More Ultra-processed Food? Higher Risk for Heart Disease and Stroke
As heart disease remains the number one killer in the US, reducing your risk is key. If you’re a self-declared “junk food junkie”, keep reading. Recent research presented at the American College of Cardiology's Annual Scientific Session (ACC.26) found that a diet of mostly ultra-processed foods (UPFs) significantly raises the risk of heart attack, stroke, and death.
People who daily ate over nine servings of UPFs were 67% more likely to have serious cardiac events, versus those who consumed only one serving per day. Packaged and convenience foods made up the majority of UPFs, including chips, crackers, frozen meals, processed meats, sugar-sweetened drinks, breakfast cereals, and bread. 1
The risk increased with higher intake. Each additional serving of UPF was associated with more than a 5% increase in the risk of heart attack, stroke, or death from coronary heart disease or stroke. This link was even higher among Black Americans than among other racial groups.
Amier Haidar, MD, a cardiology fellow at the University of Texas Health Science Center at Houston and the study's lead author, states, "Ultra-processed foods are associated with an increased risk for heart disease, and while many of these products may seem like convenient on-the-go meal or snack options, our findings suggest they should be consumed in moderation.”
Large U.S. Study Using a Diverse Population
This study is one of the largest to evaluate the association between UPFS and heart disease in racially diverse adults in the US. The findings are aligned with previous research, much of which was done in Europe. It adds more insight to broader populations.
The study evaluated data from 6,814 subjects ages 45-84 years who didn’t have known heart disease and were part of the Multi-Ethnic Study of Atherosclerosis (MESA). Scientists used food diaries and the NOVA system to estimate how many UPFs participants ate daily. The NOVA classification system sorts foods into four categories, from unprocessed or minimally processed (i.e., corn on the cob) to ultra-processed (i.e., corn chips), with moderately processed foods in between (i.e., corn starch and canned corn).
Adults with the highest intake ate an average of 9.3 servings of UPFs per day. Those with the lowest intake averaged 1.1 servings. Those in the highest group had a 67% greater risk of dying from coronary heart disease or stroke, or having non-fatal heart attacks, strokes, or resuscitated cardiac arrest, compared with the lowest group
Risk Continues Beyond Calories and Diet Quality
Haider noted, "We controlled for a lot of factors in this study. Regardless of the amount of calories you consumed per day, regardless of the overall quality of your diet, and after controlling for common risk factors like diabetes, high blood pressure, high cholesterol, and obesity, the risk associated with higher ultra-processed food intake was still about the same."
The results of this research suggest that the detrimental effects of UPFs might not be explained by just calories or overall diet quality. The way foods are processed could be an independent factor in cardiovascular risk. It’s important to consider both processing and nutrient content.
Disparities in Risk and Additional Factors
An extra daily serving of UPFs was linked with a 5.1% increase in the risk of adverse cardiac events. This rise was greater in Black Americans, who experienced a 6.1% rise in risk per serving compared with 3.2% among non-Black individuals. Scientists noted that targeted marketing and reduced access to more nutritious foods in some neighborhoods may add to differences in intake and health outcomes.
Research Limitations and Possible Biological Effects
The research has several limitations. Because the MESA study wasn’t initially designed to specifically evaluate UPF intake, the data relied on self-reported food records. Intake was measured by the number of servings, instead of tracking individual foods.
The researchers also didn’t directly study the biological mechanisms involved. But earlier studies suggest that UPFs tend to be high in calories, added sugars, and fats, and may impact hunger and metabolism. These characteristics can lead to weight gain, inflammation, and the accumulation of visceral fat, all of which raise the risk of heart disease.
Lower Risk by Eating Less UPFs
Haidar noted one way to reduce risk is to be more aware of the types of foods you eat and to read nutrition labels carefully. “Labels provide details on added sugar, salt, fat and carbohydrates per serving, which are often higher in ultra-processed foods than in less-processed options like plain oatmeal, nuts, beans and fresh or frozen produce.”
In addition, the ACC released a 2025 Concise Clinical Guidance report in JACC advising a standardized front-of-package labeling system to help ensure that better choices are more visible, accessible, and achievable for all consumers.
Below are 10 ways to get the most “food in your food”:
1. Read the ingredients on food labels. Look for long lists that include sugar, artificial colors, additives, and excess fat.
2. Replace instant oats with rolled oats, which take 2 minutes to cook in a microwave.
3. Stop buying sweetened beverages. Choose fruit-infused water, seltzer water, or Club soda over soft drinks.
4. Go for nuts over chips and pretzels if you want something crunchy.
5. Eat seasonal or frozen fruit with plain yogurt in place of sweetened yogurt.
6. Limit use of frozen meals, pizza, and fast food.
7. Take a cooking class to learn easy ways to prepare meals.
8. Keep shelf-stable, canned beans or bagged brown rice on hand for quick meals.
9. Choose nutrient-dense, affordable protein sources on hand such as eggs, cottage cheese, and Greek yogurt in place of protein bars.
10. Choose fruit over candy, cakes, and cookies. Try dates smeared with peanut butter and a few semi-sweet chocolate chips in place of a candy bar.
Lisa Andrews, MEd, RD, LD
Reference:
Amier Haidar, Rishi Rikhi, Karol E. Watson, Alexis C. Wood, Michael D. Shapiro. Association Between Ultraprocessed Food Consumption and Cardiovascular Disease Risk. JACC: Advances, 2026; 102516 DOI: 10.1016/j.jacadv.2025.102516