Ultra-processed foods linked to 47% higher risk of heart attack and stroke

Previous research has shown that people who eat large amounts of ultra-processed foods are more likely to develop metabolic syndrome. This condition includes overweight and obesity, high blood pressure, abnormal cholesterol levels, and insulin resistance. High consumption of UPFs has also been linked to elevated levels of high sensitivity C-reactive protein, a marker of inflammation that is considered a strong predictor of future cardiovascular disease (CVD), which mainly includes heart attacks and strokes. Until now, however, limited data have directly examined whether higher intake of ultra-processed foods is associated with increased cardiovascular disease risk.

Why the Link to Heart Disease Matters Now

As ultra-processed food consumption continues to rise and cardiovascular disease remains one of the leading causes of death in the United States and worldwide, understanding any connection between the two has become increasingly important. Insights into this relationship could influence how doctors advise patients and how public health policies are shaped to protect broader populations.

A National Study Examines the Evidence

Researchers from Florida Atlantic University's Charles E. Schmidt College of Medicine investigated this possible link using data from the U.S. National Health and Nutrition Examination Survey (NHANES). Their findings, published in The American Journal of Medicine, suggest that high consumption of ultra-processed foods may carry serious cardiovascular consequences.

"The findings from our study, based on a large, nationally representative sample of 4,787 U.S. adults, show that those with the highest intake of UPFs suffer a statistically significant and clinically important 47% higher risk of cardiovascular disease," said Charles H. Hennekens, M.D., FACPM, FACC, senior author, First Sir Richard Doll Professor of Medicine and Preventive Medicine, and senior academic advisor, FAU Schmidt College of Medicine. "These results have major implications for future research as well as clinical care and public policy."

How the Study Was Conducted

The research team analyzed NHANES data from 4,787 adults aged 18 and older collected between 2021 and 2023. All participants had at least one day of detailed dietary records and provided information about whether they had ever experienced a heart attack or stroke. Participants documented everything they consumed over two days, allowing researchers to calculate what percentage of each person's total calories came from ultra-processed foods. Using a validated and widely used food classification system, individuals were then divided into four groups based on their level of UPF intake, ranging from lowest to highest.

A 47% Higher Risk of Cardiovascular Disease

Cardiovascular disease in the study was defined as a self-reported history of heart attack or stroke. Researchers adjusted their analysis to account for factors such as age, sex, race and ethnicity, smoking status, and income. The average participant age was 55 years, and 55.9% were women. After these adjustments, individuals in the highest group of ultra-processed food consumption had a statistically significant and clinically important 47% higher risk of cardiovascular disease compared with those in the lowest intake group.

Parallels to Tobacco and Public Health Challenges

The researchers note that growing awareness of the health risks associated with ultra-processed foods may follow a pattern similar to tobacco in the last century. Just as it took decades for the dangers of smoking to become widely accepted, reducing reliance on ultra-processed foods may take time. This is partly due to the influence of large multinational companies that dominate the food market. In addition, many people face limited access to healthier food options, underscoring the need for broader public health solutions.

"Addressing UPFs isn't just about individual choices -- it's about creating environments where the healthy option is the easy option," said Hennekens. "Clinical guidance and public health education are necessary to make nutritious foods accessible and affordable for everyone."

Links to Colorectal Cancer and Other Diseases

The researchers also point to rising rates of colorectal cancer in the United States, especially among younger adults. Many of the risk factors for colorectal cancer overlap with those for cardiovascular disease, including dietary patterns.

"The increasing consumption of UPFs may be a contributing factor, along with other dietary and lifestyle influences that affect a range of common and serious gastrointestinal diseases," said Allison H. Ferris, M.D., FACP, co-author and professor and chair of the Department of Medicine at the FAU Schmidt College of Medicine. "Awareness is the first step toward prevention."

Guidance for Patients and Clinicians

While large scale randomized trials are still needed to confirm these findings, the researchers emphasize that health care providers can take action now. They recommend advising patients to reduce their intake of ultra-processed foods alongside other proven lifestyle changes and appropriate medical therapies.

Study co-authors include Yanna Willett, an undergraduate student at Virginia Polytechnic Institute and State University; Chengwu Yang, M.D., Ph.D., professor of biostatistics; John Dunn, FAU medical student; Tim Dye, Ph.D., professor and chair of the Department of Population Health; Katerina Benson, FAU student, all from FAU's Schmidt College of Medicine; and Kevin Sajan, medical student at Geisinger Commonwealth School of Medicine.