New research has been published (Image: KanaiPixel via Getty Images)
Ultra-processed foods (UPFs) could be responsible for approximately a quarter of all heart disease cases and related deaths, according to new research. Data published in the American Journal of Preventive Medicine and presented at the International Congress on Obesity in Mexico indicates that fatalities could be significantly reduced if people were to lower their consumption of UPFs.
Some experts have been critical of the study, arguing that there is insufficient evidence to demonstrate that UPFs increase the risk of cardiovascular disease. Previous studies have established links between UPFs and poor health outcomes, yet debate continues regarding the scale of the impact and whether food processing itself is the primary culprit, or whether the real issue lies in the fact that many UPFs are laden with fat, sugar and salt.
Common examples of UPFs include ice cream, processed meats, crisps, mass-produced bread, certain breakfast cereals, biscuits, numerous ready meals and fizzy drinks. They also typically contain additives and ingredients not found in home cooking, such as preservatives, emulsifiers and artificial colours and flavours.
In the UK, an average of 56% of daily calories are derived from UPFs, a figure that climbs to 68% amongst teenagers. These statistics are considerably higher than those recorded in comparable European nations such as France and Italy. In the latest research, scientists, including those from the University of Montreal in Canada, utilised Canadian patient records to examine cardiovascular disease – ailments that impact the heart and blood vessels, instances of heart attack and stroke, alongside deaths and disability linked to cardiovascular disease.
The analysis revealed that between 23% and 38% of all cardiovascular disease incidents, such as heart attacks and strokes, in 2019 could be attributed to UPF consumption. This amounts to 58,200 to 96,000 fresh cases of cardiovascular disease alongside 10,600 to 17,400 cardiovascular disease-related fatalities, plus disability for thousands of patients.
UPFs are under the microscope again (Image: Mariyariya via Getty Images)
Cutting UPF consumption by 20% to 50% could have prevented 16,800 to 45,900 fresh cases of cardiovascular disease, alongside 3,100 to 8,300 cardiovascular disease-related fatalities, the scientists 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.”
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 stated that when the CVD findings are examined by food subcategory, 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.”
Maeva May, director of policy for the Stroke Association said: “Stroke is a leading cause of death and disability, and this research is an important reminder that the food environment around us can influence people’s risk. It adds to growing evidence that diets high in ultra-processed foods may increase the risk of cardiovascular disease, including stroke.
“We still need to understand more about the role of processing itself, but we already know that too much salt, sugar and saturated fat can raise blood pressure and other major risk factors for stroke. People should not be blamed for choices shaped by price, availability and relentless marketing. Government and industry must do more to make healthier food affordable, accessible and easier to choose, so fewer people and families have to live with the impact of stroke.”
