Rx Nutrition Resource Center

Rx Nutrition Resource Center

Perspective from Andrew M. Freeman, MD, FACC
Disclosures: The authors report no relevant financial disclosures.
March 22, 2021
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High ultra-processed food consumption increases risk for CVD, CV death

Perspective from Andrew M. Freeman, MD, FACC
Disclosures: The authors report no relevant financial disclosures.
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Consuming large quantities of ultra-processed foods conferred elevated risk for CVD and CV death, according to a study published in the Journal of the American College of Cardiology.

The researchers defined ultra-processed foods as highly processed industrial formulations made with no or minimal whole foods that include flavorings or preservatives.

Consuming large quantities of ultra-processed foods conferred elevated risk for CVD and CV death. Data were derived from Juul F, et al. J Am Coll Cardiol. 2021;doi:10.1016/j.jacc.2021.01.047.

Using data from the Framingham Offspring Cohort, researchers conducted an analysis of 3,003 middle-aged adults without CVD (mean age, 54 years; 55% women). Participants were stratified into quintiles by energy-adjusted ultra-processed food consumption, expressed as servings per day.

In an average follow-up of 18 years, 648 CVD events occurred, including 251 incidents of hard CVD, 163 cases of hard CHD and 713 fatalities, including 108 CVD-related deaths, Filippa Juul, MS, PhD, a faculty fellow at the New York University School of Public Health, and colleagues wrote.

According to the researchers, participants in the highest quintile of ultra-processed food intake had higher incident rates of hard CVD, defined as sudden and nonsudden coronary death, MI or fatal or nonfatal stroke, (3.36 per 1,000 person-years vs. 6.64 per 1,000 person-years) and hard CHD, defined as sudden or nonsudden coronary death or MI (2 per 1,000 person-years vs. 4.36 per 1,000 person-years), compared with those in the lowest quintile of ultra-processed food consumption.

When the researchers adjusted for age, sex, education level, smoking status, alcohol intake and physical activity, they found a 1 standard deviation increase in ultra-processed food intake (2.9 servings per day) increased risk for hard CVD by 22% and hard CHD by 30%.

In multivariable-adjusted models, one additional daily serving of ultra-processed food was linked to a 7% rise in risk for hard CVD (HR = 1.07; 95% CI, 1.03-1.12), a 9% increase in risk for hard CHD (HR = 1.09; 95% CI, 1.1-3.28), a 5% increase in risk for overall CVD (HR = 1.05; 95% CI, 1.02-1.08) and a 9% increase in risk for CVD mortality (HR = 1.09; 95% CI, 1.02-1.16), the researchers wrote.

In an analysis of the study population, there was an increase in mean age, BMI and waist circumference across quintiles of ultra-processed food consumption (P for trend < .001). Higher consumption of ultra-processed foods was also linked to lower levels of physical activity (P for trend < .001) and lower education level (P = .028).

According to the researchers, the study has implications for CV prevention, including the need for increased efforts to implement population-wide strategies.

“These strategies may include fiscal measures, such as taxation of sugar-sweetened beverages and other ultra-processed foods, and recommendations regarding processing level in national dietary guidelines,” Juul and colleagues wrote.