More Processed Foods = More Cardiovascular Issues

This is yet another study that suggests the benefits of limiting ultra-processed food intake, consumption of more of these foods corresponded with a greater risk of incident cardiovascular disease and mortality. 

This study involved 3,003 participants aged 18+ with a mean age of 53.5 years who were CVD-free at baseline and were followed up with clinical exams and food frequency questionnaires every 4 years.

Participants ate on average 7.5 energy-adjusted servings of ultra-processed food per day at baseline. Each additional serving per day was found to be associated with worse outcomes which were independent of a person’s energy intake, adiposity, and other cardiovascular risk factors:

• Hard CVD (coronary death, myocardial infarction [MI], and stroke): adjusted HR 1.07 (95% CI 1.03-1.12)
• Coronary death and MI: adjusted HR 1.09 (95% CI 1.10-3.28)
• Overall CVD: adjusted HR 1.05 (95% CI 1.02-1.08)
• CVD mortality: adjusted HR 1.09 (95% CI 1.02-1.16)

“In contrast to previous studies, we did not observe an association between ultra-processed food consumption and total mortality," Niyati Parekh, MS, Ph.D., RD, of New York University's School of Global Public Health in New York City, and colleagues wrote.

According to the study published in the Journal of the American College of Cardiology, these ultra-processed foods can provide up to 58% of the daily caloric intake of the average American diet, commonly referred to as a Western Diet. Items such as processed meat, bread, and soft drinks in particular were noted as being potential drivers of poor cardiovascular outcomes. 

"From a public health perspective, our study suggests the need for increased efforts to implement population-wide strategies," write the researchers. "These strategies may include fiscal measures, such as taxation of sugar-sweetened beverages and other ultra-processed foods, and recommendations regarding processing levels in national dietary guidelines."

“Importantly, policies should be designed to simultaneously increase the availability, accessibility, and affordability of nutritious minimally processed foods, especially in disadvantaged populations," the researchers said. Adding that clinicians can play a role by providing evidence-based nutrition counseling to patients to achieve individualized patient-centered heart-healthy diets.

"Ultimately, the goal should be to make the unhealthy choice the hard choice and the healthy choice the easy choice." 

Although this study was limited by being predominantly caucasian in population with higher levels of education and income than the general American population; and the researchers could not rule out/exclude the potential for dietary measurement error and unmeasured confounding, the findings are nevertheless generally consistent with the literature, including the smaller French NutriNet-Sante cohort. 

The researchers suggest that biological mechanisms behind the link between ultra-processed foods and cardiovascular disease likely go beyond higher energy intakes and weight gain given that this study did control for those factors. Plausible mechanisms may be related to the high intake of food components that are associated with heart disease as well as additives that disrupt microbiota integrity and promote arterial calcification as well as oxidative stress.