Eur Heart J
Ultra-processed foods named as a distinct heart disease risk
Clinical Takeaway: Clinicians may need to expand nutrition counseling to ask directly about ultra-processed food intake as part of routine cardiovascular risk assessment.
Cardiovascular nutrition advice has long centered on nutrients such as sodium, saturated fat, cholesterol, and calories. A new European cardiology consensus statement argues that ultra-processed foods themselves represent a distinct cardiovascular risk factor that clinicians should address during routine care.
The statement, published by the European Society of Cardiology and European Association of Preventive Cardiology, synthesized a decade of longitudinal cohort studies and randomized trials linking ultra-processed foods (UPFs) to obesity, type 2 diabetes, hypertension, chronic kidney disease, cardiovascular disease, and cardiovascular mortality.
The authors concluded that the health effects of UPFs extend beyond poor nutritional content alone and likely involve additives, industrial processing, altered food structure, and contaminants generated during manufacturing and packaging.
Adults with the highest UPF intake had up to a 19% higher risk of coronary disease, a 13% higher risk of atrial fibrillation, and a 65% higher risk of cardiovascular death compared with those with the lowest intake. The report also highlighted consistent associations between UPFs and major cardiometabolic risk factors, including obesity, dyslipidemia, hypertension, type 2 diabetes, fatty liver disease, and chronic kidney disease.
Traditional counseling has focused primarily on nutrient composition, but the authors argue that degree of processing may independently affect cardiovascular health. Some foods with favorable nutrient profiles still qualify as ultra-processed, including flavored yogurts, meal-replacement shakes, packaged "slimming" foods, and some plant-based meat substitutes. Even products marketed as "healthy," "high-protein," or "low-fat" can fall into the category, complicating standard nutrition counseling.
The authors recommend incorporating UPF screening into routine cardiovascular prevention visits by asking about packaged snacks, sugary drinks, processed meats, and ready-to-eat meals, alongside traditional counseling on smoking, exercise, and weight management.
"The research on UPFs has been accumulating for a decade, and it highlights the risks of high UPF consumption and the benefits of choosing whole or minimally processed foods," said Marialaura Bonaccio, PhD, of IRCCS NEUROMED in Italy. "This emphasizes that disease prevention should not focus solely on nutrients, but also on the degree of food processing."
Source: Guasti L. Eur Heart J. 2026 May 7. Ultra-processed foods, lifestyle management, and cardiovascular diseases: A clinical consensus statement of the European Society of Cardiology Council for Cardiology Practice and the European Association of Preventive Cardiology of the European Society of Cardiology