Ketchup Has a Long History –⁠ and Was Originally Intended as Medicine

From Fish Sauce to Tomato Condiment

You might think of ketchup as something firmly tied to modern fast food, but its origins go much further back—to a fermented fish sauce called ke-tsiap that was made in China around 300 BCE.

That sauce had little in common with today’s ketchup except the name. It was made with anchovies and soybeans, and became popular enough to spread to other parts of Asia and eventually to Europe via British sailors, who used it to flavor meat and fish. In Europe, its ingredients adapted to local tastes—mushrooms, walnuts, and elderberries were often added.

It still didn’t resemble today’s tomato-based ketchup, however, as tomatoes were long considered poisonous due to the toxic alkaloids in their leaves or the possibility of metal poisoning when cooked in the wrong pots. They also spoiled quickly, making them hard to store.

Controversial Tomato Pills

The first known recipe for tomato-based ketchup came from James Mease, an American horticulturist, in 1812. He mixed tomatoes with spices and brandy. Many physicians experimented with tomato recipes at the time, believing them to have medicinal effects. Dr. John Cook Bennett used them to treat diarrhea, jaundice, and indigestion—recommending tomatoes raw, cooked, or as ketchup.

In 1835, tomato pills were launched, promoted with the slogan "Tomato pills will cure all your ills." A heated debate about these pills erupted in 1869 within the American Medical Association. Some members questioned their medicinal properties—and eventually it was discovered that some pills didn’t contain any tomato at all.

As the hype around tomato pills faded, the reputation of tomatoes as a food grew. Today, we know tomatoes are rich in the antioxidant lycopene. You might wonder how such small ketchup servings—like those added to fries—could have a positive effect on cardiovascular health. Surprisingly, they can. Studies show that a few weeks of increased ketchup consumption can reduce LDL cholesterol levels. Whether this benefit outweighs the risks posed by its sugar and salt content is another matter entirely.

Why Did Ketchup Become So Popular?

Besides the medicinal reputation of tomatoes, two other factors boosted ketchup's popularity. In the late 19th century, new methods were developed to preserve tomato sauce safely in glass bottles—without needing chemical preservatives. H. J. Heinz capitalized on this and added ketchup to his lineup of shelf-stable products.

Heinz ketchup stood out not only for its ingredients but also for food safety, which became a growing public concern. Ketchup soared in popularity with the rise of fast food, proving to be a perfect match for fries and burgers.

Today, the U.S. leads global ketchup consumption (three bottles per person annually), with the condiment present in 97% of American households. Children under 13 consume it at three times the adult rate. However, it is no longer the world’s favorite condiment—salsa has recently taken that title, partially due to its perceived nutritional value.

“Ketchup itself isn’t a ‘forbidden’ food—the issue is more about quantity and product quality. Ketchups can contain significant amounts of added sugar and salt, which can silently increase intake, especially if added to almost every meal. Both added sugar and salt should be limited, as their excess is linked to a number of health risks,” explains Dr. Eliška Selinger from the Czech National Institute of Public Health.

“In children, regular consumption of salty or sweet foods may create a lifelong preference for such intense tastes, which they’ll find hard to unlearn in adulthood,” she adds.

A Return to Homemade Alternatives?

Dr. Selinger doesn’t reject occasional ketchup consumption but emphasizes reading nutrition labels and choosing products with lower sugar and salt content—and a higher tomato concentration. Homemade tomato sauces are often a better alternative, as you have full control over the ingredients.

While the late 19th and early 20th centuries marked a shift from homemade to industrial food products, the trend today may be reversing. Ketchup can also be made from ingredients other than tomatoes, such as pumpkin or beetroot. It can be replaced by other dips, like white bean or chickpea hummus, which add fiber and protein from legumes to your diet.

Editorial Team, Medscope.pro

Sources:

• Ketchup was once a diarrhea cure. Popular Science, Aug 22, 2025.
• Ketchup reduces cholesterol. NICS Well.
• Lakhsmi G. NPR, Dec 3, 2013.