Ultra-processed foods (UPFs) could be responsible for approximately a quarter of heart disease cases and deaths, according to a new analysis published in the American Journal of Preventive Medicine and presented at the International Congress on Obesity in Mexico. The study estimates that thousands of cardiovascular disease (CVD) deaths could potentially be avoided if people reduce their intake of UPFs.
Study Details and Key Findings
Researchers from the University of Montreal in Canada used Canadian patient records and dietary data to model the impact of UPF consumption on cardiovascular disease, including heart attacks, strokes, deaths, and disability. Their modelling suggested that in 2019, between 23% and 38% of CVD events could be attributed to UPF consumption. This translates to an estimated 58,200 to 96,000 new CVD cases and 10,600 to 17,400 CVD-related deaths, along with disability affecting thousands more.
The researchers also estimated that reducing UPF intake by 20% to 50% could have prevented 16,800 to 45,900 new CVD cases and 3,100 to 8,300 CVD-related deaths. They concluded: "These findings reinforce the need for clinical and public health interventions aimed at reducing UPF intake as a key component of cardiovascular disease prevention. To drive meaningful change in dietary patterns, comprehensive structural measures are essential. These include regulations on food taxes, front-of-package labelling, marketing restrictions and reformulation targets aimed at improving food quality."
Prevalence of UPFs in the UK
UPFs are widely consumed in the UK and include items such as ice cream, processed meats, crisps, mass-produced bread, some breakfast cereals, biscuits, many ready meals, and fizzy drinks. They often contain additives and ingredients not typically used in home cooking, including preservatives, emulsifiers, and artificial colours or flavours. In the UK, an average of 56% of daily calories come from UPFs, rising to 68% among teenagers—figures higher than in comparable European countries such as France and Italy.
Expert Criticism and Alternative Explanations
The findings have faced criticism from experts who question whether UPFs themselves increase risk or whether the issue is that many of these products are high in salt, sugar, and saturated fat. Professor Alberto Fiore from Abertay University in Dundee highlighted limitations of the study: "This is a modelling study, not a clinical trial—it does not measure what actually happened to people who ate more or fewer ultra-processed foods. It takes a 2015 dietary snapshot, applies a risk multiplier borrowed from studies in France, Italy and the US, and projects how many CVD events might be attributable to UPF consumption."
He noted that the authors' own sensitivity analysis reduces the headline figure of 96,000 avoidable CVD cases by nearly 40% depending on the risk estimate used. "That is a very wide uncertainty range for a number being put in front of the public. But the deeper problem is one this study cannot resolve: are we actually measuring the effect of industrial processing, or are we simply measuring the well-known harms of a poor diet that happens to come in a packet?"
Professor Fiore pointed out that the paper acknowledges that 'ultra-processed dietary patterns' are characterised by excess free sugars, saturated fats, and sodium, and low fibre. It separately estimates that targeting free sugars and sodium alone could prevent thousands of CVD deaths per year in Canada. "If standard nutritional harms already explain the observed risk, then the concept of 'ultra-processing' is doing no independent scientific work whatsoever," he said. When examined by food subcategory, the CVD findings are "overwhelmingly driven by sugar-sweetened beverages and processed meat products—foods whose harmfulness has been established for decades on purely nutritional grounds."
Public Health Implications
Maeva May, director of policy for the Stroke Association, said the research adds to wider concerns about dietary patterns and the pressures that shape food choices. "Stroke is a leading cause of death and disability, and this research is an important reminder that the food environment around us can influence people's risk. It adds to growing evidence that diets high in ultra-processed foods may increase the risk of cardiovascular disease, including stroke."
She emphasised the need for further understanding of the role of processing itself, but noted that the harms of too much salt, sugar, and saturated fat are well-established. "People should not be blamed for choices shaped by price, availability and relentless marketing. Government and industry must do more to make healthier food affordable, accessible and easier to choose, so fewer people and families have to live with the impact of stroke."
