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Higher consumption of ultra-processed foods increases risk of heart disease
A study published in the Journal of the American College of Cardiology found that higher consumption of ultra-processed foods is associated with an increased risk of cardiovascular disease incidence and death, with each additional daily serving found to further increase risk. A press release reports that ultra-processed foods account for 58% of total energy in the average US diet.
Study author Dr Filippa Juul, PhD (New York University School of Public Health, New York, USA) and others used data from the Framingham Offspring Study to examine the role ultra-processed foods play in cardiovascular disease. After excluding participants with pre-existing cardiovascular disease or missing data, the authors identified 3,003 middle-aged adults (on average 53.5 years). Of these participants, over half were female, 33.1% had undergone 16 years or more of education, and two-thirds were either former or current smokers. Additionally, they were primarily Caucasian.
Juul et al assessed diet by mail using a food questionnaire in which participants reported the frequency of consumption of certain foods in the previous year, with options ranging from one or no servings/months to more than six servings/day. During in-person examinations trained personnel reviewed the questionnaires. The US Department of Agriculture nutrient database was used to calculate nutrient intakes from reported dietary intakes.
Overall, according to the press release, 5.8% of participants had diabetes and 19% had high blood pressure. However, prevalence of these risk factors was higher among participants who were high consumers of ultra-processed foods compared to low consumers. Furthermore, during an average of 18 years of follow-up, a total of 648 cardiovascular events occurred — including 251 cases of hard cardiovascular disease and 163 cases of hard coronary heart disease. There were 713 deaths during the follow-up period, including 108 cardiovascular disease deaths. Participants with the highest intakes of ultra-processed foods had higher incident rates compared to those consuming the least amount of ultra-processed foods.
The authors found that each daily serving of ultra-processed food was associated with a 7% increase in the risk of hard cardiovascular disease, a 9% increase in the risk of hard coronary heart disease, a 5% increase in overall cardiovascular disease and a 9% increased risk in cardiovascular disease mortality. They also found that intake of bread was associated with an increased risk of hard cardiovascular disease, hard coronary heart disease, and overall mortality, while ultra-processed meat intake was associated with an increased risk of hard cardiovascular disease and overall cardiovascular disease.
Dr Juul comments: “The consumption of ultra-processed foods makes up over half of the daily calories in the average American diet and are increasingly consumed worldwide. As poor diet is a major modifiable risk factor for heart disease, it represents a critical target in prevention efforts. Our findings add to a growing body of evidence suggesting cardiovascular benefits of limiting ultra-processed foods. Ultra-processed foods are ubiquitous and include many foods that are marketed as healthy, such as protein bars, breakfast cereals and most industrially produced breads. Population-wide strategies such as taxation on sugar-sweetened beverages and other ultra-processed foods and recommendations regarding processing levels in national dietary guidelines are needed to reduce the intake of ultra-processed foods. Of course, we must also implement policies that increase the availability, accessibility, and affordability of nutritious, minimally processed foods, especially in disadvantaged populations. At the clinical level, there is a need for increased commitment to individualised nutrition counselling for adopting sustainable heart-healthy diets.”
The press release reports that when foods are processed, beneficial nutrients might be removed while non-beneficial nutrients and food additives may be added. It also notes that processing also changes the physical structure of foods. The consumption of ultra-processed foods is linked with being overweight/obese, high blood pressure, metabolic syndrome, and Type 2 diabetes.
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