodium nitrite or potassium sorbate, used to slow the growth of bacteria, molds and yeasts that spoil food. The second category is that of antioxidants, such as ascorbic acid, citric acid or rosemary extracts, added to prevent oxidation, color change and rancid taste.

Experimental studies indicate two possible mechanisms. The first is oxidative stress, that is, the imbalance between the free radicals produced in the body and the cells' ability to neutralize them, which leads to inflammation of the blood vessels and hardening of the arteries. The second is aimed at disrupting the functioning of the pancreas, an organ involved both in the regulation of blood sugar and in metabolic processes that can influence the lipid profile and blood pressure.

Sodium nitrite, also known as E250, commonly used in sausages, remains one of the most controversial preservatives. In the stomach, in the presence of protein compounds, it can contribute to the formation of nitrosamines, compounds analyzed for their carcinogenic potential. All nitrite can react with hemoglobin, reducing its ability to carry oxygen. Sulfites, found in wine, beer or some juices, can release sulfur dioxide, a respiratory irritant, especially in sensitive people.

“A risk reassessment is needed”

“This study has the inherent limitations of the observational design. However, the conclusions are based on very detailed data, and we took into account other factors that may increase or decrease the risk of cardiovascular disease. Experimental research in the literature has consistently indicated that these preservatives can cause oxidative stress in the body or affect the way the pancreas works. The results indicate the need for a reevaluation of the risks and benefits of these food additives by the competent authorities, such as EFSA in Europe and FDA in the United States, for better consumer protection,” said Dr. Mathilde Touvier.

The European Food Safety Authority (EFSA) re-evaluated in 2017 the nitrites and nitrates used as food additives, E249 – E252, and maintained the acceptable daily intakes at 0.07 mg of nitrite per kilogram of body per day and 3.7 mg of nitrate per kilogram of body per day, provided that the legal limits are respected. Later, the European Commission reduced the maximum limits allowed by EU Regulation 2023/2108. For most meat products, the limit for nitrites has decreased, from 9 October 2025, from the equivalent of 150 mg/kg sodium nitrite to 120 mg/kg, i.e. a reduction of around 20%. For some sterilized meat products, the limit drops from 100 mg/kg to around 82 mg/kg, i.e. a reduction of around 18%.

The new rules do not eliminate nitrites and nitrates because they help prevent the growth of dangerous bacteria, including Clostridium botulinum. The aim is to reduce exposure to nitrosamines without compromising the microbiological safety of food.

Preservatives are not only found in ultra-processed foods

The French researchers also dispelled the myth that avoiding ultra-processed foods would be enough to reduce exposure to preservatives. Previous research by the same team showed that ultra-processed products make up only about 35% of the food with preservatives normally consumed. The rest come from products that seem more natural, such as packaged bread, sliced ​​cheeses, sauces, juices or wines.

“Preservatives are ubiquitous. There is no single category of food that you can eliminate from the menu to solve the problem,” explained Anais Hasenbohler from Sorbonne University Paris Nord and author of the study.

The researcher still recommends unprocessed or minimally processed foods. And for people who do not have time to cook every day, a better option can be vegetables, fruits or other simply frozen products, preserved by low temperature, without long lists of additives.

Ultra-processed foods were associated with about a 50% higher risk of death from cardiovascular disease, a 55% higher risk of obesity, a 41% higher risk of sleep disorders, and a 40% higher risk of type 2 diabetes.

Tracy Parker, a nutritionist at the British Heart Foundation, said the French study was one of the first large studies to look at preservatives individually. In his opinion, the results show that the discussion about ultra-processed foods cannot stop at sugar, salt and fat, because these factors do not fully explain the link between these products and the higher risks observed in population studies.

Why you can't completely give up preservatives

Preservatives are not only used to make products more attractive or to keep them on the shelf longer. In many foods, they also have a safety function. Gunter Kuhnle, professor of food science at the University of Reading, UK, explained to CNN that additives help prevent food-borne illnesses, reduce waste and extend the shelf life of products.

Without such substances, many foods would be more difficult to transport, store and sell far from where they were produced. In the case of sausages, for example, nitrite limits the development of the bacterium Clostridium botulinum, responsible for botulism, a rare but very dangerous poisoning.

What researchers are now checking

The team from the Sorbonne Paris Nord University continues to look at how preservatives can influence inflammation, oxidative stress, the metabolic profile in the blood and the gut microbiota. These analyzes could show the mechanisms by which the same additives come to be associated with different diseases, from diabetes and cardiovascular disease to certain types of cancer.

Until these mechanisms are better understood, the study authors recommend cutting back on products with long lists of additives and choosing fresh, home-cooked foods whenever possible. When time or season limits options, frozen foods without sauces and no added additives can be a better option than many canned or packaged foods with very long shelf lives.