Recent research indicates that certain ultra-processed foods may have a more detrimental effect on heart health compared to others.

 
By Chico Mies.

Consumption of ultra-processed foods significantly increases the risk of mortality due to heart disease.

In recent years, processed foods have garnered a negative reputation. However, it is important to recognize that nearly all foods we consume undergo some form of processing. Unless one opts for fresh, whole foods and consumes them immediately in their natural state, the food will inevitably be processed. This processing can include methods such as cooking or preserving, which extends the shelf life of items like canned or frozen fruits and vegetables, as well as packaged grains.

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Various levels of processing are applied to different categories of food. The most heavily processed items are commonly known as ultra-processed foods (UPFs). These foods incorporate numerous added ingredients through industrial methods that cannot be replicated in a domestic kitchen. According to researchers from a study published in September 2024 in The Lancet, UPFs are edible products that include components designed to enhance palatability, profitability, and shelf-life.

When considering ultra-processed foods, one often envisions items such as processed meats (including hot dogs, deli meats, and chicken nuggets), packaged snacks, baked goods, ice cream, soft drinks, and frozen meals. A significant number of these products are high in added sugars, salt, and fats. Some may utilize artificial sweeteners as substitutes for sugar. Additionally, many of these foods contain artificial colors, flavors, and preservatives, along with stabilizers and emulsifiers, which contribute to their distinct appearances, textures, and flavors.

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The researchers indicate that numerous ultra-processed foods (UPFs) may also contain substances produced during their manufacturing and packaging processes. This includes bisphenol-A, a chemical utilized in plastic production, as well as advanced glycated end products, which form when sugar interacts with proteins and fats in the bloodstream, particularly during high-temperature cooking. Although it is challenging to completely avoid advanced glycated end products, UPFs are often the main contributors to their presence, and these compounds have been associated with inflammation and an increased risk of chronic diseases.

However, certain UPFs may offer health benefits. For instance, packaged bread and breakfast cereals fall under the category of UPFs, yet some varieties are rich in fiber while being low in added sugars, salt, and fats. The same can be said for specific vegetarian processed items, such as veggie burgers and non-dairy milk alternatives, including almond, oat, and soy milk.
Ultra-processed foods (UPFs) are widely consumed in our society, accounting for 57% of the energy intake among U.S. adults.

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Consequently, the researchers involved in this study aimed to investigate whether individuals with a high consumption of UPFs face a greater risk of developing cardiovascular disease (CVD), coronary heart disease (CHD), and stroke, in comparison to those who consume fewer UPFs. The findings of their research are as follows.

What Methodology Was Employed in This Study and What Implications Does It Present?

This research was conducted in two distinct phases. In the initial phase, investigators examined data from three extensive cohorts to determine whether there was a relationship between high consumption of ultra-processed foods (UPF) and the incidence of cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. The subsequent phase involved a meta-analysis of prior studies related to this subject, allowing researchers to juxtapose their findings from the first phase with existing literature.

The data utilized in the first phase of this research were sourced from the Nurses’ Health Study (NHS), the Nurses’ Health Study II (NHS II), and the Health Professionals Follow-Up Study (HPFS). Each of these studies was a long-term investigation that tracked the health outcomes of nurses and health professionals over several years.

The National Health Service (NHS) study involved 121,701 female nurses aged between 30 and 55, commencing in 1976, with an average follow-up period of 32 years. The NHS II cohort consisted of 116,340 female nurses aged 25 to 42, initiated in 1989, and followed for an average of 26 years. The Health Professionals Follow-Up Study (HPFS) included 51,529 men aged 40 to 75, starting in 1986, with an average follow-up duration of nearly 30 years.

Participants were required to meet specific criteria for inclusion in the study, such as completing all relevant questionnaires and having no history of cardiovascular disease (CVD) or cancer at the baseline, among other requirements. After reviewing the data, a total of 206,957 participants from all three cohorts were incorporated into the study.

Demographic data was gathered, encompassing factors such as race, age, marital status, employment status, smoking habits, physical activity levels, sleep duration, medication use, family medical history, weight, height, and existing medical diagnoses.

Participants completed food frequency questionnaires at intervals of every 2 to 4 years. Foods were classified into four primary categories: unprocessed or minimally processed, processed culinary ingredients, processed foods, and ultra-processed foods.

Ultra-processed foods (UPFs) were further divided into ten distinct groups: bread and cereals (which included subcategories such as breakfast cereals, dark or whole-grain bread, and refined-grain bread); sauces, spreads, and condiments; packaged sweet snacks and desserts; packaged savory snacks; sugar-sweetened beverages; processed red meat, poultry, and fish; and ready-to-eat meals. Additionally, data on physical activity, sleep duration, medications, family history, weight, height, and medical diagnoses were collected.

The quality of the diet was assessed using a validated evaluation method. The total daily energy and ultra-processed food (UPF) consumption were quantified. Additionally, researchers monitored the medical records of participants for death certificates and diagnoses, focusing on cardiovascular diseases (CVD), coronary heart disease (CHD), and stroke. 

It is important to note that cardiovascular disease encompasses various conditions affecting the heart, while coronary heart disease specifically refers to the narrowing of arteries, which can elevate the risk of heart attacks and strokes.
Following a series of statistical analyses, the researchers discovered a correlation between higher UPF consumption and an increased risk of CVD, CHD, and stroke. In particular, individuals with the highest UPF intake exhibited a 17% greater risk of CVD, a 23% greater risk of CHD, and a 9% greater risk of stroke when compared to those with lower UPF consumption.
Certain food items were also linked to varying risks.

For instance, a significant consumption of sugar-sweetened beverages and processed meats was found to be associated with an elevated risk of CVD, CHD, and stroke, alongside factors such as physical activity, sleep duration, medications, family history, weight, height, and medical diagnoses.

Ultra-processed savory snacks, such as popcorn, along with cold cereals and yogurt or dairy-based desserts, demonstrated an inverse relationship with the risk of cardiovascular disease (CVD) and coronary heart disease (CHD), indicating a correlation with reduced risk. Additionally, ultra-processed bread and cold cereals were linked to a decreased risk of stroke.

The latter portion of this research comprised a review and meta-analysis of 19 previously published cohort studies, encompassing a total of 1,261,040 adults worldwide. In summary, the researchers observed that some of their findings aligned with numerous earlier studies, particularly those that categorized ultra-processed foods (UPFs) into distinct subgroups. They also noted that certain prior studies exhibited limitations, particularly in their tendency to aggregate UPFs into a single category.

In what ways is this relevant to everyday life?

News headlines frequently categorize ultra-processed foods (UPFs) as a single group. While it is accurate that the regular intake of several UPFs, such as processed meats and beverages containing sugar or artificial sweeteners, may elevate the risk of various diseases, it is important to note that certain UPFs can actually enhance health. Examples of such beneficial foods include high-fiber options like whole-grain bread, cereals, popcorn, and yogurt.

However, it is essential to approach these foods with discernment and carefully examine their labels. Some whole-grain products may still have significant amounts of added sugars, fats, and/or salts.

Media reports often group ultra-processed foods (UPFs) together indiscriminately. Although it is true that the frequent consumption of many UPFs, such as processed meats and sugary or artificially sweetened drinks, can lead to an increased risk of disease, certain UPFs may actually provide health benefits. High-fibre foods, including whole-grain bread, cereals, popcorn, and yoghurt, fall into this category.

Nevertheless, consumers must exercise caution and scrutinize product labels. It is important to be aware that some whole-grain items may still contain elevated levels of added sugars, fats, and/or salts.

This principle is also relevant to yoghurt. Whether you prefer Greek yoghurt or traditional yoghurt, opting for plain varieties is generally the most advantageous choice. This allows you to incorporate your preferred additions, such as honey and fruit for sweetness, while maintaining control over the ingredients. It is important to be aware that low-fat or non-fat yoghurts often contain thickeners. To avoid these additives, select yoghurt made from whole milk.
If you frequently consume soda, consider replacing it with sparkling water infused with herbs and fruit for added flavor. This alternative provides a refreshing and effervescent option. You might begin by substituting one soda per day with this a healthier choice and gradually increases the amount over time, facilitating a smoother transition.

For sandwich enthusiasts, alternatives such as egg salad, tuna salad, or nut butter can be excellent options. Additionally, utilizing leftover chicken or steak from the previous night can enhance your sandwich. However, if you enjoy the taste and convenience of deli meats, it is advisable to select healthier options that are low in sodium, free from added sugars, and devoid of nitrates and nitrites, often labeledled as “uncured.”

Conclusion

According to the researchers' findings, it is recommended that the consumption of soda and processed meats be restricted or eliminated due to their negative correlation with cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. Additionally, they advise being cautious of sodium levels, saturated fats, added sugars, and unnecessary artificial additives in certain seemingly healthy ultra-processed foods (UPFs), such as whole-grain bread, cereals, and savory snacks.