- New research on ultra-processed foods unveils their impact on cardiovascular disease risk.
- People who ate nine servings of ultra-processed foods per day experienced a 67% increased risk of experiencing a cardiovascular event, like heart attack or stroke.
- Cardiologists weigh in on the findings.
Headlines about ultra-processed foods abound. Though they’ve become a staple in the American diet, the type of food is proving to have detrimental effects on human health. For example, studies have linked the food group to early death, chronic disease, and stifled weight loss and gut health. Now, scientists have found that ultra-processed foods may significantly impact heart disease risk.
If you’re not familiar with the definition of ultra-processed foods, they are considered by the Nova classification system as industrial formulations made mostly or entirely from substances extracted from foods (such as oils, fats, sugar, starch, and protein isolates) or synthesized in laboratories (such as artificial flavorings, colorings, non-sugar sweeteners, and emulsifiers). Examples include commercially produced breads, desserts, deli meats, breakfast cereals, soy burgers, flavored yogurts, ready-to-heat meals like frozen pizzas, soft drinks, and candy. Past research has indicated that over 73% of the U.S. food supply is ultra-processed.
Researchers behind the latest study, published in JACC: Advances, examined how these foods affect heart health by collecting self-reported, observational data from a group of 6,814 U.S. adults aged 45 to 84 who, initially, did not have clinically apparent cardiovascular disease. Researchers used food frequency questionnaires to estimate how much ultra-processed foods participants ate. Follow-up questionnaires were collected intermittently over 12 years, after which researchers scanned the participants’ medical records for cardiovascular events like heart attack, stroke, or heart health-related death. Researchers adjusted for lifestyle habits, diet quality, and other risk factors to make sure they were looking narrowly at the impacts of food processing on these health outcomes.
Scientists concluded that adults who ate the most ultra-processed foods (about 9.3 servings per day, on average) were 67% more likely to experience a major cardiovascular event compared to those who consumed less (about 1.1 servings per day). The researchers also found that risk rose incrementally, with each additional daily serving linked to a 5.1% higher risk—a statistic that is “quite significant,” says Minhal Makshood, M.D., a cardiologist at MedStar Montgomery Medical Center. The relationship appeared even stronger among Black participants, which points to ongoing inequities when it comes to food access, food environment, and targeted marketing, all of which may increase cardiovascular risk, she adds. However, it’s important to note that these findings outline a correlation, or noted relationship—they do not prove causation.
How many servings of ultra-processed food are considered high?
For the purpose of the study, researchers found that nine servings led to an increased risk of heart disease. “Nine servings of ultra-processed foods may sound high, but in modern eating patterns, it is quite achievable, because each component of a meal can count separately,” explains Allen Taylor, M.D., chairman of cardiology at MedStar Heart and Vascular Institute. “A typical day might include packaged cereal and flavored yogurt at breakfast, a protein bar as a snack, a deli sandwich at lunch, chips in the afternoon, and a frozen entrée or fast food dinner. The key point is that ultra-processed foods are so embedded into our diets we don’t even recognize them as such.”
How do ultra-processed foods impact heart health?
These foods’ impact on heart health is layered. Firstly, they tend to replace or displace healthier, nutrient-dense whole foods in people’s diets, and have higher levels of sodium, refined carbohydrates, added sugars, and unhealthy fats, says Dr. Taylor. They also deliver excess calories but usually aren’t satiating, often due to their lack of fiber, adds Dr. Makshood. Beyond that, the food processing itself “may alter the food matrix, affect gut microbiome function, disrupt gut–brain signaling, and contribute to inflammation, insulin resistance, cholesterol problems, and hypertension,” Dr. Taylor explains, all of which may contribute to cardiovascular disease risk.
How to realistically limit ultra-processed foods
Balance should be the goal—not perfection. Dr. Makshood often recommends patients adopt an 80/20 approach that focuses on eating whole, minimally processed foods most of the time, “while allowing yourself the flexibility to enjoy processed foods occasionally without guilt,” she says.
“Emphasizing whole or minimally processed foods such as vegetables, fruits, legumes, fish, and nuts is key,” says Dr. Taylor. “Simple substitutions, reducing reliance on packaged snacks and convenience meals, cooking more frequently at home, and paying attention to ingredient lists can all move patients in the right direction. Even modest changes are likely to be beneficial.”
The closer you can get to the Mediterranean diet, the better, Dr. Taylor says. “It sounds fancy, but the Mediterranean diet is essentially just a whole food/low ultra-processed food diet,” he says. “And, it has major health benefits already demonstrated, ranging from reduced heart disease risk to reduced dementia risk.”
The bottom line
Dr. Makshood concludes: “This study should not make people feel that eating one packaged snack is dangerous or that nutrition has to be all-or-nothing. The larger message is that pattern matters. The more ultra-processed foods dominate the diet, the greater the likely cardiovascular burden over time.”
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