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Expert explainer: What ultra-processed foods mean for heart health
By Emily Leighton
A new international consensus paper examines the evidence linking ultra-processed foods to cardiovascular disease
By Emily Leighton
Ultra-processed foods have become a staple of modern diets. They’re inexpensive, convenient and readily available. But growing evidence suggests they may also be contributing to cardiovascular disease, diabetes and other chronic health conditions.
A new clinical consensus paper published in the European Heart Journal brings together international experts to examine the evidence linking ultra-processed foods to cardiovascular health and offer practical guidance for health professionals.
Dr. Saverio Stranges is a public health physician, epidemiologist and professor at Schulich School of Medicine & Dentistry, and co-author on the paper.
In this Q&A, he discusses what defines ultra-processed foods, why they’re becoming a growing public health concern and what individuals, health professionals and policymakers can do to reduce their impact.
What exactly are ultra-processed foods?
Ultra-processed foods are products created through extensive industrial processing. They’re very different from foods that remain close to their natural state, such as fruits, vegetables, eggs, milk or plain yogurt.
Many ultra-processed foods are high in salt, sugar and unhealthy fats, while being low in important nutrients such as fibre, vitamins and minerals. They can also contain additives to enhance flavour, texture or shelf life. The concern isn’t only what’s added to these foods, but also what they can replace in our diets. An over-reliance on ultra-processed foods can reduce the overall nutritional quality of what we eat.
Many are designed to be ready to eat, inexpensive and convenient. That convenience is one of the reasons they’ve become such a large part of modern diets.
But our food choices aren’t simply personal choices. They’re also shaped by our social and economic environments. Families with limited financial resources may rely more heavily on ultra-processed foods because they’re often less expensive and more accessible than healthier alternatives – which speaks to the broader influence of the social determinants of health.
Why have they become a focus of your research?
We’ve known for at least 50 years that diet and nutrition play a fundamental role in preventing many chronic diseases, including cardiovascular disease, diabetes, cancer and cognitive decline. Traditionally, nutrition research focused on nutrients, like saturated fat, salt or sugar, and on encouraging healthy dietary patterns, like the Mediterranean diet.
During the past two decades, we’ve been looking more closely at food processing itself. Ultra-processed foods now make up a large proportion of diets around the world, including Canada, and the research consistently links higher consumption with increased risk.
From a public health perspective, it’s an important shift in how we think about diet. It’s not just what we eat, but how our food is made.
How strong is the evidence that these foods affect our health?
The epidemiological evidence is now very consistent. Large prospective studies conducted around the world have linked higher consumption of ultra-processed foods with increased risk of cardiovascular disease, hypertension, stroke, heart failure and diabetes. We also see strong associations with obesity, which is itself an important cardiovascular risk factor.
For example, one study involving more than 105,000 adults found that every 10 per cent increase ultra-processed food intake was associated with a 12 per cent higher risk of cardiovascular disease. Other large studies have found that people who consume the most ultra-processed foods have a higher risk of coronary heart disease compared with those who consume the least.
We do have to interpret these findings carefully. Cardiovascular disease is multifactorial. Diet is one piece of a much larger puzzle that includes physical activity, sleep, genetics, age and other lifestyle factors. It’s difficult to isolate the exact contribution of each one.
But diet remains one of the major modifiable contributors. As smoking rates have declined in many countries, dietary factors and sedentary behaviours have become even more important drivers of chronic disease.
Should people avoid processed foods altogether?
Not necessarily. Some food processing is important because it helps preserve food, improves food safety and increases access to food. The concern is our growing over-reliance on ultra-processed foods.
The goal isn’t to eliminate processed foods entirely. It’s to restore a better balance and improve the overall quality of our diets.
What prompted the international consensus paper?
The European Society of Cardiology brought together experts from several countries to review the growing body of evidence linking ultra-processed foods with cardiovascular disease and cardiometabolic health.
Our goal was to assess the strength of the evidence and provide practical guidance for clinicians who counsel patients about nutrition and cardiovascular risk. The evidence shows consistent associations between higher consumption of ultra-processed foods and cardiovascular risk factors, including obesity, Type 2 diabetes and abnormal cholesterol levels.
The paper is also intended to raise awareness among consumers. Many people still aren’t familiar with the concept of ultra-processed foods or how heavily they’ve become integrated into modern diets.
Why is it important for clinicians to understand this evidence?
Many health professionals simply aren’t discussing ultra-processed foods with their patients.
If you visit a primary care provider, you’re unlikely to be asked about whether you regularly consume them. The same is true for other important lifestyle behaviours, such as sleep, unless you’re already experiencing a clinical problem.
That’s a missed opportunity.
Lifestyle management should be central to preventing chronic disease, not something we think about only after disease develops.
Public interest in nutrition has grown significantly, but so has misinformation. How do people know what to trust?
That’s one of the biggest challenges in public health today.
Recommendations should be grounded in evidence. Consensus papers like this one are based on peer-reviewed research, systemic reviews and large bodies of scientific evidence. That’s very different from information circulating on social media or being driven by political agendas.
The challenge is communicating that evidence in ways people can understand while ensuring it reaches both health professionals and the public.
Beyond individual food choices, what changes would you like to see?
I hope this paper increases awareness among health professionals, policymakers and the general public about the potential health risks associated with ultra-processed foods.
We need practical public health measures – better food labelling, improved food literacy, stronger nutrition education and policies that make healthier foods easier to choose.
In the long term, we also need to rethink our food systems. Food choices affect not only individual health but also the health of the planet. More sustainable food systems that support healthier, minimally processed foods can benefit both people and the environment.