Cohort studyindependent cross-checkabstract checked I-UPF-119 standard review
Food preservatives, blood pressure and heart disease
Preservative food additives, hypertension, and cardiovascular diseases: the NutriNet-Santé study.
Overview
Hasenböhler A et al.. Eur Heart J 2026 · PMID 42161430 · DOI 10.1093/eurheartj/ehag308
People with higher preservative intake had more high blood pressure and somewhat more cardiovascular disease in a French cohort.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
To link preservatives with blood pressure and CVD.
- How was the study done?
Cohort study.
- How many people, animals or samples were studied?
112,395 adults.
- What was actually found?
More hypertension and CVD with higher preservative intake.
- How large was the observed effect?
Hypertension HR 1.29; CVD HR 1.16.
- What do the results mean in everyday life?
A signal worth checking.
- What are the study's limitations?
Observational; same cohort.
- What does it say about Elawady's specific claim?
Contradicts C-UPF-11.
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Cannot prove causation.
Scientific in-depth review
1. Full reference
- Authors
- Hasenböhler A et al.
- Journal
- Eur Heart J
- Year
- 2026
- Identifier
- PMID 42161430 DOI 10.1093/eurheartj/ehag308 · PMC13690824
- Verification
- verified – PubMed efetch 2026-10-26; Crossref works API 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
No COI statement in PubMed record; funding listed: European Research Council, European Union's Horizon, French Ministry of Health, French Network for Nutrition And Cancer Research, Institut National de la Santé et de la Recherche Médicale, Sorbonne Paris Nord University
2. Research question
Are preservative food additives associated with hypertension and CVD?
3. Study design and population
- Study design
- Cohort study – Prospective cohort (NutriNet-Sante)
- Population
French adults (78.7% women; mean age 42.8)
- Country
France
- Period
2009-2024; median follow-up 7.9 years
- Sample size
112,395; 5,544 hypertension and 2,450 CVD cases
- Inclusion and exclusion criteria
NutriNet-Sante participants
4. Methods and endpoints
- Exposure / intervention
Cumulative time-dependent preservative exposure
- Comparator
Lower consumers
- Endpoints
Incident hypertension and CVD
- Statistical methods
Multi-adjusted Cox models; multiple-testing correction
5. Actual results
- Results
Total non-antioxidant preservatives: hypertension HR 1.29 (1.20-1.39); CVD HR 1.16 (1.04-1.29). Total antioxidant preservatives: hypertension HR 1.22 (1.13-1.31). Of 17 individual preservatives, eight associated with hypertension and one with CVD after multiple-test correction.
- Absolute risks
not reported in abstract
- Authors' conclusion
Multiple associations with hypertension or CVD; experimental research needed; if confirmed, regulations should be re-evaluated.
6. Strengths
- Detailed exposure
7. Weaknesses
- Observational; same cohort
- Antioxidant preservatives (e.g. vitamin C/E) also associated - possible confounding
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Abstract only.
9. Assessment of the statistical interpretation
Moderate HRs; same cohort.
10. Relevance to the specific claim
Third outcome from the same cohort; challenges 'little health concern'.
11. Independent contrary findings
Not independent of I-UPF-117/118.
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Signal; needs replication.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | not replicated |
| Consistency with the overall evidence | unknown |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Replication.