Experts say the dangers posed by the increasing and alarming global consumption of ultra-processed food – raised BP levels, heart disease and strokes – is threatening a “tidal wave of harm” and should serve as a wake-up call for governments worldwide.
In the UK and US, more than half of the average diet now comprises ultra-processed food (UPF) like cereals, protein bars, fizzy drinks, instant meals and fast foods. For some, especially people who are younger, poorer or from disadvantaged areas, a diet of as much as 80% UPF is typical.
Two large studies presented at the world’s largest heart conference showed the devastating impact UPF has on cardiovascular health, reports The Guardian.
The first study, which tracked 10 000 women for 15 years, found that those with the highest proportion of UPF in their diet were 39% more likely to develop high blood pressure than those with the lowest. This was the case even after academics adjusted for the effect of salt, sugar and fat.
High blood pressure, or hypertension, increases the risk of serious heart conditions including heart disease, peripheral arterial disease, aortic aneurysms, kidney disease and vascular dementia.
The second study, a gold-standard meta-analysis of more than 325 000 men and women, showed those who ate the most UPF were 24% more likely to have cardiovascular events including heart attacks, strokes and angina.
Increasing daily UPF consumption in calorie intake by 10% was associated with a 6% increased risk of heart disease. And those with UPF making up less than 15% of their diet were least at risk of any heart problems, found the research led by the Fourth Military Medical University in Xi’an, China.
The findings were revealed at the annual meeting of the European Society of Cardiology in Amsterdam, where thousands of the world’s leading heart doctors, scientists and researchers were briefed on the studies.
The results prompted calls from experts for urgent action.
Ultra-processed foods are products that have gone through multiple processes during manufacturing, and are usually high in salt and sugar and may contain additives and preservatives. Often, they are low in fibre and lacking the nutrients present in fresh or minimally processed foods, like fresh fruit and vegetables, plain yoghurt and homemade bread.
Previous studies have linked eating high levels of ultra-processed foods with a range of health problems including obesity, type 2 diabetes and cancer.
One of the researchers behind the first study, Anushriya Pant, of the University of Sydney, said many people were unaware that food they assume is healthy, such as shop-bought sandwiches, wraps, soups and low-fat yoghurts, were in fact UPF.
Women typically eat more UPF than men, she said, but added that more research was needed to establish whether this was driven by the marketing of ultra-processed diet and low-fat foods at women.
Dr Chris van Tulleken, one of the world’s leading UPF experts and author of the book Ultra Processed People, said: “The findings of these new papers are entirely consistent with a large and growing body of work showing that increasing consumption of UPF is associated with an increased risk of cardiovascular disease.”
Van Tulleken called for black warning labels to be added to UPF packaging, as is already the case in Chile and Mexico, and said there should be a clampdown on marketing of UPF, and in particular adverts aimed at children.
Study 1 details
Association of ultra-processed foods with cardiovascular disease and hypertension in Australian women
A Pant, S Gribbin, P Machado, A Hodge, L Moran, S Marschner, S Zaman.
Presented at ESC 365
Background
Ultra-processed food (UPF) intake has increased in the past few decades, yet knowledge around the long-term effects on cardiovascular disease (CVD) risk is limited. Moreover, the magnitude of the impact of UPF intake on CVD in Australia has not been established.
Objective
To investigate the association of UPF intake with incident CVD and hypertension in a population-based cohort of middle-aged women.
Methods
Women aged 46-55 years were prospectively recruited into the Australian Longitudinal Study on Women’s Health and followed for 15 years. UPFs were defined according to the NOVA classification, and the contribution of these foods to total dietary intake was estimated. Outcomes were incident CVD (self-reported heart disease/stroke) and/or hypertension. Logistic regression models assessed the association between UFP intake and endpoints with adjustment made for confounders.
Results
A total 10,006 women (mean age 52.5±1.5) with an average UPF intake of 26.6% of total food dietary intake (mean 347.8 g/d) were included. Over 15 years of follow-up, 1,038 incident CVD and 4,204 hypertension cases occurred. Higher UPF intake was associated with higher risk of CVD (ptrend=0.05) and hypertension (ptrend=0.02). The highest intake of UPF (mean 42% of total food intake) versus the lowest UPF intake (mean 14.2% of total food intake) was associated with incident CVD [odds ratio (OR) 1.35, 95% confidence interval (CI) 1.03-1.78; p=0.03)] and hypertension [OR 1.33, 95% CI 1.06-1.66; p=0.01].
Conclusion
In middle-aged women, a higher intake of ultra-processed food was associated with increased CVD risk and hypertension. These findings lend support to minimising UPF intake as a component of a heart-healthy diet.
Study 2 details
Ultra-processed food consumption and cardiovascular events risk: A Systematic Review and Dose–Response Meta-Analysis
Y Qu, W Hu, C Xing, L Yuan, J Huang.
Presented at ESC 365
Background
The consumption of ultra-processed food (UPF) has been suggested to be associated with cardiovascular events risk, but their dose-response relationship have not reached a consensus.
Methods
We searched PubMed, EMBASE, Cochrane Library, and Web of Science databases for manuscripts published from inception to November 17, 2021, which reported the relationship between UPF consumption and cardiovascular events risk. A total of 10 studies were included with 325 403 participants and 38 720 cardiovascular events cases. Using the fixed/random-effects models, hazard ratios of pooled outcomes were estimated.
Results
A non-linear relationship of UPF consumption with cardiovascular events risk was identified (P for heterogeneity = 0.013, P for dose-response < 0.001, P for non-linearity = 0.013). Compared with the lowest UPF consumption category, the third highest pooled HR for cardiovascular events risk was 1.02 (95% CI, 0.98 to 1.05), the second highest was 1.08 (95% CI, 1.04 to 1.12) and the highest was 1.24 (95% CI, 1.16 to 1.32). A linear association between UPF consumption and coronary heart disease (CHD) risk was identified (P for heterogeneity = 0.110, P for dose-response < 0.001, P for non-linearity = 0.202). A 10% increase in UPF consumption in daily calorie intake was associated with a 6% increase in CHD risk. UPF consumption was non-linearly associated with cerebrovascular disease (CeVD) risk (P for heterogeneity = 0.001, P for dose-response < 0.001, P for non-linearity = 0.026).
Conclusions
There was a nonlinear relationship between UPF consumption and cardiovascular events. Moderate intake of UPF was associated with a lower risk of cardiovascular events, with the lowest risk at <15%/day of UPF consumption out of total calorie intake. Heavy UPF consumption was significantly and positively associated with increased risk of cardiovascular events.
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