Observational study finds 47% increased risk of cardiovascular disease with high UPF intake — Evidence Review
Published in The American Journal of Medicine, by researchers from Florida Atlantic University, Virginia Polytechnic Institute and State University
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Table of Contents
A new observational study of nearly 5,000 U.S. adults found that those consuming the most ultra-processed foods had a 47% higher risk of cardiovascular disease. These findings are consistent with a growing body of research showing that high intake of ultra-processed foods is linked to increased risks of heart disease and related conditions. The results, published in The American Journal of Medicine, align with international and U.S.-based studies on this topic.
- Multiple large cohort studies and meta-analyses have similarly reported increased cardiovascular and all-cause mortality risks associated with high ultra-processed food consumption, with risk estimates often ranging from 12% to 66% higher depending on outcome and population 1 2 3 5 6 7.
- These findings persist even after adjusting for traditional nutritional factors (e.g., saturated fat, sugar, sodium), suggesting that risks may be attributable to food processing itself or to non-nutrient components such as additives and packaging byproducts 1 3 7.
- The observed associations are robust across diverse populations, including U.S., European, and global cohorts, and are supported by evidence linking unhealthy dietary patterns (including high ultra-processed food intake) to metabolic syndrome, obesity, and other cardiovascular risk factors 2 4 11 12.
Study Overview and Key Findings
Ultra-processed foods have become a dominant part of modern diets, representing a significant proportion of caloric intake in the United States, especially among children and adults. Given the ongoing rise in cardiovascular disease (CVD) and the widespread consumption of these foods, this study from Florida Atlantic University aimed to clarify the direct relationship between ultra-processed food intake and cardiovascular disease risk in a contemporary U.S. population. Unlike many past studies, which often relied on older datasets or non-U.S. populations, this research used recent national survey data and accounted for several demographic and lifestyle factors.
| Property | Value |
|---|---|
| Organization | Florida Atlantic University, Virginia Polytechnic Institute and State University |
| Journal Name | The American Journal of Medicine |
| Authors | Charles H. Hennekens, Allison H. Ferris, Yanna Willett, Chengwu Yang, John Dunn, Tim Dye, Katerina Benson, Kevin Sajan |
| Population | U.S. adults aged 18 and older |
| Sample Size | n=4,787 |
| Methods | Observational Study |
| Outcome | Cardiovascular disease history, UPF intake levels |
| Results | 47% higher risk of cardiovascular disease with high UPF intake |
Literature Review: Related Studies
To provide context for the new findings, we searched the Consensus research database—containing over 200 million scientific papers—using the following queries:
- ultra-processed foods cardiovascular disease risk
- heart attack stroke ultra-processed food intake
- dietary patterns heart attack stroke association
Below is a summary of key themes and findings from the most relevant related studies:
| Topic | Key Findings |
|---|---|
| Does higher ultra-processed food intake increase cardiovascular disease risk? | - Higher ultra-processed food consumption is consistently associated with increased risk of cardiovascular disease, coronary heart disease, and stroke in large cohort studies and meta-analyses 1 2 3 4 5 7. - These associations persist even after adjusting for nutritional quality, suggesting that processing-related factors may contribute independently 1 3 7. |
| What other health outcomes are linked to ultra-processed food intake? | - High ultra-processed food intake is associated with increased all-cause mortality, metabolic syndrome, depression, and some cancers, including colorectal cancer in certain cohorts 2 3 4 6 7. - Risk increases are observed for obesity, hypertension, and adverse metabolic profiles, reinforcing the broad health implications 2 4 6 7. |
| How do dietary patterns affect cardiovascular risk? | - Diets rich in minimally processed foods (fruits, vegetables, whole grains) are associated with lower cardiovascular risk, while Western and Southern dietary patterns (high in processed foods) are associated with increased risk 8 9 10 11 12. - Substituting whole foods for ultra-processed items is consistently linked to reduced CVD incidence 8 9 11. |
Does higher ultra-processed food intake increase cardiovascular disease risk?
Numerous recent studies support the link between high ultra-processed food (UPF) intake and elevated cardiovascular disease risk. The new U.S. study's findings are in line with large prospective studies from France, Italy, and the U.S., as well as several meta-analyses, which have found increased risks of CVD incidence and mortality associated with higher UPF consumption. These associations remain significant even when accounting for traditional dietary risk factors.
- The NutriNet-Santé cohort in France found a 12% increase in overall CVD risk for each 10% increase in UPF consumption 1.
- A meta-analysis reported a 29% higher risk of CVD and a 34% higher risk of cerebrovascular disease for highest vs. lowest UPF consumers 2.
- U.S. data from the Framingham Offspring Study and NHANES III cohorts documented increased CVD and all-cause mortality with higher UPF intake 5 6.
- Associations persist after adjusting for nutrients, suggesting processing-specific risks 1 3 7.
What other health outcomes are linked to ultra-processed food intake?
The health impacts of UPF consumption extend beyond cardiovascular disease. Observational and meta-analytic evidence links high UPF intake to higher rates of all-cause mortality, metabolic syndrome, depression, and certain cancers, including colorectal cancer—an outcome highlighted in the new study's discussion of overlapping dietary risk factors.
- High UPF intake is associated with increased risks for obesity, metabolic syndrome, depression, and all-cause mortality 2 3 4 6 7.
- Some studies report links to specific cancers, including postmenopausal breast cancer and colorectal cancer, especially among younger adults 4.
- Metabolic abnormalities such as low HDL cholesterol and high waist circumference are more common among high UPF consumers 2.
- A large umbrella review found "convincing" evidence linking UPFs to CVD mortality and type 2 diabetes, but also noted most evidence is "low" or "very low" quality due to study design limitations 3.
How do dietary patterns affect cardiovascular risk?
The broader literature on dietary patterns reinforces the risks associated with UPF-rich diets and points to the benefits of whole, minimally processed foods. Multiple large cohort and meta-analytic studies show that healthy eating patterns—such as Mediterranean and plant-based diets—consistently lower CVD risk, while Western or Southern dietary patterns, which are high in processed foods, increase risk.
- Healthy dietary patterns reduce CVD risk by 14% to 31%, depending on the specific index and population studied 9 11.
- Diets rich in fruits, vegetables, whole grains, nuts, and fish are protective, whereas higher intake of processed meats, sugar-sweetened beverages, and ultra-processed foods increases risk 8 9 11 12.
- The Southern U.S. dietary pattern, high in fried and processed foods, is associated with a 37–56% higher hazard of acute coronary heart disease 12.
- Recommendations to reduce UPF intake align with these findings and are reflected in national dietary guidelines 9 11.
Future Research Questions
Although the evidence linking ultra-processed food intake to cardiovascular and other health risks is substantial, most studies are observational and cannot establish causality. Further research is needed to clarify mechanisms, assess interventions, and understand the impact across diverse populations.
| Research Question | Relevance |
|---|---|
| Do randomized controlled trials confirm that reducing ultra-processed food intake lowers cardiovascular disease risk? | Most evidence is observational; randomized trials are needed to determine if reducing UPF consumption directly lowers CVD risk and to test feasible interventions 1 2 3. |
| What mechanisms link ultra-processed foods to cardiovascular disease beyond nutritional composition? | Studies suggest risks persist after adjusting for nutrients, indicating possible roles for additives, packaging contaminants, or processing-induced changes 1 3 7. |
| How does ultra-processed food consumption affect cardiovascular risk in different ethnic and socioeconomic groups? | Evidence from U.S. and European cohorts suggests generalizability, but more research is needed in diverse and high-risk populations to inform targeted public health strategies 5 6 12. |
| What is the impact of public health policies designed to reduce ultra-processed food consumption? | Interventions at the policy level (e.g., taxation, labeling, marketing restrictions) have potential, but their effectiveness and unintended consequences require evaluation 3 7. |
| Are certain subtypes of ultra-processed foods more strongly linked to cardiovascular disease risk? | Ultra-processed foods are diverse; identifying which categories (e.g., processed meats vs. sugary drinks) are most harmful could refine dietary recommendations and interventions 1 5 8. |