Ultra processed foods linked to higher cardiovascular disease and death

People who eat more ultra processed food (UPF) have a higher risk of cardiovascular disease and death, according to a report published in the European Heart Journal today (Thursday). The report, by a group of cardiology experts from across Europe, brings together the results of all research on UPFs and cardiovascular disease that has been published to date.

It highlights the risks of obesity, diabetes, hypertension, chronic kidney disease and death from cardiovascular that have now been linked to eating large amounts of UPF.

The authors of the report are calling on doctors to talk to their patients about how much UPF they are eating and give advice on how to reduce UPFs.

The clinical consensus statement is from the European Society of Cardiology's Council for Cardiology Practice and the European Association of Preventive Cardiology, together with a group of topic expert, led by Professor Luigina Guasti from the University of Insubria, Varese, Italy; Dr Marialaura Bonaccio, IRCCS NEUROMED, Pozzilli, Italy; Professor Massimo Piepoli, University of Milan, Italy; and Professor Licia Iacoviello, LUM University, Casamassima, Italy.

UPFs, made from industrial ingredients and additives, have largely replaced traditional diets. Research suggests these foods are linked to several risk factors for cardiovascular disease, such as obesity, diabetes and high blood pressure, and to the risk of developing and dying from heart disease. However, this evidence has not yet made its way into the advice we give to patients on healthy eating.

We hope that this consensus statement from the European Society of Cardiology will help doctors recognize UPFs as a potential risk factor and provide clear guidance to their patients on limiting UPFs to prevent cardiovascular risk factors, disease and death."

Professor Luigina Guasti, University of Insubria, Varese, Italy

Key findings of the expert consensus report:

• Adults with the highest UPF consumption have up to a 19% higher risk of heart disease, a 13% higher risk of atrial fibrillation, and up to a 65% increased risk of cardiovascular death, compared with those with the lowest consumption.
• These foods also worsen key risk factors, including obesity, type 2 diabetes, high blood pressure and the build-up of unhealthy fats in the blood stream.
• Consumption of UPF is increasing in Europe with the percentage of calories from UPF ranging from 61% in the Netherlands and 54% in the UK, to 25% in Spain, 22% in Portugal and 18% in Italy.
• Most national dietary guidelines prioritize nutrient-based recommendations and do not address the issue of food processing.

The report's authors call for:

• Better public understanding of UPFs through food labeling, food regulation and updated guidelines.

• Doctors treating people with cardiovascular disease, or at risk of cardiovascular disease, should ask about UPFs when assessing their patients' diets.
• Doctors should discuss reducing UPF to lower risk – alongside other advice on diet, physical activity, smoking and drinking – including explaining that foods marketed as 'healthier' can often be ultra processed.

The authors say that evidence on the risks of UPF is consistent across large, diverse populations and holds true across different cardiovascular risks, diseases and death. However, they caution that most of the research is made up of observational studies, with few long-term interventional trials.

Dr Bonaccio adds: "The associations between UPF and heart disease are consistent and biologically plausible. UPFs raise cardiovascular risk mainly by promoting obesity, diabetes, hypertension and the build-up of unhealthy fats in the blood. UPFs tend to be high in sugar, salt, and unhealthy fats. They also have additives, contaminants and an altered food structure, which may trigger inflammation, metabolic disruption, gut microbiome changes and overeating.

"We need long-term intervention trials to test whether reducing UPFs improves cardiovascular health. More research is also needed to understand the effects of specific additives, processing compounds and food structures on heart health. Future studies could focus on implementing UPF-focused dietary interventions in clinical practice.

"The research on UPFs has been accumulating for a decade, and it highlights the risks of high UPF consumption and the benefits of choosing whole or minimally processed foods. This emphasizes that disease prevention should not focus solely on nutrients, but also on the degree of food processing. Even foods with good nutritional profiles can be harmful if highly processed. Integrating UPF awareness into routine medical care could improve patient's health without adding significant cost or time."