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Ultra-processed Foods Linked to Greater Heart Attack, Stroke Risk

Adults whose diets were highest in ultra-processed foods -- like sodas and packaged snacks -- had a 47% higher risk of heart attack or stroke than those who ate the least, even after adjusting for other factors.

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Ultra-processed foods (UPFs) are industrially modified products loaded with added fats, sugars, starches, salts and chemical additives like emulsifiers. From sodas to snacks and processed meats, these foods are stripped of natural nutrients. UPFs introduce many ingredients that our bodies have never encountered. In the United States today, UPFs make up nearly 60% of adults’ and 70% of children’s diets.

Prior studies have shown that people who consume large amounts of UPFs have higher risks of metabolic syndrome, a constellation of overweight and obesity, hypertension, dyslipidemia and insulin resistance, as well as increased levels of high sensitivity C-reactive protein, a sensitive marker of inflammation and accurate predictor of future cardiovascular disease (CVD), which is mainly comprised of heart attacks and strokes. However, data are sparse on whether people who consume higher amounts of UPFs have increased risks of CVD.

With consumption of UPFs on the rise and CVD remaining a leading cause of death in the U.S. and increasing around the world, understanding the link between the two is more urgent than ever – as insights could have profound implications for individual patient care as well as the health of the general public.

Researchers from �����Դ�ɼ���’s Charles E. Schmidt College of Medicine explored this possible link by examining data from the U.S. National Health and Nutrition Examination Survey (NHANES). The results of the study, published in , provide more troubling news for individuals who consume high amounts of UPFs.

“The findings from our study, based on a large, nationally representative sample of 4,787 U.S. adults, show that those with the highest intake of UPFs suffer a statistically significant and clinically important 47% higher risk of cardiovascular disease,” said Charles H. Hennekens, M.D., FACPM, FACC, senior author, First Sir Richard Doll Professor of Medicine and Preventive Medicine, and senior academic advisor, FAU Schmidt College of Medicine. “These results have major implications for future research as well as clinical care and public policy.”

The researchers analyzed data from the NHANES, which collects health, diet and lifestyle information from a large, random sample of U.S. adults. They analyzed the 4,787 participants aged 18 and older from 2021 to 2023 who had at least one day of detailed dietary records and information about heart attack or stroke. Participants reported everything they ate over two days, and researchers calculated what percentage of each person’s total calories came from UPFs, using a validated and widely used system that classifies foods. People were then grouped into four categories, ranging from low to high UPF food intake.

The study focused on CVD, defined as a self-reported history of heart attack or stroke. Researchers also accounted for factors such as age, sex, race and ethnicity, smoking and income. Average age of participants was 55 years, and 55.9% were women. After adjusting for these confounding factors, those in the highest quartile of UPFs intake had a statistically significant and clinically important 47% higher risk of CVD compared with those in the lowest quartile.

The researchers note increasing public awareness and policy change around UPFs may mirror that of tobacco in the last century. Just as it took decades for the dangers of cigarettes to become widely recognized, changing consumption habits around UPFs will likely take time, given the influence of multinational companies that dominate the market. At the same time, many people face real barriers to access healthier options, highlighting the need for a broader public health approach.

“Addressing UPFs isn’t just about individual choices – it’s about creating environments where the healthy option is the easy option,” said Hennekens. “Clinical guidance and public health education are necessary to make nutritious foods accessible and affordable for everyone.”

The researchers also address the rising rates of colorectal cancer in the U.S., particularly among younger adults as the risk factors are similar to those of CVD.  

“The increasing consumption of UPFs may be a contributing factor, along with other dietary and lifestyle influences that affect a range of common and serious gastrointestinal diseases,” said Allison H. Ferris, M.D., FACP, co-author and professor and chair of the Department of Medicine at the FAU Schmidt College of Medicine. “Awareness is the first step toward prevention.”

Although large scale randomized trials are needed, the researchers say that in the meantime, health care providers should advise patients to decrease consumption of UPFs in addition to adopting other therapeutic lifestyle changes and adjunctive drug therapies of proven benefit.

Study co-authors are Yanna Willett, an undergraduate student, Virginia Polytechnic Institute and State University; Chengwu Yang, M.D., Ph.D., professor of biostatistics; John Dunn, FAU medical student; Tim Dye, Ph.D., professor and chair, Department of Population Health, all within FAU’s Schmidt College of Medicine; Katerina Benson, FAU student; and Kevin Sajan, medical student at Geisinger Commonwealth School of Medicine.

-FAU-

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