Ultra-processed foods (UPFs) could be driving around a quarter of cases of heart disease and heart disease deaths, research suggests. Data published in the American Journal of Preventive Medicine and presented at the International Congress on Obesity in Mexico indicates that deaths will fall if people cut their intake of UPFs.
Study Details and Findings
Experts from the University of Montreal in Canada used Canadian patient data to examine cardiovascular disease, including heart attacks and strokes, as well as deaths and disability related to cardiovascular disease. Analysis showed that between 23% and 38% of all cardiovascular disease events in 2019 were attributable to UPF intake. This equates to 58,200 to 96,000 new cases of cardiovascular disease, plus 10,600 to 17,400 cardiovascular disease-related deaths, and disability for thousands of patients.
Reducing UPF consumption by 20% to 50% may have prevented 16,800 to 45,900 new cases of cardiovascular disease, along with 3,100 to 8,300 cardiovascular disease-related deaths, the experts said.
Examples of Ultra-Processed Foods
Examples of UPFs include ice cream, processed meats, crisps, mass-produced bread, some breakfast cereals, biscuits, many ready meals, and fizzy drinks. They also tend to contain additives and ingredients not used in home cooking, such as preservatives, emulsifiers, and artificial colours and flavours. In the UK, 56% of calories on average come from UPFs, rising to 68% in teenagers—figures far higher than in comparable European countries like France and Italy.
Expert Criticisms and Limitations
Some experts criticised the study, citing a lack of evidence that UPFs directly increase cardiovascular disease risk. Professor Alberto Fiore from Abertay University in Dundee noted: “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 added that the authors' sensitivity analysis reduces the headline figure of 96,000 avoidable CVD cases by nearly 40% depending on the risk estimate used, calling it “a very wide uncertainty range for a number being put in front of the public.” Fiore argued that the study cannot resolve whether the effect is due to industrial processing or the well-known harms of a poor diet high in sugar, fat, and salt. He pointed out that when CVD findings are broken down by food subtype, they are “overwhelmingly driven by sugar-sweetened beverages and processed meat products,” whose harmfulness has been established on purely nutritional grounds.
Public Health Implications
The study authors 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.”
Maeva May, director of policy for the Stroke Association, said: “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. We still need to understand more about the role of processing itself, but we already know that too much salt, sugar and saturated fat can raise blood pressure and other major risk factors for stroke. 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.”
