Ultraprocessed Foods Tied to Widespread Health Risks

A new American Heart Association advisory links ultraprocessed foods (UPFs) to significant health concerns, including heart disease and diabetes, urging a reevaluation of dietary habits.

The UPF Predicament

The majority of ultraprocessed foods, a staple in many diets, are nutritionally deficient. They often contain high levels of saturated fats, added sugars, and sodium (HFSS), contributing to excess calories and adverse cardiometabolic health outcomes. These risks include heart attack, stroke, obesity, inflammation, Type 2 diabetes, and vascular issues.

Observational research has established a connection between elevated UPF consumption and increased risks for cardiovascular disease, chronic illnesses, and mortality. Emerging scientific findings also suggest that certain food additives and industrial processing methods may negatively impact health.

Nuance in Processing

However, not all UPFs are detrimental; some offer positive nutritional value and can be integrated into a healthy eating plan. This complexity, exemplified by items like commercial whole grain breads or certain low-fat dairy products, creates confusion for both the public and healthcare professionals.

AHA’s Comprehensive Review

The American Heart Association’s new Science Advisory, “Ultraprocessed Foods and Their Association with Cardiometabolic Health: Evidence, Gaps and Opportunities,” delves into current knowledge on UPFs’ health effects. It also identifies crucial areas for future research, policy changes, and regulatory reforms to enhance dietary patterns and overall well-being. The advisory was published today in the journal Circulation.

“The relationship between UPFs and health is complex and multifaceted,” stated Maya K. Vadiveloo, Ph.D., R.D., FAHA, volunteer chair of the advisory’s writing group. “We know that eating foods with too much saturated fat, added sugars and salt is unhealthy. What we don’t know is if certain ingredients or processing techniques make a food unhealthy above and beyond their poor nutritional composition.”

Shifting Consumption Patterns

The proliferation of UPFs since the 1990s has significantly altered traditional eating habits, potentially contributing to poorer health outcomes. It is estimated that 70% of U.S. grocery store products contain at least one ultraprocessed ingredient. A recent CDC report indicated that 55% of calories consumed by Americans are from UPFs, rising to nearly 62% for youth aged 1-18.

Families with lower incomes tend to consume a higher proportion of UPFs. These foods are frequently inexpensive, convenient, and heavily marketed, particularly to young people and underserved communities, often displacing healthier options. This trend has lowered the overall nutritional quality of typical U.S. diets.

Dietary Recommendations Reinforced

The advisory reaffirms the American Heart Association’s dietary guidance: reduce intake of most UPFs, especially those high in HFSS content and excess calories. It also advocates for replacing UPFs with nutrient-dense alternatives such as vegetables, fruits, whole grains, beans, nuts, seeds, and lean proteins.

Defining Ultraprocessing

UPFs are defined as multi-ingredient foods containing additives often used in industrial production to improve shelf life, appearance, flavor, or texture. The advisory primarily utilizes the Nova framework, which classifies foods based on the nature, extent, and purpose of their industrial processing. However, this system does not account for nutritional quality, and some industrial processing can be beneficial for food preservation and safety.

Challenges in studying UPFs include inconsistent definitions, limitations in dietary assessment tools, and a lack of detailed information on additives and processing methods from manufacturers, hindering accurate risk assessments and consumer understanding.

Health Impacts Explored

A meta-analysis cited in the advisory revealed a dose-response relationship between UPF consumption and cardiovascular events, Type 2 diabetes, obesity, and all-cause mortality. High UPF intake was associated with a 25%-58% greater risk of cardiometabolic outcomes and a 21%-66% higher risk of mortality.

Research also suggests UPFs may influence eating behaviors and contribute to obesity through combinations of ingredients and additives that affect brain activity and reward pathways, potentially disrupting flavor-nutrient relationships and leading to weight gain.

Future Directions: Research and Policy

To improve public health, the advisory calls for multifaceted strategies. These include promoting dietary shifts away from HFSS UPFs towards whole foods, implementing policies like front-of-package labeling to reduce consumption of problematic products, and increasing research funding to clarify whether ultraprocessing itself or the ingredients within UPFs are the primary drivers of poor health.

“More research is needed to better understand the mechanisms of how UPFs impact health. In the meantime, the Association continues to urge people to cut back on the most harmful UPFs that are high in saturated fats, added sugars and sodium, and excessive calories,” added Vadiveloo.

Research challenges decades-old assumptions about weight gain

A major international study suggests that the global rise in obesity is driven more by increased consumption of ultra-processed foods than by a decline in physical activity. The findings, which analyzed data from over 4,000 individuals across 34 diverse populations, indicate a need for a significant shift in public health strategies.

Rethinking the Obesity Equation

For years, economic development was commonly linked to obesity through a reduction in people’s exercise levels. However, new research published in the *Proceedings of the National Academy of Sciences (PNAS)* directly contradicts this simplified view. The study, “Energy expenditure, obesity, and economic development across populations,” meticulously examined how economic progress influences energy expenditure and body composition.

Researchers, led by **Herman Pontzer** from Duke University and **Amanda McGrosky**, analyzed data from hunter-gatherer societies, pastoralists, farmers, and highly industrialized communities. They observed that as societies become more economically developed, individuals tend to have higher body mass, body mass index (BMI), and body fat. Counterintuitively, these same developed populations also showed greater overall energy expenditure, including basal and activity-related spending.

“Our findings challenge the simplistic notion that reduced energy expenditure is the primary driver of obesity in developed contexts. Instead, we found that people in more economically developed societies tend to expend more energy overall, yet they still experience higher rates of obesity, indicating other powerful factors are at play.”

—Herman Pontzer, Principal Investigator, Pontzer Lab

The Processed Food Factor

The study highlights that differences in total energy expenditure explained only a small portion of the increase in body fat associated with economic development. This points to other significant factors being at work.

“While we saw a marginal decrease in size-adjusted total energy expenditure with economic development, differences in total energy expenditure explained only a fraction of the increase in body fat that accompanied development. This suggests that other factors, such as dietary changes, are driving the increases in body fat that we see with increasing economic development.”

—Amanda McGrosky, Assistant Professor of Biology at Elon University

The research strongly implicates the proliferation of ultra-processed foods in driving obesity rates. Changes in food availability, accessibility, and composition appear to be more influential than previously emphasized.

Shifting Public Health Focus

The implications for tackling the global obesity epidemic are substantial. While maintaining physical activity is crucial for general health, the study emphasizes the urgent need for public health initiatives to prioritize dietary interventions.

Strategies aimed at combating obesity should focus on reducing the consumption of ultra-processed items and promoting healthier eating habits. For instance, a 2023 study found that individuals consuming more than 20% of their daily calories from ultra-processed foods had a 37% faster rate of overall mortality compared to those consuming less (JAMA Network Open).

The authors conclude that diet and physical activity should be viewed as essential and complementary components, rather than interchangeable elements, in addressing weight management.

Representational image illustrating the choice between healthy and processed foods. Photo: Unsplash @Towfiqu barbhuiya

ultraprocessed foods

Excessive ultraprocessed foods (UPFs) and poor nutrition tied to poor health