A recent study published in The Lancet Regional Health – Americas highlights the significant risks associated with ultra-processed food (UPF) consumption, linking it to increased rates of coronary heart disease (CHD), cardiovascular disease (CVD), and stroke among U.S. populations.
Study Overview
The research analyzed data from three major cohorts: the Nurses’ Health Study (NHS), initiated in 1976 with 121,701 female participants; the Nurses’ Health Study II (NHSII), which began in 1989 with 116,340 women; and the Health Professionals Follow-Up Study (HPFS), starting in 1986 with 51,529 men. Participants with a history of cardiovascular disease or cancer, or those who only completed the baseline questionnaire, were excluded from the analysis. Ultimately, the study included 75,735 participants from NHS, 90,813 from NHSII, and 40,409 from HPFS.
Dietary habits were assessed every 2-4 years using validated food frequency questionnaires. The researchers categorized foods into four groups based on the NOVA classification system and further divided UPFs into ten categories. They calculated daily UPF intake as a percentage of total energy intake and divided it into quintiles. The study’s primary outcomes included new cases of CHD, stroke, and overall CVD, with non-fatal cases confirmed through medical records.
Key Findings
Participants’ average age at baseline was 50.8 years for NHS, 36.7 years for NHSII, and 53.4 years for HPFS. The study found that UPF contributed significantly to participants’ caloric intake, ranging from 15.3% to 20.8% in the lowest quintile and up to 49.6% in the highest.
NHSII participants reported the highest UPF intake at 34.4% of their total energy consumption. The most significant contributors to energy intake were bread and cereals, sweet snacks, and ready-to-eat meals.
During the median follow-up periods of 26 to 31.9 years, the study observed that higher UPF intake was associated with increased risks of CVD and CHD, although no significant link was found for stroke.
Sensitivity analyses confirmed the robustness of these associations across various models.
Further analysis indicated that removing certain UPF categories, such as hard liquors and yogurt, did not significantly affect the associations with CVD and CHD. However, excluding sugar-sweetened beverages and processed meats notably reduced the risk estimates for these conditions.
Systematic Review And Meta-Analysis
In addition to the cohort study, a systematic review and meta-analysis of 19 studies involving over 1.2 million adults revealed that higher UPF consumption correlates with increased risks of CHD, CVD, and stroke, particularly for CHD. The quality of evidence varied, being high for CHD and low for stroke.
Conclusion
This study underscores the health risks associated with ultra-processed foods, which account for a substantial portion of the average American diet. As UPFs are linked to various health issues, including heart disease, public health strategies aimed at reducing their consumption may be crucial for improving cardiovascular health outcomes.