Headlines about ultra-processed foods are everywhere and for good reason. These foods have become a regular part of modern diets and research continues to link higher intake with poorer health outcomes. Now, a new study suggests ultra-processed foods may also meaningfully raise the risk of major heart events.
If the term feels vague, ultra-processed foods are defined in the NOVA classification system as industrial formulations made mostly or entirely from substances extracted from foods, such as oils, fats, sugar, starch and protein isolates, or made from ingredients synthesised in laboratories, such as artificial flavourings, colourings, non-sugar sweeteners and emulsifiers. Common examples include mass-produced breads, packaged desserts, processed meats, breakfast cereals, plant-based meat alternatives, flavoured yoghurts, ready-to-heat meals like frozen pizza, soft drinks and lollies.
Researchers behind the study, published in JACC: Advances, analysed self-reported dietary data from 6,814 adults aged 45 to 84 in the United States who did not have clinically apparent cardiovascular disease at the start. Participants completed food frequency questionnaires to estimate ultra-processed food intake. Researchers collected follow-up questionnaires over 12 years, then checked medical records for major cardiovascular events such as heart attack, stroke or cardiovascular-related death. They adjusted for lifestyle habits, diet quality and other risk factors to better isolate the role of food processing.
The researchers found that adults who ate the most ultra-processed foods, averaging about 9.3 servings a day, were 67% more likely to experience a major cardiovascular event compared with those who ate the least, averaging about 1.1 servings a day. Risk also rose step-by-step. Each additional daily serving was linked with a 5.1% higher risk, a statistic that is “quite significant,” says cardiologist Dr Minhal Makshood. The relationship appeared stronger among Black participants, which she says may reflect broader inequities in food access, food environment and targeted marketing that can compound cardiovascular risk.
It is important to note the limits here. This study shows an association, not proof that ultra-processed foods directly cause heart disease.
How many servings of ultra-processed food counts as high?
In this study, the higher-risk group averaged roughly nine servings a day. “Nine servings of ultra-processed foods may sound high, but in modern eating patterns, it is quite achievable, because each component of a meal can count separately,” explains cardiologist Dr Allen Taylor.
He points out how quickly it can add up across a day. “A typical day might include packaged cereal and flavoured yoghurt at breakfast, a protein bar as a snack, a deli sandwich at lunch, chips in the afternoon, and a frozen entrée or fast food dinner. The key point is that ultra-processed foods are so embedded into our diets we don’t even recognise them as such.”
How ultra-processed foods can affect heart health
The impact is not just one thing, it is a chain reaction.
Ultra-processed foods often crowd out more nutrient-dense options and tend to be higher in sodium, refined carbohydrates, added sugars and unhealthy fats, says Dr Taylor. They can also be easier to overeat because they are calorie dense but not always satisfying, which Dr Makshood links to lower fibre and lower satiety.
Beyond the nutrition label, Dr Taylor says processing may play a role too. It “may alter the food matrix, affect gut microbiome function, disrupt gut–brain signaling, and contribute to inflammation, insulin resistance, cholesterol problems, and hypertension,” he explains, all of which can raise cardiovascular risk over time.
How to realistically limit ultra-processed foods
The goal is progress, not perfection. Dr Makshood often recommends an 80/20 approach: prioritise whole and minimally processed foods most of the time, “while allowing yourself the flexibility to enjoy processed foods occasionally without guilt,” she says.
Dr Taylor suggests focusing on practical swaps that reduce reliance on packaged foods. “Emphasizing whole or minimally processed foods such as vegetables, fruits, legumes, fish, and nuts is key,” he says. “Simple substitutions, reducing reliance on packaged snacks and convenience meals, cooking more frequently at home, and paying attention to ingredient lists can all move patients in the right direction. Even modest changes are likely to be beneficial.”
He also points to a familiar eating pattern as a useful guide. “It sounds fancy, but the Mediterranean diet is essentially just a whole food/low ultra-processed food diet,” Dr Taylor says. “And, it has major health benefits already demonstrated, ranging from reduced heart disease risk to reduced dementia risk.”
The bottom line
“This study should not make people feel that eating one packaged snack is dangerous or that nutrition has to be all-or-nothing,” Dr Makshood says. “The larger message is that pattern matters. The more ultra-processed foods dominate the diet, the greater the likely cardiovascular burden over time.”
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