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Even 'Healthy' Ultraprocessed Foods Tied to Heart Risk

March 26, 2021 -- Eating ultraprocessed foods poses a significant risk to heart health, according to a study of about 3,000 people taking part in an ongoing heart study.

Each regular, daily serving of ultraprocessed food was linked with significant increases in rates of "hard" heart disease events and death, Filippa Juul, PhD, and associates wrote in a report published in the Journal of the American College of Cardiology.

"Consumption of ultraprocessed foods makes up over half of the daily calories in the average American diet and are increasingly consumed worldwide. As poor diet is a major modifiable risk factor for heart disease, it represents a critical target in prevention efforts," said Juul, a nutritional epidemiologist at New York University, in a statement released by the American College of Cardiology.

"Our findings add to a growing body of evidence suggesting cardiovascular benefits of limiting ultraprocessed foods,” Juul said.

Ultraprocessed foods are increasingly available and include many foods that are marketed as healthy, such as protein bars, breakfast cereals, and most industrially produced breads, she added. Other common ultraprocessed foods are carbonated soft drinks, packaged snacks, candies, sausages, margarines, and energy drinks.

The concept of ultraprocessed foods as a distinct, wide-ranging, and dangerous food category first appeared in 2010, and then received an update from a United Nations panel in 2019 as what's now called the NOVA classification system.

Ultraprocessed Foods Fly Under the Radar

"Although cardiovascular guidelines emphasize consuming minimally processed foods, such as fruits, vegetables, whole grains, and nuts, they give less attention to the importance of minimizing ultraprocessed food," wrote Robert J. Ostfeld, MD, and Kathleen E. Allen, MS, in an editorial that accompanied the new report. This reduced attention may be because of a "paucity of studies examining the association cardiovascular outcomes and ultraprocessed foods."

The new evidence demands new policies, educational efforts, and changes to product labels, say Ostfeld, director of preventive cardiology at Montefiore Health System in New York, and Allen, a dietitian at the Geisel School of Medicine at Dartmouth University in Hanover, NH "The goal should be to make the unhealthy choice the hard choice and the healthy choice the easy choice."

The new analysis used data from people enrolled the Framingham Offspring Cohort. Study participants were an average of 54 years old. Fifty-five percent were women, and about 6% had diabetes. They reported eating, on average, 7.5 servings of ultraprocessed food daily.

During follow-up, the study participants experienced 648 heart events, including 251 who died, had a stroke or heart attack. and 713 total deaths.

Convenient, Omnipresent, and Affordable

The authors said the study needs to be done again in more diverse populations, but the findings "suggest the need for increased efforts to implement population-wide strategies" to lower consumption of ultraprocessed foods. "Given the convenience, omnipresence, and affordability of ultraprocessed foods, careful nutrition counseling is needed to design individualized, patient-centered, heart-healthy diets," they concluded.

"Population-wide strategies such as taxation on sugar-sweetened beverages and other ultraprocessed foods and recommendations regarding processing levels in national dietary guidelines are needed to reduce the intake of ultraprocessed foods," Juul said. "Of course, we must also implement policies that increase the availability, accessibility, and affordability of nutritious, minimally processed foods, especially in disadvantaged populations. At the clinical level, there is a need for increased commitment to individualized nutrition counseling for adopting sustainable heart-healthy diets."

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