High ultra-processed food consumption increases risk for CVD, CV death
Consuming large quantities of ultra-processed foods conferred elevated risk for CVD and CV death, according to a study published in the Journal of the American College of Cardiology.
The researchers defined ultra-processed foods as highly processed industrial formulations made with no or minimal whole foods that include flavorings or preservatives.
Using data from the Framingham Offspring Cohort, researchers conducted an analysis of 3,003 middle-aged adults without CVD (mean age, 54 years; 55% women). Participants were stratified into quintiles by energy-adjusted ultra-processed food consumption, expressed as servings per day.
In an average follow-up of 18 years, 648 CVD events occurred, including 251 incidents of hard CVD, 163 cases of hard CHD and 713 fatalities, including 108 CVD-related deaths, Filippa Juul, MS, PhD, a faculty fellow at the New York University School of Public Health, and colleagues wrote.
According to the researchers, participants in the highest quintile of ultra-processed food intake had higher incident rates of hard CVD, defined as sudden and nonsudden coronary death, MI or fatal or nonfatal stroke, (3.36 per 1,000 person-years vs. 6.64 per 1,000 person-years) and hard CHD, defined as sudden or nonsudden coronary death or MI (2 per 1,000 person-years vs. 4.36 per 1,000 person-years), compared with those in the lowest quintile of ultra-processed food consumption.
When the researchers adjusted for age, sex, education level, smoking status, alcohol intake and physical activity, they found a 1 standard deviation increase in ultra-processed food intake (2.9 servings per day) increased risk for hard CVD by 22% and hard CHD by 30%.
In multivariable-adjusted models, one additional daily serving of ultra-processed food was linked to a 7% rise in risk for hard CVD (HR = 1.07; 95% CI, 1.03-1.12), a 9% increase in risk for hard CHD (HR = 1.09; 95% CI, 1.1-3.28), a 5% increase in risk for overall CVD (HR = 1.05; 95% CI, 1.02-1.08) and a 9% increase in risk for CVD mortality (HR = 1.09; 95% CI, 1.02-1.16), the researchers wrote.
In an analysis of the study population, there was an increase in mean age, BMI and waist circumference across quintiles of ultra-processed food consumption (P for trend < .001). Higher consumption of ultra-processed foods was also linked to lower levels of physical activity (P for trend < .001) and lower education level (P = .028).
According to the researchers, the study has implications for CV prevention, including the need for increased efforts to implement population-wide strategies.
“These strategies may include fiscal measures, such as taxation of sugar-sweetened beverages and other ultra-processed foods, and recommendations regarding processing level in national dietary guidelines,” Juul and colleagues wrote.
Perspective
Back to Top
In this research regarding ultra-processed foods, it is no surprise that the researchers found that eating more processed foods results in worse CV outcomes. This concept of course is not new, but this adds to the existing body of evidence in this space already. What most people don't realize is that many of the foods we consume everyday are considered ultra-processed: instant soups, granola bars or other packaged goods. Many of us in the medical profession eat these foods regularly because of convenience and due to the time crunch that our jobs pose. The researchers in this case found nearly double the rates of CVD when comparing highest to lowest quintiles of intake. They also found that for just one additional serving of ultra-processed foods there was a 7% increase in the risk for CHD events and a 5% increase in risk for overall heart disease. They also found a nearly 10% increase in CV mortality.
What needs to be highlighted from this trial is that clinicians are under prepared and undertrained in the space of nutrition. Despite being asked about nutrition almost daily, many cardiologists have little to no nutrition training. Because the intervention is so inexpensive and so highly effective, making these changes in our practice and for our own personal lives is critically important. As such, we as clinicians should arm ourselves with all tools available, particularly in the nutrition and lifestyle medicine space.
Further, there is only one diet that has been proven to reduce the incidence of both CVD and cancer: a predominantly plant-based, whole food, minimally processed diet. This means that we should spend most of our time shopping in the produce section, which of course welcomes us into almost every supermarket. I frequently quote an adage, which is “the longer the shelf life, the shorter your life.” I think we should pay respect to that and stay away from many of these processed foods.
Collapse