Ultra-processed Foods and Cardiovascular Diseases: Potential Mechanisms of Action
Open accessAbstract
Ultra-processed foods are industrially manufactured ready-to-eat or ready-to-heat formulations containing food additives and little or no whole foods, in contrast to processed foods, which are whole foods preserved by traditional techniques such as canning or pickling. Recent epidemiological studies suggest that higher consumption of ultra-processed food is associated with increased risk of cardiovascular disease (CVD). However, epidemiological evidence needs to be corroborated with criteria of biological plausibility. This review summarizes the current evidence on the putative biological mechanisms underlying the associations between ultra-processed foods and CVD. Research ranging from laboratory-based to prospective epidemiological studies and experimental evidence suggest that ultra-processed foods may affect cardiometabolic health through a myriad of mechanisms, beyond the traditionally recognized individual nutrients. Processing induces significant changes to the food matrix, for which ultra-processed foods may affect health outcomes differently than unrefined whole foods with similar nutritional composition. Notably, the highly degraded physical structure of ultra-processed foods may affect cardiometabolic health by influencing absorption kinetics, satiety, glycemic response, and the gut microbiota composition and function. Food additives and neo-formed contaminants produced during processing may also play a role in CVD risk. Key biological pathways include altered serum lipid concentrations, modified gut microbiota and host-microbiota interactions, obesity, inflammation, oxidative stress, dysglycemia, insulin resistance, and hypertension. Further research is warranted to clarify the proportional harm associated with the nutritional composition, food additives, physical structure, and other attributes of ultra-processed foods. Understanding how ultra-processing changes whole foods and through which pathways these foods affect health is a prerequisite for eliminating harmful processing techniques and ingredients.
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Food availability and exposure to highly palatable, often ultraprocessed foods may affect energy balance.
“In addition, food availability and exposure to highly palatable, often ultraprocessed foods may affect energy balance.65,66”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [65]
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- Authors
- Juul, F., Vaidean, G., & Parekh, N.
- Affiliations
- New York University (US)
- Northwell Health (US)
- Corresponding author
- Parekh, Niyati
- Venue
- Advances in Nutrition
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 12
- Issue
- 5
- Pages
- 1673-1680
- ISSN
- 2156-5376 (ISSN-L)
- 2161-8313
- PMC
- PMC8483964
- OpenAlex
- W3157346013
- Semantic Scholar
- ba346fa7fce9b95e7691b7a13442c0043a268a9b
- Cited by
- 374
- References
- 72
- Citations by year
- 2026: 66 · 2025: 97 · 2024: 78 · 2023: 72 · 2022: 46 · 2021: 15
- FWCI
- 9.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Advances in Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Consumer Attitudes and Food Labeling
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Keywords
- ultra-processed foods, cardiovascular disease, cardiometabolic health, food additives, food processing, gut microbiota, obesity, inflammation, oxidative stress, insulin resistance, dysglycemia, hypertension, serum lipids, satiety, glycemic response
- MeSH terms
- Cardiovascular Diseases, Diet, Food Handling, Humans, Prospective Studies, Fast Foods
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