Ultra-processed food linked to quarter of heart disease cases and deaths

Examples of UPFs include ice cream, processed meats, crisps, mass-produced bread, some breakfast cereals, biscuits, many ready meals, and fizzy drinks. File picture

Ultra-processed foods (UPFs) could be driving around a quarter of cases of heart disease and heart disease deaths, research suggests.

Data published in the American Journal of Preventive Medicine and presented at the International Congress on Obesity in Mexico suggests deaths will fall if people cut their intake of UPFs.

Some experts criticised the study, saying there was a lack of evidence to show UPFs increase the risk of cardiovascular diseases.

Previous research has shown UPFs are linked to poor health but there is debate over the scale of the effect and the extent to which processing itself is to blame compared with the fact many UPFs can cause health problems as they are high in fat, sugar, and salt.

Examples of UPFs include ice cream, processed meats, crisps, mass-produced bread, some breakfast cereals, biscuits, many ready meals, and fizzy drinks.

They also tend to include additives and ingredients that are not used when people cook from scratch, such as preservatives, emulsifiers, and artificial colours and flavours.

In the new study, experts, including from the University of Montreal in Canada, used Canadian patient data to look at cardiovascular disease — conditions that affect the heart and blood vessels, cases of heart attack and stroke, plus deaths and disability related to cardiovascular disease.

Analysis showed between 23% and 38% of all cardiovascular disease events, such as heart attacks and strokes, in 2019 were attributable to UPF intake.

This equates to 58,200 to 96,000 new cases of cardiovascular disease plus 10,600 to 17,400 cardiovascular disease-related deaths, plus disability for thousands of patients.

Reducing UPF consumption by 20% to 50% may have prevented 16,800 to 45,900 new cases of cardiovascular disease, plus 3,100 to 8,300 cardiovascular disease-related deaths, the experts said.

They concluded: “These findings reinforce the need for clinical and public health interventions aimed at reducing UPF intake as a key component of cardiovascular disease prevention… To drive meaningful change in dietary patterns, comprehensive structural measures are essential.

“These include regulations on food taxes, front-of-package labelling, marketing restrictions, and reformulation targets aimed at improving food quality.” 

Study limitations

Professor Alberto Fiore, from Abertay University in Dundee, said the study had limitations.

“This is a modelling study, not a clinical trial — it does not measure what actually happened to people who ate more or fewer ultra-processed foods.

“It takes a 2015 dietary snapshot, applies a risk multiplier borrowed from studies in France, Italy, and the US, and projects how many CVD events might be attributable to UPF consumption.

“The authors’ own sensitivity analysis reduces the headline figure of 96,000 avoidable CVD cases by nearly 40% depending on which risk estimate is used — that is a very wide uncertainty range for a number being put in front of the public.

“But the deeper problem is one this study cannot resolve: Are we actually measuring the effect of industrial processing, or are we simply measuring the well-known harms of a poor diet that happens to come in a packet?

“The paper itself tells us the answer. It acknowledges that ‘ultra-processed dietary patterns’ are characterised by excess free sugars, saturated fats, and sodium, and low fibre — and it separately estimates that targeting free sugars and sodium alone could prevent thousands of CVD deaths per year in Canada.

“If standard nutritional harms already explain the observed risk, then the concept of ‘ultra-processing’ is doing no independent scientific work whatsoever.” 

He said when the CVD findings are broken down by food subtype, they are “overwhelmingly driven by sugar-sweetened beverages and processed meat products.

“These are foods whose harmfulness has been established for decades on purely nutritional grounds — high free sugar, high saturated fat, high sodium, low fibre — with no need to invoke the concept of industrial processing at all.”