Link Between Ultraprocessed Food and Cardiovascular Risk

by

Introduction

Consumption of ultraprocessed food (UPF) has already been linked to increased cardiovascular risk; however, previous research looked at populations that lacked racial and ethnic diversity. A new study called the Multiethnic Study of Atherosclerosis, published on March 17, 2026, investigated whether cardiovascular risk differs by race/ethnicity, sex, or socioeconomic status (whether people were better educated, richer, or poorer). 

Multiethnic Study of Atherosclerosis (MESA) Study 

The Multiethnic Study of Atherosclerosis (MESA) analyzed self-reported food frequency questionnaires collected intermittently over 12 years from 6,531 US adults (3,438 females, 3,093 males) aged 45 to 84 years who did not have clinically apparent cardiovascular disease at the start of the study. 

Ultraprocessed food (UPF) was classified according to the Nova Food Classification System, and study participants’ medical records were analyzed for cardiovascular events, including nonfatal myocardial infarction (“heart attack”), resuscitated cardiac arrest, death due to coronary heart disease, stroke (excluding transient ischemic attack (T.I.A.s), and death resulting from stroke, while adjusting for lifestyle habits, diet quality, and other factors that could affect outcome.

Nova Food Classification System

From the time food is harvested to when it is eaten, most food is processed in some way. Some of this processing may be as simple as peeling, chopping, or cooking it, and food doesn’t become unhealthy just because it is processed. The issue is how much processing a food undergoes.

As first covered in this article from June 18, 2019 titled Distinguishing Food from Food Like Products, the Nova Food Classification System was developed by the Center for Epidemiological Studies in Health and Nutrition, School of Public Health at the University of São Paulo in Brazil, and has been used in the US, Canada, and other countries around the world since the mid-2000s to define the level of food processing [2].

The Nova Food Classification System has 4 different groups of processed foods, beginning with the least processed and concluding with the most processed. 

  1. Minimally processed foods are defined as unprocessed foods altered in ways that do not add or introduce any new substance (such as fats, sugars, or salt) but often involve the removal of parts of the food. Examples of these include fresh, dry, or frozen vegetables, root vegetables, grains and legumes, fruits and nuts, and meats, fish, seafood, eggs, and milk [2]. For the most part, minimal processing is what’s involved in preparing it for eating and/or improving its palatability.
  2. Processed culinary ingredients are minimally processed foods that have been altered by pressing, refining, or grinding, and examples include vegetable seed oils, butter, vinegar, salt, sugar, and molasses from cane or beet, and honey.
  3. Processed foods are defined as foods made by adding processed culinary ingredients such as fats, oils, sugars, salt, and others to minimally processed foods to make them more durable or more palatable. They include simple breads and cheeses; salted, pickled, or cured meats, fish, and seafood; and vegetables, legumes, fruits, and animal foods preserved in oil, brine, or syrup. Canned fish in oil would fall in this category, as would hummus (ground chickpeas with sesame seed butter, garlic, and lemon juice), as well as bacon and sausages. 
  4. Ultra-processed foods are industrially created food products created with the addition of multiple ingredients, including some processed culinary ingredients, additives to enhance the taste or convenience, including hydrolyzed proteins, soy protein isolate, maltodextrin, high fructose corn syrup, stabilizers, flavor enhancers, non-sugar sweeteners, and processing aids such as stabilizers and bulking and anti-bulking agents. Ultra-processed foods are convenient, durable, ready-to-eat, -drink or -heat, attractive (hyper- palatable), and profitable (cheap ingredients). 

In the MESA study, the following foods were categorized as ultraprocessed food:

  • sausage
  • pancakes
  • hot cereal
  • cold cereal
  • white bread
  • dark bread
  • muffins
  • biscuits
  • margarine (on bread or rolls)
  • chips
  • crackers
  • French fries
  • Oriental noodles
  • dumplings
  • chow mein
  • refried beans
  • pizza
  • hamburger
  • ham hocks
  • fried chicken
  • fried fish
  • ice cream
  • frozen yogurt
  • tofu dessert
  • white donuts
  • chocolate donuts
  • pies
  • pudding
  • candy
  • sweetened milk
  • soy milk
  • soda
  • diet soda
  • instant breakfast
  • hot cocoa
  • liquors

Findings of the Study

The study sample of 6,531 US adults (3,438 females, 3,093 males) aged 45 to 84 years was broken down by race/ethnicity, as follows.

  • 39% Caucasian (white)
  • 12% Chinese-Americans
  • 27% Afro-Americans (black)
  • 22% Hispanic-Americans

In terms of education, 

  • 65% of participants had attained at least some college education or higher

In terms of socioeconomic status,

  • 32% of participants reported a yearly total gross family income of less than $25,000,
  • 46% had an income between $25,000 and $75,000
  • 22% had an income exceeding $75,000.

Consumption of Ultraprocessed Food

  • The average consumption of ultraprocessed food was 4.38 servings per day, ranging from 1.14 servings per day to 9.3 servings per day.
  • On average, ultraprocessed food accounted for 28% of the total daily food servings
  • Ultraprocessed food (UPF) consumption broken down by race was as follows;
    • 32% UPF consumption among Afro-American (black)
    • 30% UPF consumption among Caucasian (white)
    • 24% UPF consumption among Hispanics
    • 19% UPF consumption among Chinese-Americans

Cardiovascular Risk

In terms of cardiovascular risk, it was found that

  • Adults who ate the most ultraprocessed foods (~ 9.3 servings per day) had a 66.8% higher risk of having a major cardiovascular (CVD) event compared to those who consumed less ultraprocessed foods (~1.1 servings per day)
  • The risk of having a major CVD event rose incrementally with each additional daily serving

The relationship between ultraprocessed food (UPF) consumption and CVD appeared to be even stronger for Black Americans. 

  • For every 10% increase in the proportion of ultraprocessed food (UPF) consumption in total daily food intake, Black Americans experienced a 12.3% increased risk of incident CVD events, compared with 7.9% increased risk among non-Black Americans.
  • When compared to White, Chinese-Americans, or Hispanic-Americans, Black Americans had the highest percentage of ultraprocessed food consumption in their diet and fewer servings of non-ultraprocessed food per day.

Researchers proposed that systemic factors rooted in historical racism, rather than inherent biological differences, may explain why ultraprocessed foods have disproportionately negative health consequences for Black Americans. 

Final Thoughts

In this study, ultraprocessed food consumption was associated with adverse cardiovascular (CVD) outcomes, and seems to indicate the need for targeted public health interventions and dietary guidelines aimed at reducing ultraprocessed food consumption in vulnerable populations.

I recommend that as much as possible, people seek to building their meals from minimally processed foods, including fresh or flash frozen meat, fish, seafood, eggs, dairy, and fresh, dry, or frozen vegetables, root vegetables, grains, and legumes, fruit (especially berries) and nuts in amounts and with the frequency determined based on your current lab test results, family risk factors, and preferences.

More Info

If you would like help designing your diet around minimally processed whole foods as much as possible, with convenience and real life considered, learn about me and the Comprehensive Dietary Package that I offer.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

References

  1. Haidar, A, Rikhi, R, Watson, K. et al. Association Between Ultraprocessed Food Consumption and Cardiovascular Disease Risk: MESA (Multiethnic Study of Atherosclerosis). JACC Adv. null2026, 0 (0) .
    https://doi.org/10.1016/j.jacadv.2025.102516
  2. Blake, J., Academy of Nutrition and Dietetics, EatRightPro, Examining the Nova Food Classification System and the Healthfulness of Ultra-Processed Foods, August 19, 2024 (updated January 23, 2025) https://www.eatrightpro.org/news-center/practice-trends/examining-the-nova-food-classification-system-and-healthfulness-of-ultra-processed-foods 
byline for BBDNutrition - Nutrition is BetterByDesign

 
 
LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

 

Privacy Policy | Terms of Use