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Common food preservatives linked to high blood pressure and heart disease
- The study of 112,395 people includes detailed analysis of diet and food ingredients.
- Researchers found eight preservative food additives linked to high blood pressure or cardiovascular disease.
- The highest risks were in people who ate the most preservatives.
Eating foods that contain common preservative food additives may increase the risks of high blood pressure and cardiovascular disease, according to research published in the European Heart Journal [1] today (Thursday).
The research was led by Dr Mathilde Touvier, a research director at INSERM (the French National Institute for Health and Medical Research), and Anaïs Hasenböhler, PhD student, both from the Nutritional Epidemiology Research Team at the Université Sorbonne Paris Nord and Université Paris Cité, France.
Ms Hasenböhler said: “Food preservatives are used in hundreds of thousands of industrially processed foods. Experimental studies suggest that some preservative food additives may be harmful to cardiovascular health, but we have not had enough evidence on the impact of these ingredients in humans. As far as we know, this is the first study of its kind to investigate the links between a wide range of preservatives and cardiovascular health.”
The research is part of a larger study, called NutriNet-Santé, and included 112,395 volunteers from across France. Every six months the volunteers told researchers everything they ate and drank over a period of three days.
Researchers carried out detailed analyses of the ingredients of all the food and drink, including any preservatives. They also tracked the volunteers’ health for an average of seven to eight years to see if they develop high blood pressure or any cardiovascular disease.
Researchers found that 99.5% of the volunteers had consumed at least one food preservative within the first two years of taking part.
Overall, they found that people who ate the largest amounts of ‘non-antioxidant’ preservatives had a 29% higher risk of hypertension, compared to those who ate the least, and a 16% higher risk of cardiovascular disease, including heart attack, stroke and angina. People who ate the most antioxidant preservatives had a 22% higher risk of hypertension. Non-antioxidant preservatives are designed to stop harmful microbes, such as mould and bacteria, from growing, whereas antioxidant preservatives are designed to stop oxidation which means the food will not turn brown or become rancid.
Researchers also looked at 17 of the most commonly eaten preservatives and found that eight of these were specifically linked to high blood pressure. These were: potassium sorbate (E202), potassium metabisulphite (E224), sodium nitrite (E250), ascorbic acid (E300), sodium ascorbate (E301), sodium erythorbate (E316), citric acid (E330) and extracts of rosemary (E392). Ascorbic acid (E300) was also specifically linked to cardiovascular disease.
Dr Touvier added: “This study has some limitations inherent to its observational design. However, the findings are based on highly detailed data, and we have taken account of other factors that can increase or lower the risk of cardiovascular disease. Experimental research in the literature consistently suggested that preservatives may cause oxidative stress in the body or affect the way the pancreas works.
“These results suggest we need a re-evaluation of the risks and benefits of these food additives by the authorities in charge, such as the EFSA in Europe and the FDA in the USA, for better consumer protection. In the meantime, these findings support existing recommendations to favour non-processed and minimally processed foods, and avoid unnecessary additives. Doctors and other healthcare professionals play a key role in explaining these recommendations to the public.”
The researchers are now looking at how food additives and ultra-processed foods may affect signs of inflammation, oxidative stress, metabolic profile in the blood and the composition of the gut microbiota. This may help them to understand why additives may increase the risks of disease.
Expert Reaction
These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.
Prof Gunter Kuhnle, Professor of Nutrition and Food Science, University of Reading
“The most difficult aspect of nutrition research is knowing what people eat. And it is even more difficult to measure the consumption of individual compounds, because food is neither standardised nor regularly analysed. Processed food is usually standardised for taste and texture, not for composition, and the use of additives – including preservatives – depends on many factors, for example the quality of raw materials.
In this study, the authors attempted to investigate whether preservatives are associated with cardiovascular disease risk. However, they have no reliable data to estimate individual consumption of preservatives because:
– the food industry is not required to provide information on the additive use in individual products and in most cases, there is only an upper limit;
– food composition changes regularly, and without analysis of individual food items, estimates are unreliable;
– the authors rely on the analysis of a small number of food-item and additive combinations and estimate composition for most other compounds.
This means that any association observed in this study is less likely due to actual preservative intake and more likely due to specific dietary patterns. The authors divide the preservatives into “anti-oxidant” and “non-antioxidant” – which combines large, diverse groups of compounds which have very different effects on the human body. Among the non-antioxidant preservatives, which were associated with increased disease risk, where for example nitrites and nitrates, as well as sulphites – compounds found in foods that are known to increase the risk of heart disease such as processed meats.
Preservatives have an important role in the food system, not only by preventing food-borne diseases, but also by preventing spoilage, reducing food waste and extending shelf life. In turn, this makes food more affordable.
In the UK and Europe, food additives, including preservatives, are regularly reviewed by regulators for potentially adverse effects on health. There are sufficient examples that show that regulators are willing to make unpopular decisions and remove additives from the market when they consider there to be a health risk. Research into the health effects of additives is therefore important, but it needs to rely on reliable estimates of intake by individuals to avoid confounding with dietary patterns.
Consumers should not be concerned by the findings of this study.
Rachel Richardson, Methods Support Unit Manager, The Cochrane Collaboration
Comment from the UK Science Media Centre:
“The authors of this research have drawn on data from the NutriNet Santé cohort, a large group of people recruited in France and followed up over several years. In this study they have measured the consumption of various food preservatives and the incidence of hypertension and cardiovascular diseases to see if these are linked.
It’s important to note that this is an observational study: this means that participants were not randomly allocated to consume more or fewer preservatives. As such we cannot be sure that the people who consumed more preservatives were not different from those who consumed fewer preservatives in ways that affected their risk of hypertension and CVD. For example, higher consumers may also have less healthy lifestyles than lower consumers and so the reason that they experience more ill-health is due to this, and not the preservatives.
Having said that, the authors of this study did a good job of controlling for other factors that may influence health, such as age, BMI, smoking, physical activity and diet in general. Other strengths of this study include the way in which they assessed people’s diets and their comprehensive approach to identifying hypertension and CVD in the cohort. Although they cannot prove causation, there are signals in the results that warrant further investigation.
There are reasons to be cautious when thinking about the implications of their findings for people in general and people in the UK. The people in the cohort were predominantly female and had healthier lifestyles than the general French population. The cohort is made up of volunteers so participants are likely to be more interested in diet and health than the average person. Finally French diets are likely to be quite different to UK diets and so the associations found in this study will not necessarily be similar in a UK context.”
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