Some Ultra-Processed Foods May Be Worse for Your Heart Health Than Others, According to New Research

These researchers also point out that not all UPFs are created equal.

Reviewed by Dietitian Jessica Ball, M.S., RDReviewed by Dietitian Jessica Ball, M.S., RD

Processed foods have certainly gotten a bad rep over the last few years. But most of the foods we eat are processed on some level. I mean, unless you’re choosing fresh, whole food and eating it right away and as is, it’s going to be processed, whether that’s cooking it or storing it so that it lasts longer—like in the case of canned or frozen fruits and vegetables or packaged rice.

Related: The 10 Best Processed Foods You Should Be Eating for Weight Loss, According to Nutrition Experts

But there are levels of processing that's done to different types of foods. Those that are the most processed are often referred to as ultra-processed foods (UPFs). These are foods that contain multiple added ingredients via industrial processing that could not be recreated in a home kitchen. Or, as the researchers of a new study published in September 2024 in The Lancet say, UPFs are edible products that contain ingredients that extend palatability, profitability and shelf-life.

When we think of ultra-processed foods, we typically think of things like processed meats (hot dogs, deli meats, chicken nuggets, etc.), packaged snacks, packaged baked goods, ice cream, soda and frozen meals. Most of these foods contain a lot of added sugar, salt and fat. Some may contain artificial sweeteners in place of sugar. Many also contain artificial colors, flavors and preservatives, as well as stabilizers and emulsifiers, to help them achieve specific appearances, textures and tastes.

These researchers state that many UPFs can also contain compounds that are generated through their production and packaging. This includes bisphenol-A, a chemical compound that’s used to make plastic, and advanced glycated end products, which occur as a result of sugar interacting with protein and fat in the bloodstream, especially when foods are cooked at high temperatures. While it’s difficult to totally avoid advanced glycated end products, UPFs tend to be the primary sources of them—and they’ve been linked to inflammation and higher chronic disease risk.

But some UPFs might be considered good for you. For example, packaged bread and breakfast cereals are considered UPFs but some of them can be high in fiber and low in added sugar, salt and fat. Same with certain vegetarian processed foods, like veggie burgers and non-dairy milks—like almond, oat and soy milks.

UPFs are prevalent in our society, representing 57% of U.S. adults’ energy intake. So the researchers for this study wanted to know if people who eat a high amount of UPFs are at an increased risk of cardiovascular disease (CVD), coronary heart disease (CHD) and stroke, compared to people who eat fewer UPFs. Here’s what they found.

How Was This Study Conducted & What Does it Suggest?

This study was done in two parts. For the first part, researchers analyzed data from three large cohorts to see if there was a connection between high UPF intake and CVD, CHD and stroke. The second part of this study was a meta-analysis of previous studies done on this topic. Researchers wanted to compare them to what they found in the first part of the study.

The data for the first part of this study came from the Nurses’ Health Study (NHS), the Nurses’ Health Study II (NHS II) and the Health Professionals Follow-Up Study (HPFS). All three were long-term studies that followed nurses and health professionals for several years.

The NHS included 121,701 female nurses, aged 30-55, began in 1976 and were followed for an average of 32 years. The NHS II was comprised of 116,340 female nurses aged 25-42, started in 1989 and were followed for an average of 26 years. The HPFS recruited 51,529 men aged 40-75, started in 1986 and were followed for an average of almost 30 years.

Certain criteria applied to these participants to be included in this study—like, they had to have filled out all the pertinent questionnaires and not have had CVD or cancer at baseline, among other things. After sifting through that information, 206,957 total participants across all three cohorts were included in the study.

Demographic information was collected, including race, age, marital status, working status, smoking, physical activity, sleep duration, medications, family history, weight, height and medical diagnoses.

Participants filled out food frequency questionnaires every 2 to 4 years. Food was categorized into four main groups: unprocessed/minimally processed, processed culinary ingredients, processed foods, and ultra-processed foods.

UPFs were then broken down into 10 mutually exclusive groups: bread and cereals (which were then broken down into subgroups: breakfast cereals, dark/whole-grain bread, refined-grain bread); sauces, spreads and condiments; packaged sweet snacks and desserts; packaged savory snacks; sugar-sweetened beverages; processed red meat, poultry and fish; ready-to-eat/heat mixed dished; yogurt/dairy-based desserts; hard liquors; artificially-sweetened beverages.

Diet quality was determined by using a validated assessment. Daily total energy and UPF intakes were calculated. Researchers also followed participants’ medical records for death certificates and diagnoses, specifically, CVD, CHD and stroke (cardiovascular disease is an umbrella term for any type of disease that affects the heart—and coronary heart disease is a specific type of CVD that involves the arteries becoming clogged and can increase the risk of a heart attack or stroke).

After several statistical analyses were run, researchers found that a higher total UPF intake was associated with a higher risk of CVD, CHD and stroke. Specifically, compared to those with a lower overall intake of UPFs, those with the highest intake of UPFs appeared to have a 17% higher risk of CVD, 23% higher risk of CHD and 9% higher risk of stroke.

Specific foods were also associated with higher or lower risk. For example, a high intake of sugar-sweetened beverages and processed meats was associated with higher CVD, CHD and stroke risk. And high consumption of artificially-sweetened beverages was associated with greater CVD and CHD risk.

But ultra-processed savory snacks (like popcorn), cold cereals and yogurt/dairy-based desserts were inversely associated with CVD and CHD risk—meaning, they were linked to lower risk. And ultra-processed bread and cold cereals were associated with lower stroke risk.

The second part of this study involved the review and meta-analysis that included 19 cohort studies that had previously been published. This included a total of 1,261,040 adults from around the globe. In short, researchers found that some of their findings were consistent with many of the previous studies, especially ones that broke UPFs up into subgroups. They also felt that some of the previous studies had some flaws, including lumping UPFs all into one category.

How Does This Apply to Real Life?

News headlines often lump UPFs all together. And while it’s true that regular consumption of many of them may contribute to higher disease risk—like processed meats, and sugar- and artificially-sweetened beverages—some foods considered UPFs may actually help improve your health. This includes high-fiber foods like whole-grain bread, cereal and popcorn, as well as yogurt.

But you also need to be a wise consumer of these foods and read the labels. Some whole-grain foods can still contain high levels of added sugar, fat and/or salt.

Related: The Healthiest Types of Bread, According to a Dietitian

This also applies to yogurt. Whether you’re choosing Greek yogurt or regular yogurt, plain is typically your best bet. This way, you can add your own extras, like honey and fruit to sweeten it, and you know exactly what’s going into it. It’s worth noting that if you’re choosing low-fat or no-fat yogurt, it’s likely to have some sort of thickener added to it. If you want to avoid that, choose yogurt made with whole milk.

If you regularly drink soda, consider swapping it out for sparkling water and add herbs and fruit to it for flavoring, which still gives you something flavorful and bubbly to sip on. You could start by replacing one soda a day with the alternative and gradually increase how much you're replacing over time. This can help make the transition easier.

And if sandwiches are your thing, you could opt for egg salad, tuna salad or nut butter, or use last night’s leftover chicken or steak in your sandwich. But if you just simply like the taste and convenience of deli meat, choose a healthier variety that is low- or no-sodium, no-added-sugar and nitrate- and nitrite-free (usually labeled “uncured”).

The Bottom Line

Based on their findings, these researchers suggest that soda and processed meats should be limited or avoided due to their adverse association with CVD, CHD and stroke. They also suggest watching out for sodium content, saturated fats, added sugars and non-essential artificial chemicals in potentially healthy UPFs, like whole-grain bread, cereal and savory snacks.

Read the original article on Eating Well.