Ultra-processed foods linked to 67% higher risk of heart attack and stroke in major US study

A major US study has found that people who consume around nine servings of ultra-processed foods per day face a 67% higher risk of serious cardiovascular events compared to those eating significantly less. The foods in question are familiar: chips, frozen dinners, packaged snacks, sugary drinks, and mass-produced breads and cereals. What makes this study notable is the argument it advances about mechanism. The researchers found that processing itself appears to drive cardiovascular risk independently of the sodium, saturated fat, and added sugar content of those foods.

That distinction matters more than it might seem. For decades, dietary health guidance has focused on nutrients. Reduce sodium. Cut saturated fat. Limit added sugar. Ultra-processed foods tend to be high in all three, so they have always looked bad on a nutrient scorecard. But this study, and the body of research it builds on, suggests that even after statistically controlling for nutrient composition, the degree of industrial processing itself independently predicts worse outcomes. Something about how these foods are made, beyond what they contain, appears to be doing harm.

What counts as ultra-processed and how consumption was measured

The study used the NOVA classification system, a food categorization framework developed by researchers at the University of São Paulo that sorts foods into four groups based on the extent and purpose of their industrial processing. Ultra-processed foods in NOVA Group 4 are defined as industrial formulations containing ingredients rarely used in home cooking, such as hydrogenated oils, modified starches, protein isolates, artificial colors, emulsifiers, and flavor enhancers. The classification does not depend on a food being high in any particular nutrient. Some ultra-processed foods have been reformulated to be lower in sodium or saturated fat, but they remain ultra-processed under NOVA criteria and still show elevated health risks in observational research.

Participants in the study completed detailed dietary recall interviews over multiple years as part of a prospective cohort design, and their reported ultra-processed food intake was tracked against cardiovascular outcomes including heart attack, stroke, and cardiovascular death. The average high-consumption group was eating roughly nine servings per day. For context, a serving could be a can of soda, a handful of chips, a portion of a frozen meal, or a serving of packaged breakfast cereal. Nine servings across a full day is not unusual for many Americans.

How widespread ultra-processed food consumption actually is in the US

Ultra-processed foods account for approximately 57% of total caloric intake among US adults, according to a 2016 analysis published in the BMJ that used National Health and Nutrition Examination Survey data. Among children and adolescents, that figure is closer to 67%. Those numbers have not meaningfully declined in the years since. The United States has one of the highest rates of ultra-processed food consumption in the world, alongside the United Kingdom, Canada, and Australia, all of which have seen similar epidemiological trends in cardiovascular disease rates.

The economic structure of food access in the US makes this particularly hard to address. Ultra-processed foods are cheaper per calorie than fresh or minimally processed alternatives, they have longer shelf lives, they require no preparation, and they are aggressively marketed. Lower-income households spend a higher proportion of their food budgets on ultra-processed products, which means the cardiovascular risk identified in this study is not evenly distributed across the population.

The proposed mechanisms behind the processing-risk link

Researchers have proposed several biological pathways through which ultra-processed food consumption could drive cardiovascular risk beyond nutrient content. One involves food matrix disruption. Whole foods have a physical structure that affects how quickly they are digested and how rapidly glucose and lipids enter the bloodstream. Industrial processing breaks down or eliminates that structure, producing faster digestion and larger post-meal spikes in blood glucose and triglycerides, both of which are associated with arterial inflammation and atherosclerosis.

A second proposed mechanism involves food additives. Emulsifiers like carrageenan and polysorbate 80, which are used to improve texture and shelf life in many ultra-processed foods, have been shown in animal studies to alter gut microbiome composition and increase intestinal permeability. A 2015 study in Nature found that two common emulsifiers promoted metabolic syndrome and low-grade intestinal inflammation in mice fed doses proportional to typical human exposure levels. Human gut microbiome studies have produced consistent findings, though causation in humans remains under active investigation.

What public health researchers are now calling for

The study's publication has renewed calls from public health researchers for US dietary guidelines to explicitly address ultra-processed food consumption, rather than continuing to focus solely on individual nutrients. The current 2020-2025 Dietary Guidelines for Americans do not use the term ultra-processed foods or reference the NOVA classification system. Brazil updated its national dietary guidelines in 2014 to specifically recommend avoiding ultra-processed foods, making it one of the first countries to do so. Chile, Uruguay, and Peru have since followed with similar guidance and graphic front-of-package warning labels targeting ultra-processed products.

The US Dietary Guidelines Advisory Committee begins its review process for the 2025-2030 edition in 2026. Several members of that committee have published research on ultra-processed foods, and advocacy groups including the American Heart Association have formally petitioned for ultra-processed food guidance to be incorporated into the next edition. Whether the committee formally adopts processing-level language will likely depend on how the FDA's concurrent work on front-of-package nutrition labeling develops over the same period.