The relationship between ultra-processed foods and heart health has been an ongoing concern among healthcare professionals, particularly cardiologists. A recent study published in The Lancet Regional Health - Americas has shed new light on the impact of various types of ultra-processed foods on cardiovascular health, offering both guidance and caution for consumers.
This study analyzed data from over 200,000 participants over 30 years, as well as data from 19 other studies that involved approximately 1.25 million adults. The findings show that high consumption of ultra-processed foods is associated with an increased risk of cardiovascular disease (CVD), coronary heart disease (CHD), and stroke. However, not all ultra-processed foods pose the same level of risk, with some foods faring worse for heart health, and others offering surprising benefits.
Before diving into the specific findings, it’s important to understand what qualifies as "ultra-processed" food. Ultra-processed foods (UPFs) are typically characterized by a high degree of industrial processing, involving the use of additives, preservatives, artificial colors, and flavors, and ingredients that do not resemble whole foods. These foods often have little to no nutritional value and are typically high in added sugars, unhealthy fats, and sodium. Examples include sugary drinks, processed meats, packaged snacks, and fast foods.
While ultra-processed foods are convenient and often inexpensive, they have been linked to numerous health issues, including obesity, type 2 diabetes, and various cancers. Their association with cardiovascular diseases has drawn particular attention from the medical community, especially given the rising rates of heart disease globally.
The study identified two types of ultra-processed foods that stand out as particularly harmful to cardiovascular health: processed meats and sugar-sweetened beverages. These findings are consistent with previous research, which has long warned about the dangers of these products.
Processed meats, such as bacon, hot dogs, sausages, and deli meats, are rich in unhealthy fats and sodium. They often contain nitrates and nitrites, preservatives linked to an increased risk of heart disease and cancer. A diet high in processed meats is known to raise blood pressure and cholesterol levels, two of the leading risk factors for heart disease. Additionally, the excessive salt content in these meats can lead to hypertension, further straining the cardiovascular system.
The study also pointed to sugar-sweetened beverages as a significant risk factor. These drinks, which include sodas, fruit juices with added sugar, and sweetened teas, are packed with high levels of fructose, which can lead to insulin resistance, inflammation, and increased fat accumulation around vital organs. Chronic consumption of sugary drinks is associated with obesity, type 2 diabetes, and ultimately, an elevated risk of cardiovascular diseases.
Both processed meats and sugary beverages contribute to inflammation and oxidative stress in the body, two processes that are central to the development of atherosclerosis (plaque build-up in the arteries), heart attacks, and strokes.
On the other end of the spectrum, the study revealed that some ultra-processed foods, such as cold cereals, yogurt, and certain savory snacks, were associated with a reduced risk of cardiovascular disease. This is somewhat surprising, given that these foods are often lumped into the "unhealthy" category due to their processing.
Cold cereals can be a source of heart-healthy nutrients, especially those fortified with vitamins, minerals, and fiber. Fiber, in particular, is a key player in reducing cholesterol levels and maintaining healthy blood pressure. Whole grain cereals, in particular, provide beneficial nutrients that promote heart health.
Yogurt is another ultra-processed food with potential health benefits. The probiotics found in yogurt can improve gut health, which is increasingly recognized as a factor in cardiovascular wellness. Yogurt is also rich in calcium and protein, making it a nutritious option when consumed in moderation. However, it is important to note that not all yogurts are created equal—those with added sugars and artificial flavors can negate these health benefits.
Finally, savory snacks such as certain types of nuts, seeds, and whole grain crackers were also linked with lower cardiovascular risk. These snacks, when chosen carefully, can offer a healthy balance of fats, fiber, and protein. For example, nuts contain heart-healthy monounsaturated fats and have been shown to reduce bad cholesterol (LDL) while increasing good cholesterol (HDL). The key is to avoid heavily salted or artificially flavored versions of these snacks, as they can still be detrimental to heart health.
One of the key insights from the study is that not all ultra-processed foods should be judged solely by their degree of processing. Instead, their nutritional profiles—the specific balance of macronutrients, micronutrients, and additives—are what make the difference.
For example, ultra-processed foods high in fiber, vitamins, and minerals may offer some protection against heart disease, while those high in added sugars, sodium, and unhealthy fats pose significant risks. This means that while it’s best to limit ultra-processed foods, some items can still be part of a balanced diet if they contain beneficial nutrients.
For cardiologists, this study offers an opportunity to provide more nuanced dietary guidance to patients. While it has long been recommended to reduce the intake of ultra-processed foods, this research shows that not all ultra-processed foods are equally harmful. A more tailored approach to diet could help patients make better choices without feeling like they have to completely eliminate all processed foods.
For instance, rather than recommending a blanket avoidance of all packaged or processed foods, healthcare providers can encourage patients to prioritize whole grain cereals, unsweetened yogurt, and nut-based snacks while limiting sugary drinks and processed meats. This approach may be more sustainable for many patients and could lead to better adherence to heart-healthy diets.
Furthermore, educating patients on how to read food labels is crucial. Understanding which ingredients contribute to heart disease—such as added sugars and unhealthy fats—can empower individuals to make smarter decisions about the processed foods they consume. For example, patients should be advised to choose products with fewer ingredients, especially those that are recognizable and associated with whole foods (e.g., "oats" versus "high-fructose corn syrup").
The relationship between ultra-processed foods and cardiovascular health is complex, but this new study offers valuable insights. While many ultra-processed foods contribute to an increased risk of heart disease, not all of them are equally harmful. Processed meats and sugary drinks stand out as particularly dangerous, while yogurt, whole grain cereals, and certain savory snacks can be part of a heart-healthy diet when consumed in moderation.
For cardiologists, the key takeaway is to provide patients with balanced, personalized dietary advice that focuses on reducing the intake of the most harmful ultra-processed foods while recognizing that some can still have a place in a healthy eating plan. This nuanced approach can help patients make informed choices that support their long-term cardiovascular health.
