Americans are consuming more ultra-processed foods (UPFs) than ever before, with estimates suggesting that up to 70% of the U.S. diet consists of these foods. UPFs, which are loaded with additives to enhance flavor, appearance, and shelf life, are increasingly being linked to a range of health issues, including cardiovascular disease.
Research is gradually revealing the dangers of UPFs. “Many ultra-processed foods are high in saturated fats, added sugars, and sodium—substances already known to contribute to heart disease,” explained Alison Brown, Ph.D., RDN, program director at the National Heart, Lung, and Blood Institute (NHLBI). Despite some progress, the connection between UPFs and cardiovascular disease remains complex and under-researched, prompting the National Institutes of Health (NIH) to deepen its investigations into the health effects and underlying mechanisms of UPF consumption.
One of the largest studies published in 2023 highlights the link between UPFs and heart disease, the leading cause of death in the U.S. and globally. The observational study, which followed over 200,000 participants and analyzed data from 1.2 million individuals, revealed that high UPF consumption increases the risk of heart disease and stroke. Specifically, those with the highest intake of UPFs had a 17% greater risk of cardiovascular disease, a 23% higher risk of coronary heart disease, and a 9% increased risk of stroke compared to those with the lowest intake.
Study co-author JoAnn Manson, M.D., DrPH, a professor at Harvard Medical School, emphasized the study’s findings, noting that while all UPFs pose a health risk, certain foods are particularly harmful. “Sugar-sweetened beverages and processed meats, such as hot dogs and deli meats, were linked to the highest risks for heart disease,” Manson stated. In contrast, breakfast cereals, yogurt, and some whole grain products were associated with a lower risk of heart disease. Additives commonly found in UPFs include high-fructose corn syrup, hydrogenated oils, sodium nitrite, and artificial dyes.
While observational studies are growing in number, clinical trials—considered the gold standard in scientific research—are still limited. A 2019 NIH-supported clinical trial that examined the effects of UPFs on obesity found that participants on a high-UPF diet consumed more calories and gained more weight compared to those on a minimally processed diet, despite both diets containing the same caloric intake.
Kevin D. Hall, Ph.D., a senior investigator at the National Institute of Diabetes and Digestive and Kidney Diseases, led the trial and highlighted a critical pathway for understanding how UPFs contribute to heart disease: overeating. “Our lab focuses on the factors that drive overeating in response to UPFs,” said Hall. “If we can identify these triggers, we may be able to reduce overeating and lower the risk of cardiovascular disease.”
Hall also pointed to other potential mechanisms through which UPFs may affect heart health, including inflammation, immune system disruption, and alterations to the gut microbiome—the collection of microorganisms in the digestive tract. These mechanisms, independent of calorie consumption, are areas of ongoing research.
The list of health problems associated with UPFs continues to grow. Studies have also linked UPFs to weight gain, hypertension, type 2 diabetes, chronic obstructive pulmonary disease (COPD), and even cancer. Health disparities are also a concern, as low-income populations tend to consume higher amounts of UPFs due to factors like limited access to healthy foods and the high cost of fresh produce.
NHLBI’s Alison Brown stressed the urgent need for more research to understand the connection between UPFs and chronic diseases, especially heart disease. “While it may be difficult to completely eliminate ultra-processed foods, people should consider reducing their consumption,” Brown advised. “Unfortunately, consumption trends are heading in the wrong direction, which is concerning for a nation already grappling with high rates of heart disease.”
For those looking to minimize their intake of UPFs, Brown recommends reading food labels carefully, choosing meals with whole grains, fruits, and vegetables, and limiting foods high in saturated fats, added sugars, and salt. She also highlighted the benefits of the Dietary Approaches to Stop Hypertension (DASH) diet, which has recently been named the “Best Heart-Healthy Diet” by U.S. News & World Report.
In conclusion, while the full scope of the health risks linked to ultra-processed foods is still being uncovered, the growing body of research underscores the importance of making informed dietary choices for better heart health.
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