Study Links Ultra-Processed Foods to Increased Cardiovascular Risk, Highlights Racial Disparities

A recent study has identified a significant association between high consumption of ultra-processed foods (UPFs) and an increased risk of major cardiovascular events, including heart attack, stroke, and fatal heart disease. The research highlights particular disparities in risk among different racial groups. Concurrently, public health and nutrition experts continue to grapple with a consistent definition for ultra-processed foods, leading to varying perspectives on policy and consumer guidance.

Key Research Findings on Cardiovascular Risk

A 12-year study, published in the Journal of the American College of Cardiology, analyzed data from 6,814 adults aged 45–84 who participated in the Multi-Ethnic Study of Atherosclerosis. None of the participants had cardiovascular disease at the study's commencement.

Individuals consuming more than nine servings of ultra-processed foods daily were 67% more likely to experience major cardiac events compared to those consuming approximately one serving per day. This significant finding underscores the potent link between high UPF intake and heart health.

The study further detailed that each additional daily serving of UPFs was linked to an increase in the probability of heart attacks, strokes, or death from coronary heart disease by more than 5%.

Dr. Amier Haidar, a cardiology fellow at UTHealth Houston and the study’s lead author, noted that this risk persisted even after controlling for factors such as calorie intake, overall diet quality, existing health conditions, race, gender, socioeconomic status, lifestyle behaviors, and traditional cardiovascular risk factors.

Among the various types of ultra-processed foods, sugary items were specifically associated with a higher risk.

Pronounced Racial Disparities in Risk

The research identified a striking disparity in cardiovascular risk among racial groups. For Black individuals, the chance of heart attack, stroke, and fatal heart disease associated with UPFs increased by 6.1% with each daily serving. This contrasts with a 3.2% increase for other racial and ethnic groups, indicating a nearly double increased risk for Black Americans.

Dr. Haidar attributed this disparity to socioenvironmental determinants of health, including chronic stress and limited access to healthy food options, often referred to as food deserts, in predominantly Black neighborhoods. He also emphasized the need for further biological analysis.

Understanding Ultra-Processed Foods: Prevalence and Characteristics

Ultra-processed foods constitute a significant portion of the American diet. A 2025 report in the Journal of Nutrition indicated that the majority of Americans obtain over half their daily calories from UPFs. The Centers for Disease Control and Prevention (CDC) reports that average American adults consume over 50% of their daily calories from these foods, with consumption reaching nearly 67% among children and teenagers.

Dr. Haidar noted that most Americans in the study consumed approximately 4.5 servings per day, with higher numbers observed among those facing economic disadvantages.

Ultra-processed foods (UPFs) are defined by the NOVA classification system, originating from Brazilian researchers, as products made from manufactured ingredients that typically contain additives not commonly used in home cooking. These include artificial colors, flavors, emulsifiers, and preservatives.

Common examples of UPFs include:

• Packaged snack cakes, sugary cereals, instant noodles, frozen chicken nuggets
• Soft drinks, chips, candy
• Deli meats, fast-food meals
• Processed deli meats, packaged cookies, sweetened beverages, and frozen ready meals

Scientists suggest that UPFs may disrupt the gut microbiome and cause inflammation, which is linked to various cardiometabolic diseases and certain cancers. The processing methods are thought to alter the physical and chemical structure of foods, leading to rapid digestion and quick absorption of sugars and starches, potentially impacting insulin resistance and the gut microbiome.

The Prevailing Debate: Defining UPFs and Policy Implications

Despite public interest and recent policy efforts, such as California's ban on specific UPFs in school lunches and a reported initiative by the Trump administration to develop a federal definition, a consistent definition of ultra-processed foods remains a challenge among public health and nutrition experts.

Perspectives on Classification:

• Focus on Processing Methods: Dr. Dariush Mozaffarian, head of the Food is Medicine Institute at Tufts University, emphasizes that processing methods themselves are crucial.

  He states that UPFs are "molecularly disassembled and reassembled," leading to rapid digestion and absorption, which over time can increase the risk of insulin resistance and Type 2 diabetes. He cites nearly 100 observational studies and three randomized controlled trials linking overconsumption of UPFs to increased risks of Type 2 diabetes, obesity, cardiovascular disease, certain cancers, and depression.

• Focus on Nutrient Profile: Dr. David Ludwig, a professor of nutrition at the Harvard T.H. Chan School of Public Health, argues that the "ultra-processed" concept is too broad.

  He advocates for focusing on the overall nutritional quality of foods and targeting harmful nutrients such as added sugars and refined grains, rather than the degree of processing. The Institute of Food Technologists (IFT) supports this approach, recommending a definition that prioritizes nutritional quality (e.g., high in salt, sugar, and fat).

• Arguments for Nuance: Julia Wolfson, an associate professor at the Johns Hopkins Bloomberg School of Public Health, notes that some foods classified as ultra-processed, such as whole-grain breads, certain plant-based milks, and some yogurts, have been associated with health benefits. She suggests that health policies should differentiate among ultra-processed foods rather than treating them uniformly, also acknowledging their role in offering convenience and cost savings.

Expert Recommendations and Consumer Guidance

The study findings align with new dietary guidelines from the Department of Health and Human Services, which recommend avoiding foods like chips and candy.

Experts offer practical guidance for consumers:

• Dr. Amier Haidar recommends individuals evaluate their diets and consider replacing ultra-processed foods and snacks with whole foods, unprocessed meats, vegetables, and fruit. He also suggests buying frozen options for cost-effectiveness and reading ingredient labels on prepared meals.
• Wolfson advises reducing consumption of sugary and artificially sweetened beverages and processed meats, which have strong links to health concerns. She also recommends choosing whole-grain options for packaged breads and reading ingredient lists, aiming for products with fewer unfamiliar ingredients.
• While acknowledging the prevalence, affordability, and accessibility of UPFs, experts suggest prioritizing whole foods like beans, frozen fruits, and vegetables when possible.

Dr. Mozaffarian highlights the difficulty for average consumers given expert disagreement, underscoring the necessity for federal policy guidance on ultra-processed foods.

Broader Health Implications

Beyond cardiovascular health, previous research, including a study published in Neurology, has linked high ultra-processed food consumption to an increased likelihood of early signs of Parkinson’s disease.