Ultra-processed food consumption associated with increased risk for heart disease

People who consumed over nine servings of ultra-processed foods per day on average were 67% more likely to suffer a major cardiac event than people consuming about one serving of such foods per day, in a study being presented at the American College of Cardiology's Annual Scientific Session (ACC.26). Ultra-processed foods include many packaged and convenience foods, such as chips, crackers, frozen meals, processed meats, sugary drinks, breakfast cereals and breads.

With each additional daily serving, the risk of adverse events such as heart attacks, strokes and death from coronary heart disease or stroke increases by more than 5%, according to the findings. The association between ultra-processed food intake and adverse events was more pronounced among Black Americans compared with other racial groups.

Ultra-processed foods are associated with an increased risk for heart disease, and while many of these products may seem like convenient on-the-go meal or snack options, our findings suggest they should be consumed in moderation." 

Amier Haidar, MD, cardiology fellow at the University of Texas Health Science Center at Houston and study's lead author

The research is among the first large studies to examine ultra-processed food consumption and heart disease risk in a racially diverse population of U.S. adults. The findings align with those of previous studies, most of which have been conducted in Europe, and offer additional context for the more diverse U.S. population.

The study is based on data from 6,814 U.S. adults without known heart disease who enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) between ages 45-84 years. Using food questionnaires, researchers assessed each participant's daily intake of ultra-processed foods based on the NOVA classification system, which categorizes foods into four groupings ranging from unprocessed or minimally processed (e.g., corn on the cob) through ultra-processed (e.g., corn chips), with more lightly processed items falling in the middle (e.g., corn starch and canned corn). 

Participants in the highest quintile for ultra-processed food intake consumed 9.3 servings of such foods per day on average, while participants in the lowest quintile averaged 1.1 servings per day. Compared with the lowest quintile, participants in the highest quintile were 67% more likely to die from coronary heart disease or stroke or to experience a non-fatal heart attack, stroke or resuscitated cardiac arrest.

"We controlled for a lot of factors in this study," Haidar said. "Regardless of the amount of calories you consumed per day, regardless of the overall quality of your diet, and after controlling for common risk factors like diabetes, high blood pressure, high cholesterol and obesity, the risk associated with higher ultra-processed food intake was still about the same."

Haidar said these findings suggest that ultra-processed foods may contribute to cardiovascular risk through mechanisms beyond excess calories or poor overall diet quality, and that paying attention to how foods are processed alongside their nutrient content may be important for heart health.

Overall, each additional daily serving of ultra-processed foods was associated with a 5.1% increased risk of adverse cardiac events. However, this association was amplified among Black Americans, who saw a 6.1% increase in risk with each additional serving compared with a 3.2% increase per serving among non-Black individuals. Researchers said that minority-targeted food marketing and neighborhood environmental factors that make it harder to access less-processed foods have likely contributed to inequities in ultra-processed food consumption and associated health impacts among different racial groups.

There were several limitations to the study. Since the MESA study was not designed specifically to collect data on ultra-processed food intake, researchers said that the dietary questionnaire data relied on self-reporting by participants and assessed processed food intake by number of servings rather than individual food items.

The study also did not focus on the biological mechanisms involved, but previous research suggests that the high energy density, added sugars and fats, and effects on satiety and metabolism from ultra-processed foods drives weight gain, inflammation and the buildup of visceral fat tissue, all of which can contribute to heart disease.

Heidar said one way to reduce risk is to pay attention to the types of foods being consumed and to the food labels. Nutrition labels provide important information about the amount of added sugar, salt, fat and carbohydrates in each serving. These are often higher in ultra-processed foods compared with less-processed foods like plain oatmeal, nuts, beans and fresh or frozen produce.

The ACC published a 2025 Concise Clinical Guidance report in JACC endorsing a standardized front-of-package labeling system to help make sure that healthier choices are more visible, accessible and achievable for all consumers.

This study was published simultaneously in JACC Advances.