Consumption of ultra-processed foods is linked to a higher risk for death — from all causes, as well as from cardiovascular causes — in people with cardiovascular disease, according to a new study published in the European Heart Journal.
Ultra-processed foods — those “made with no or minimal whole foods” and produced with dyes, flavorings, or preservatives — have a particularly bad track record in studies examining their health impact. Consumption of these foods has gone up dramatically around the world in recent decades, and they now account for about 58% of all calories consumed in the United States — with one study showing that they account for about 66% of food intake among school-aged children. Consuming ultra-processed foods is linked to an increased risk for type 2 diabetes, along with higher risks for cardiovascular disease and hypertension in Black adults. And when children consume them, it appears to increase their risk for being overweight or obese years later, as adults.
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For the latest study, researchers set out to examine the impact of consuming ultra-processed foods on the risk of dying in people with established cardiovascular disease. They looked at data from 1,171 people with cardiovascular disease, with an average age of 67, over a median study period of 10.6 years. Participants’ food intake was assessed using a detailed food frequency questionnaire, and participants were divided into four groups of equal size based on the ratio of ultra-processed foods to all foods in their diet, as measured by weight (grams per day). The researchers looked not only at cardiovascular outcomes and death, but also at 18 different biomarkers (body or blood measurements) related to inflammation and cardiovascular, metabolic, or kidney health.
Ultra-processed food linked to increased risk of death
The researchers found that participants in the group with the highest consumption of ultra-processed foods — at least 11.3% of total food intake — were 38% more likely to die of all causes, and 65% more likely to die of cardiovascular causes, than those with the lowest consumption of ultra-processed foods (less than 4.7% of total food intake). They also found a linear relationship between intake of these foods and both the overall and cardiovascular deaths risk — meaning that for every 1% incremental increase in consumption of ultra-processed foods, the death risk went up by a more or less even amount. Finding a linear relationship reinforces the likelihood that consumption of ultra-processed foods — rather than some unknown factor — actually explains the increased death risk.
When the researchers looked at the 18 different biomarkers in all participants, they found that one measurement in particular — for cystatin C, a protein that acts as a biomarker for kidney function — explained 18.3% of the relationship between ultra-processed food consumption and death from all causes, and 16.6% of the relationship between consuming these foods and death from cardiovascular causes. Other biomarkers showed a weaker or no link to ultra-processed food consumption and death risk.
“This study conveys an important message: it is time to overcome the distinction between healthy and unhealthy food solely on the basis of the nutrient value,” said study author Licia Iacoviello, director of the Department of Epidemiology and Prevention at the I.R.C.C.S. Neuromed in Pozzilli, Italy, in a press release. “Fresh vegetables are not the same as pre-cooked and seasoned vegetables, and the same goes for many other foods.” The study authors recommend that “the level of industrial processing of foods should be added to the front-of-pack labels,” which currently show only limited nutritional information in many countries.
Want to see more recent research about the effects of ultra-processed foods? Read “Ultra-Processed Foods in Children Linked to Extra Weight As Adults,” “Ultra-Processed Foods Linked to Hypertension in Black Adults,” “Study Links Type 2 Diabetes to Ultra-Processed Foods.”