Each daily serving of ultra-processed food increases heart attack and stroke risk

A recent study presented at the American College of Cardiology’s 2026 Annual Scientific Session and published in the Journal of the American College of Cardiology: Advances linked high intake of ultra-processed foods to a 67% higher risk of cardiovascular events, such as heart attack and stroke.¹

This prospective cohort study followed 6,814 U.S. adults aged 45 to 84 without cardiovascular disease at baseline. Dietary data was collected at baseline, and cardiovascular events were recorded over about 10 years, including heart attack, death from coronary heart disease, stroke, and death from stroke.

Participants in the highest fifth of ultra-processed food consumption – who were consuming about nine servings per day – had a 67% higher risk of cardiovascular events compared to those in the lowest fifth, who were consuming about one serving per day.

Source: Association Between Ultraprocessed Food Consumption and Cardiovascular Disease Risk

A 5% increase in risk for each daily serving of ultra-processed food

It’s no surprise that consuming large amounts of ultra-processed food increases cardiovascular risk. But many people may think that smaller amounts won’t affect their health, or that they can compensate for a few servings of ultra-processed food by adding some more fruit and vegetables. The data suggests not.  

First, the researchers’ dose-response analysis found each daily serving of ultra-processed food raised cardiovascular risk by 5%.

Plus, the 67% increase in risk in the top fifth of ultra-processed food consumption, and the 5% increase in risk per serving were observed after adjustment for potential confounding factors including overall diet quality. This suggests that higher ultra-processed food consumption was not linked to higher risk simply because it’s a marker of overall poor diet quality.
   
The average ultra-processed food intake among participants in the study was 4.4 servings/day and 28% of total daily food servings. Previous studies found that more than 50% of Americans’ calories come from ultra-processed food.² The average American is eating a dangerous quantity of ultra-processed food.

Sources: 
Association Between Ultraprocessed Food Consumption and Cardiovascular Disease Risk
Trends in Adults’ Intake of Un-processed/Minimally Processed, and Ultra-processed foods at Home and Away from Home in the United States from 2003–2018

What counts as “ultra-processed”?

The term “ultra-processed food” seems to be everywhere. But not all packaged foods are considered ultra-processed. There are four degrees of processing:

1. Unprocessed or minimally processed foods: the edible parts of natural products, such as fruits, vegetables, nuts, and meat. Minimal processing refers to processes such as removing unwanted parts (such as stems), drying, freezing, cooking, or placing in containers. 
2. Processed culinary ingredients: oils, butter and other animal fats, sugar, and salt. These are derived from Group 1 foods but are depleted in some or most nutrients compared to the original food. 
3. Processed foods: adding Group 2 processed ingredients to Group 1 foods, for example, a jar of sliced fruit in syrup, or canned beans with added salt.
4. Ultra-processed foods: processed foods produced using industrial techniques, such as extrusion or pre-frying, and usually containing ingredients used mostly only in industry, rarely in home kitchens. These industrial ingredients such as high fructose corn syrup, isolated proteins, colors, artificial sweeteners, emulsifiers, or preservatives. Sugars, oils and other fats, and salt are most often included. Often, the process and additives aim to make the final product highly palatable or more cosmetically appealing. Examples of ultra-processed foods include soda, candy, ice cream, packaged breads, cookies and crackers, breakfast cereals, hot dogs, instant soups, meal replacement shakes, and pre-prepared frozen meals.³

Source: Ultra-processed foods: what they are and how to identify them

How does ultra-processed food damage health? 

Ultra-processed food is a broad category of foods with different combinations of ingredients, but most contain refined carbohydrate, sugar, excessive sodium, and/or oils, as well as industrial additives. The researchers investigated subgroups of ultra-processed foods and found that sugary foods had the strongest links to cardiovascular risk in this study.¹ 

High-glycemic foods with high levels of added sugars and fiber-depleted refined carbohydrates are known to drive heart disease risk via insulin resistance, oxidative stress leading to endothelial dysfunction and inflammation, and elevated triglyceride levels.^4,5 

Excess sodium in ultra-processed foods increase cardiovascular risk by increasing blood pressure and arterial stiffness, and promoting endothelial dysfunction.^6,7 

Ultra-processed foods have a combination of characteristics that lead to incomplete satiety and higher calorie intake compared to whole and minimally processed foods: lack of fiber, processing that requires less chewing, and calorie density.⁵

Eating ultra-processed foods also means missing out on the cardiovascular benefits of the nutrients, fiber and phytochemicals in fruits, vegetables, beans, nuts, and seeds. 

Related: Heart Attacks Are Preventable: Why Stents Miss the Real Problem and What to Do Instead

Processed meats contain cancer-promoting preservatives and excess heme iron that promotes cardiovascular disease.⁸ 

Related: The Protein Problem: How the source affects cardiovascular risk

In addition to those ingredients, the industrial emuslifers polysorbate 80 and carboxymethylcellulose have been linked to gut microbiome disruption.9 Some food colorants, (such as Red No. 3, which is currently being phased out in the U.S.) and some plastic-derived chemicals that could migrate into food from packaging have endocrine-disrupting properties. Caramel color in particular may disrupt blood glucose regulation.^10,11

Sources:
Ultra-processed Foods and Cardiovascular Diseases: Potential Mechanisms of Action
Salt Reduction to Prevent Hypertension and Cardiovascular Disease: JACC State-of-the-Art Review 
Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study
Impact of Food Additives on Gut Homeostasis
Additives in Processed Foods as a Potential Source of Endocrine-Disrupting Chemicals: A Review

Avoiding ultra-processed foods and eating for heart health

You don’t need to learn how to read ingredient lists and food labels in detail to identify which are ultra-processed. Instead, eat mostly foods that either don’t have labels or only have one ingredient on the list. If your diet is made up of vegetables, beans, nuts, seeds, and fruit, and you avoid added sugar, salt, and oils, you’ll avoid ultra-processed foods.

What truly works for cardiovascular health is a diet that addresses the underlying causes of cardiovascular disease, primarily oxidative stress, inflammation, and excess body fat. A Nutritarian diet is high in fiber, antioxidant and anti-inflammatory phytochemicals, and healthy fats, and it works for heart disease prevention and reversal. Each of the G-BOMBS works in its own way to keep the heart and vessels healthy.

Related: Heart Disease is Preventable and Reversible through Nutritional Intervention 

In 2015, I published a scientific article in the American Journal of Lifestyle Medicine demonstrating with survey data and case histories the dramatic weight loss benefits and improvements in LDL cholesterol, triglycerides, and blood pressure possible with a Nutritarian diet. Case reports demonstrated dramatic reversal of heart disease and long-term maintenance of healthy dietary habits.¹²  

Related: Improved Cardiovascular Parameters With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases

Source: Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases