115: Are Food Preservatives Raising Your Blood Pressure? A New Study Explained

That scary nutrition headline about preservatives and high blood pressure is everywhere right now and it’s easy to jump straight from “linked” to “proven.” We slow it down and do what we’d do in an exam room: look at what the study actually says, what it doesn’t say, and how to translate it into real-life choices that protect your heart without turning grocery shopping into a panic spiral.

We talk through a new European Heart Journal paper using data from the NutriNet-Santé cohort (over 112,000 adults followed for nearly eight years) that finds several common food preservatives are associated with a higher risk of developing hypertension and cardiovascular disease. We explain why that word “associated” matters, how observational nutrition research can be confounded by overall ultra-processed food intake, sodium, fiber, lifestyle, and other factors, and why the results are best viewed as a signal not a verdict.

Then we get practical by walking through a typical kitchen day and pointing out where you might run into additives like sodium nitrite, potassium sorbate, phosphoric acid, citric acid, and calcium propionate: breads, deli meats, chips, frozen meals, and even cola beverages. We also share the habits with the strongest evidence for blood pressure control: more minimally processed foods, more fruits and vegetables, less excess sodium, regular activity, better sleep, and stress management.

If you found this helpful, subscribe, share it with a friend or neighbor, and leave a review so more people can find clear, patient-centered health info. What’s the first preservative you spot when you check five labels in your kitchen?

Transcript

Welcome And Remote Recording Test

SPEAKER_00 0:00

Hi, welcome to your checkup. We are the Patient Education Podcast, where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Delesky, a family medicine doctor in the Philadelphia area.

SPEAKER_01 0:16

And I'm Nicola Rufo, I'm a nurse.

SPEAKER_00 0:18

And we are so excited you were able to join us here again today. What you're seeing here today or listening to is us trying out a remote recording solution because we're realizing that during the summertime we are traveling on Sundays a great bit. And well, on the weekends. On the weekends, yeah. Meaning that like we're going to the beach and back and forth. And Sunday is our normal recording day. So we have a low budget setup here that I am hoping works. So

The Headline About Preservatives

SPEAKER_00 0:56

what are we going to talk about today, Nick?

SPEAKER_01 0:58

Today we're talking about your favorite thing, hypertension and hypertension and preservatives.

SPEAKER_00 1:08

So there's been a headline, or I became aware of a study that was done that introduced the concept for this episode. You know, it's making waves a little bit in nutrition and cardiovascular health. And they were exploring with some observational data to answer the question: could food preservatives be raising your blood pressure? So there was a new study published in the European Heart Journal where they followed 112,000 adults and found that several common food preservatives were associated, not causal, but associated with higher risk of developing hypertension and cardiovascular disease. Now, before you go ahead into the kitchen and start throwing everything in your pantry into the trash, we'll slow down and we'll talk about what this study actually found, what it didn't find, and what it might mean for your health. Because often, as is the case in medicine, the truth is unfortunately more complicated than the headline. Nikki, can you get a um can you take it from here a little bit?

How The Study Measures Additives

SPEAKER_01 2:20

Sure. So when most people think about blood pressure, the first thing they think about is salt. And for good reason, because excess sodium intake is one of the most well-established dietary contributors that we have to hypertension. But researchers are increasingly asking whether ingredients in our food may also influence cardiovascular health. And this brings us to preservatives, what we're talking about today.

SPEAKER_00 2:48

So, you know, it went back in the day, um, about like when we didn't have I'm talking like Jamestown, like 1600s, they I think they were like first now that was deep cut Jamestown. I did deep cut. Um and Roanoke.

SPEAKER_01 3:04

And oh my god, did you go through a Roanoke phase?

SPEAKER_00 3:07

Uh yeah, um, yes. I absolutely have gone through a Roanoke phase. This is so funny. Yeah. And an Anne Frank phase. Yes, and an Anne Frank phase um together at the same time. Did you know that the two stories are related?

SPEAKER_01 3:22

Yeah, Anne Frank was hiding out in Roanoke.

SPEAKER_00 3:25

Yes, yeah. Um so but the um oh uh Sokotoa, right? Or is that how people know Sokotoa is a like trigonometry little treat thing. It was Croatone.

SPEAKER_01 3:41

Croatoin.

SPEAKER_00 3:42

Croatoin, not Socatoa. Oh my goodness, wow. Two deep cuts in like the matter of moments. Basically, what I was trying to get at is that they learned how to put salt on meat to make it last longer so they didn't die when they were eating food. So that's what we're up against here is that like the food industry has taken us pretty far where like food can last longer than 30 seconds. However, preservatives are substances added to foods to improve shelf life, prevent spoilage, maintain freshness, and improve food safety? They're really everywhere in the modern food supply. You can find them in breads, deli meats, frozen meals, chips, soft drinks, sauces, and many of the packaged foods lining grocery store shelves. Researchers wanted to know are people who consume more preservatives more likely to develop high blood pressure? To investigate this question, researchers used data from the Nutranet Sante study. That's my interpretation of the pronunciation there. Do you have a different take on that?

SPEAKER_01 4:48

That's probably what I would say.

SPEAKER_00 4:50

It's an a large ongoing study based in France. More than 112,000 adults were followed for nearly eight years. Participants completed detailed dietary records, and researchers used extensive food composition databases and laboratory analyses of food products to estimate exposure to specific preservatives. Nikki, can you tell us why that might be important?

SPEAKER_01 5:16

It's important because many nutritional studies only measure broad dietary patterns, and this study attempted to identify exposure to the individual preservatives with much greater precision.

SPEAKER_00 5:32

So the researchers identified fifty-eight preservatives in participants' diets. Seventeen were consumed by at least ten percent of participants, and subsequently eight preservatives were associated with a higher incidence of hypertension. Some of the preservatives included sodium nitrite, potassium sorbate, phosphoric acid, citric acid, calcium propionate, and others commonly found in processed foods. Researchers also found that people with the highest intake of certain preservative groups had higher rates of hypertension and cardiovascular disease than those with lower intake.

SPEAKER_01 6:24

So at this point you may be wondering what exactly are these preservatives and where do we actually encounter them?

A Kitchen Tour Of Preservatives

SPEAKER_01 6:32

So let's take a walk through the typical American kitchen. Um, not because these foods themselves are necessarily dangerous, um, or because you need to avoid every single one of them, but understanding where these ingredients show up will help us explain why researchers are interested in studying them. So let's start with breakfast. Maybe you have a couple slices of toast that you bought at the store, not your little handmade sourdough from your feeder or your, what's it called? Not your feeder, your starter that you feed.

SPEAKER_00 7:10

Beach bread.

SPEAKER_01 7:12

Um, many commercially produced breads contain calcium. How do you say that? I was going propionate. Maybe you grab a bagel or an English muffin. These packaged goods can often contain potassium sorbate. Um, alongside that toast, you might have bacon, sausage, or ham, and many curd meats contain sodium nitrate. So before you've even finished breakfast, you've potentially encountered several preservatives that researchers are actively studying.

SPEAKER_00 7:50

Now we'll move to lunch. Suppose you make a turkey sandwich. The bread may contain the bread may contain calcium propionate again, the deli turkey may contain sodium nitrite or similar preservatives. You grab a handful of chips. Certain flavored chips may contain preservatives such as sodium acetate. And nothing about these meals are unusual, but millions of Americans eat meals every day very similar to this. Later in the afternoon, maybe you grab a fridge cigarette, like I have one sitting right here. I'm talking about a diet coke. And maybe you find that, let's see, what is in this diet coke here? Phosphoric acid. Or citric acid, even right here in this thing that's sitting in the fridge. Many cola beverages contain phosphoric acid. Or later in the afternoon, maybe you enjoy a sports drink, which may have some of these tucked in there as well. Citric acid is particularly interesting because it naturally exists in citrus fruits. So, an important thing to say here is that researchers are not suggesting oranges cause hypertension. Instead, they're examining citric acid used as a food additive in processed products. That distinction matters here so that we don't get too overzealous and think that oranges are causing badness. So then dinner rolls around. Maybe it's a frozen pizza. It's not delivery, it's de giorno. Well, yeah. Maybe it's a sandwich or hamburger buns. Maybe it's another packaged convenience food. Many of these products contain preservatives designed to keep food stable during storage and transportation, but you'll notice something important. Nothing we've discussed sounds extreme. We're not talking about bizarre foods. We're not talking about unusual diets. We're talking about bread, deli meat, chips, soda, and packaged foods. These kind of foods live in millions of kitchens right now. And that's why for us this study generated a lot of interest. The concern isn't exposure to one preservative once. Researchers are asking whether years of repeated exposure to multiple preservatives could influence long-term cardiovascular health.

Association Versus Causation Basics

SPEAKER_01 10:20

Now, before we conclude that preservatives are causing high blood pressure, we need to talk about one of the most important concepts in medical research, and that is association does not equal causation.

SPEAKER_00 10:35

So this was an observational study, maintaining meaning that researchers tracked what people chose to eat rather than assigning diets. Studies like this are valuable for spotting patterns, but they cannot determine whether a specific ingredient directly caused an outcome. One reason is something called confounding. People who consume more preservatives often eat more ultra-processed foods overall and may differ in many other ways that affect cardiovascular risk, including sodium intake, fiber intake, or lack thereof, overall diet quality, and lifestyle habits. The researchers adjusted for many of these factors, which makes the findings more compelling, but even so, observational research cannot completely rule out hidden influences, so the results should be viewed as an important signal rather than the definitive proof. Scientists have proposed several ways preservatives could potentially affect blood pressure. Some add sodium to the diet, while others may influence inflammation, oxidative stress, blood vessel function, or the gut microbiome. These ideas are biologically plausible, but this study wasn't designed to test them directly. In fact, some findings highlight how complex nutrition science can be. For example, calcium propionate was associated with hypertension in this study, yet other research has suggested propionate may have beneficial cardiovascular effects under certain conditions. Similarly, nitrites can be converted into nitric oxide, a molecule that helps blood vessels relax. These apparent contradictions remind us that health effects of a food ingredient may depend on dose, context, and the overall dietary pattern in which it is consumed. Which

Practical Steps For Heart Health

SPEAKER_00 12:28

brings us to the most practical takeaway.

SPEAKER_01 12:30

So you don't need to panic about one single ingredient or single food. Instead, you can use this study as a reminder to build more of your meals around minimally processed foods and to pay closer attention to ingredient labels when choosing packaged products. And if you're looking to protect your heart and lower your blood pressure, focus on the habits with the strongest evidence, like eating more fruits, vegetables, beans, whole grains, nuts, and lean proteins, while reducing excess sodium, staying physically active to maintain a healthy weight, sleeping well, and managing stress.

SPEAKER_00 13:09

Thank you. And before we wrap up, I want to leave you with a challenge. After this episode ends, head to your kitchen. Pick five packaged foods from your pantry or refrigerator. Turn them around and read the ingredient labels. See if you can find sodium nitrite, potassium sorbate, calcium propionate, phosphoric acid, citric acid, or some of the other preservatives discussed in the paper if you choose to read it. Not because you should be afraid of them, but because understanding what's in our food is the first step towards making informed decisions about our health. As researchers continue studying food additives, we'll learn more about whether these preservatives are innocent bystanders, contributors to disease, or somewhere in between. For now, this study provides an important signal worth paying attention to, but definitely not a verdict. And

Beach Weekend Banter And Photos

SPEAKER_00 14:01

now for the banter. So, um, I am happy I got my Ernest and Son sandwich.

SPEAKER_01 14:11

Ernest and son.

SPEAKER_00 14:12

Ernest and son. Um, I you know, the it's turned out to be really, I don't know, really like wrapped around my whole like brigantine news thing. Are you having a tough time over there? Oh, okay.

SPEAKER_01 14:25

I was just making sure it was still recording.

SPEAKER_00 14:27

We're gonna see how this comes out. Uh great weekend. Brother Vanessa came.

SPEAKER_01 14:32

Oh, we love Brother Vanessa. It wasn't the best beach day, but she still came and she hung out all day.

SPEAKER_00 14:42

Yeah, we love that. Um, there was a little sandblasting.

SPEAKER_01 14:45

Yeah, I think my face got a little sandblasted.

SPEAKER_00 14:49

It happens.

SPEAKER_01 14:50

When you're taking pictures later this afternoon.

unknown 14:54

It's okay.

SPEAKER_00 14:55

Well, tell us a little bit about how you um about this picture taking experience and what you're hopeful for.

SPEAKER_01 15:03

About the ex- We haven't done it yet.

SPEAKER_00 15:04

No, I know, but like we like this girl.

SPEAKER_01 15:07

Oh, we did, yeah. We uh got pictures done when I got my wedding hair and makeup trial done because like I just got my hair and makeup done, so like let's put on a cute outfit.

SPEAKER_00 15:18

You're a genius for that.

SPEAKER_01 15:19

Get some photos. Um I think people like to do that for their like engagement pictures, but I don't know when you would do that so far. I guess people like plan weddings way far ahead of time.

SPEAKER_00 15:37

But couldn't be us.

SPEAKER_01 15:39

Yeah. I wanted her to shoot our wedding, but she was like having a baby around October 10th, so that was rude of her. So we did pictures before, and then I saw on her Instagram that she was doing, she does like mini sessions here and there that she'll like put up a link to sign up, and then I saw she was doing ones in Brigantine. So I was like, we'll be in Brigantine on May 31st.

SPEAKER_00 16:05

But we will. I'm excited. I've always wanted beach pictures with you. We have one on our little like point-and-shoot camera that we have, and I think it came out really well.

SPEAKER_01 16:14

Um we're doing like cozy, like a cosier because sometimes like I feel like beach photos and stuff sometimes are like people aren't dressed like they're gonna be on the beach. And then the photos look a little bit out of place, I think. Sometimes fair, yeah. So yeah, we're going on the cozy beach route.

SPEAKER_00 16:43

And you picked up a brown panic dress anyway that looks like I did.

SPEAKER_01 16:47

I have like a brown panic dress, but like beachy, not like too formal girl. What are you doing on the beach with his dress, you know? And or like when people like have like beach weddings and it's like, brother, why are you in a three-piece suit in the sand? Like, you're not going to the beach, you know. But yeah, we have like linen pants and this like cute little beach sweater. Gotta get our Christmas card photo, you know?

SPEAKER_00 17:13

You're right. And don't worry, we take step we take different pictures with Ollie.

SPEAKER_01 17:17

Yeah, if we were doing it's like a mini session, so it's only 20 minutes. So I feel like if we were doing like a just us, like hour plus long thing, maybe I would try to like figure out a way to like bring Ollie. But I only have 20 minutes, you know.

SPEAKER_00 17:34

Oh, it's gotta be high and tight. Hey, buddy. He's with us right now. He's sitting.

SPEAKER_01 17:39

You have to be more efficient than your 20-minute office visits.

SPEAKER_00 17:42

Oh my god. Yeah, hundreds of well, I don't know if it's gonna be hundreds, but probably.

SPEAKER_01 17:49

He's so tired. He's had so much outside time this weekend.

SPEAKER_00 17:52

He really has. I mean, normally he sleeps for like all night, like we do, and then he like wakes up, we like bop him around, give him breakfast, welcome around, and then we like he sleeps the entire time that we're gone. I'm pretty sure. And he has not gotten a lot of snoozing time, but I think he just he just fell fast asleep just now. Like in three 30 seconds, he's out cold. I mean, we've got exciting. Oh, what else happened this weekend? We got sushi yesterday. Um, I don't know why. Like, there are plenty of places to eat on this island, and uh some people would claim that there are no places to eat on this island. And we got like a full Asian soiree last night. We did. The sushi was pretty good. I like the sushi. The chicken dishes were the same. Like they I they might have very well given us the same dish twice.

SPEAKER_01 18:47

I'm glad we didn't get the pad thai.

SPEAKER_00 18:49

Me too.

SPEAKER_01 18:50

It's not better than grandma's.

SPEAKER_00 18:54

No, that that place's great. And luckily, I was gosh, I'm all over the place. Luckily for me, the um shaving stuff was laying around, so I can like tighten up my facial hair before these pictures. I like rushed out Friday when we were leaving and had no idea, like totally forgot. I knew I forgot certain things, but yeah, I'm happy about that. Um, we finished up the Summer House reunion. Oh my goodness. Well, the first episode of it.

SPEAKER_01 19:24

Yeah, that was like a euphoria that I haven't had in a while watching a TV show or a reunion for that matter.

SPEAKER_00 19:34

What did you feel in the beginning versus the end?

SPEAKER_01 19:38

Um well, in the beginning, I was like, because the some of the leaked audio came out, so like some of the lines were kind of circulating on the internet for a little while, so I had heard them, but it was nothing like watching it on the episode.

SPEAKER_00 19:59

No, they um when Sierra went and Amanda at the end of it, and towards the very tail end, and no spoilers here for anyone who would listen. You know, it's like uh there were two best friends, seemingly, who like there was a betrayal between the two of them for anyone who doesn't watch this show, which is probably everyone listening to this at this point.

SPEAKER_01 20:19

Well, the one girl Amanda was married to Kyle, they separated, and then Amanda started dating or whatever with West, who was previously in like a weird on again, off again in limbo with Sierra, and he really he was like messing around, yeah. But she like really liked him and was like all like upset about him and really like whatever, and then Amanda was like going behind everyone's backs with West. Well, Amanda and West, not just her, but yeah, yeah, yeah. It was so bad to watch, but it was so good. Because then Amanda, like, she should have watched the Scandal reunion because Raquel just like took it and was remorseful and let them all yell at her, and whatever. Yeah. So then everyone kind of just like felt bad for her, and now like no one really cares. Where Amanda came and was like not, she was like rolling her eyes at Sierra, like has no idea why she's mad at her. I know, and like everyone's gonna hate you now, and your crappy ex-husband's gonna come out on top of all this.

SPEAKER_00 21:43

Somehow. Somehow. When Sierra came out with the like digs that only a close personal friend would know at the end, like she was using explicatives, she was like yelling and screaming in the beginning, but then she She like became calm and started like doing some like real mental damage, like going for the jugular.

SPEAKER_01 22:07

Yeah, it was good.

SPEAKER_00 22:08

That I was like, I was like, oh my god, God. And even her ex-husband was like, wow, that might have been a lot.

SPEAKER_01 22:17

She in Western Italy right now.

SPEAKER_00 22:19

They did leave. I saw they left the country.

SPEAKER_01 22:22

They had a wedding. She was going to a wedding with him.

SPEAKER_00 22:26

Was it one of his friends?

SPEAKER_01 22:28

She was wearing that same rat button that she was wearing. Everyone, people like, there's a picture of them going around from the wedding, and she has that like stupid little button where it's like a little button with like a like rat tail basically hanging down.

SPEAKER_00 22:42

Oh, that's a tasteful hairstyle.

SPEAKER_01 22:45

But everyone was like trolling her because that's how she wore her hair at the reunion. And then she's wearing her hair like that again at this wedding, and people in the comments are like, why is she trolling us with this hairstyle? Oh my god.

SPEAKER_00 23:00

Oh my goodness. No, it's good stuff. And then we are not to switch topics here, but um, what time we got over there?

Reality TV Talk And Love Island

SPEAKER_01 23:08

Like the time or how long we've been recording.

SPEAKER_00 23:11

Oh, do you have both?

SPEAKER_01 23:12

It is 3:30, and we've been going for 11 minutes.

SPEAKER_00 23:16

Oh, okay. So this big weekend, we've um big week, we've got our um, you know, the pop culture Super Bowl coming, which is Love Island.

unknown 23:26

Yes.

SPEAKER_00 23:28

Can you explain to the like Generation X and boomers who listen what Love Island is?

SPEAKER_01 23:35

Well, it's like the greatest reality show ever. Um, highest form of brain rot there is really. And we've talked about it before every summer that we've done this now.

SPEAKER_00 23:46

And someone's new though.

SPEAKER_01 23:47

All of these eligible singles are on an island together in Fiji, and they like match up together. There are challenges to, you know, give you something to watch, and then of course, there's drama. And there is also an element to it where the people can vote on like who gets voted off, who's coupled up. There are like different things you can vote for every so often. And it comes out like every night except Sunday and Wednesday. So they're really churning the episodes out.

SPEAKER_00 24:25

The thing is like that it's real time.

SPEAKER_01 24:27

Yeah, it's like real time, and it's just so good. The only tragic thing is that it's at 9 p.m. and I really wish they would just I feel like last year they started it started coming out at like 8 30. Like it would be available.

SPEAKER_00 24:44

Nine's late for us.

SPEAKER_01 24:46

Yeah. It is late, and it's like not fair because then people on the West Coast, like Sam, who I used to work with, last summer me, her, and Lauren were texting about it when it came out. And Lauren and I were so jealous because we were like starting at 9 p.m. And we were like, oh, we would kill to like because she Sam moved to California. So we were like, oh, I would kill to be able to watch this at 6 p.m. while I was watching while I was eating dinner.

SPEAKER_00 25:14

That is nice. The West Coast timing has some good perks, good early sports. Sunday night football at 6 p.m.

SPEAKER_01 25:24

Uh-huh.

SPEAKER_00 25:24

5 30. That'd be great. Regular football starting at like one o'clock slate at 10. Not bad.

SPEAKER_01 25:33

Not bad at all.

SPEAKER_00 25:35

Alright, let's boogie. So thank

Where To Find Us And Wrap-Up

SPEAKER_00 25:38

you for coming back to another episode of Your Checkup. Hopefully, you were able to learn something for yourself, a loved one, or a neighbor. You can find us on Instagram, threads, or you can send us an email. And you can share this with a friend or a neighbor or listen to any of our old episodes. But most importantly, stay healthy, my friends. Until next time, I'm Ed Delesky. I'm Nicole Rufo. Thank you and goodbye. Bye.

Medical Disclaimer And Final Reminder

SPEAKER_00 26:11

This information may provide a brief overview of diagnosis, treatment, and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments, or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for a complete information tailored to you. In short, I'm not your doctor. I am not your nurse. And make sure you go get your own checkup with your own personal doctor.