The link between ultra-processed food and cardiovascular disease
Source: www.ewg.org By Owen Curtin (EWG)
Research and public attention to heart disease has for decades focused on its known risk factors, such as tobacco use, physical inactivity, excessive drinking and cholesterol levels. But a growing body of research points to another, often overlooked culprit: ultra-processed food, or UPF.
Heart disease is one of the most common and deadly medical conditions in the U.S. It’s a type of cardiovascular disease, a group of disorders that together affect nearly half of all American adults.
Not all processed foods are harmful. Cooking, canning and freezing can count as processing yet make food safe and convenient. But UPF fall into an entirely different category, which includes certain types of soda, chips, packaged snacks, instant noodles and shelf-stable baked goods.
UPF are manufactured using ingredients and additives that are rarely, if ever, found in a home kitchen: artificial colors, sweeteners, stabilizers, emulsifiers and flavor enhancers.
These products are sometimes optimized to hit the perfect combo of salt, sugar and fat, often with little or no fiber or real nutrients. The result? Intensely appealing products that are hard to resist and easy to overeat.
Because of their craveable appeal – and the fact they’re affordable, convenient and heavily marketed – UPF now make up almost 60% of the average American adult’s diet. It’s even higher for children and teens.
Harming the heart
A 2024 umbrella review examined meta-analyses including data from nearly 10 million people across 45 different studies to understand how UPF can affect our health.
While UPF is linked to many health problems, the evidence for heart disease risks was found to be among the most convincing.
When researchers looked at all the evidence, results showed consistent and significant findings across studies. They classified the link between higher consumption of UPF and increased cardiovascular disease–related mortality as “convincing evidence.”.
Less convincing evidence was nonetheless highly suggestive for other heart-related deaths and overall mortality.
Cardiovascular disease encompasses a range of conditions affecting the heart and blood vessels, including coronary heart disease, peripheral artery disease, hypertension and heart failure. It is associated with the buildup of fatty deposits inside the arteries, which puts strain on the heart.
A single type of cardiovascular disease also increases the risk of developing another. It can lead to heart attacks, strokes and other life-threatening complications.
More than a heart issue
The health effects of UPF don't stop at cardiovascular disease.
There is convincing evidence that eating more UPF increases Type 2 diabetes risk, with a clear dose-response relationship – meaning the more you eat, the higher your risk.
A similar level of evidence links UPF consumption to common mental health problems like depression and anxiety.
Research shows UPF consumption can contribute to weight gain and obesity, as well as respiratory problems like wheezing and difficulty breathing.
Beyond this, UPF consumption has been linked to various types of cancer, metabolic syndrome and fatty liver disease, though the evidence for these conditions is still developing.
The pattern is clear: UPF may disrupt multiple normal body processes, likely contributing to high blood pressure, elevated cholesterol and metabolic dysfunction.
States tackling UPF
Individual steps taken to lower UPF consumption can reduce their health harms. The American Heart Association has also called for reducing consumption of most UPF.
The federal government can help to reduce UPF prevalence in our food supply through legal and regulatory efforts. Several bills introduced in Congress aim to restrict the use of UPF.
But actual recent progress on the policy front is coming from states introducing and enacting landmark legislation.
California recently enacted two historic laws banning certain harmful food chemicals, with one targeting synthetic dyes used in school food specifically. EWG co-sponsored both measures.
Other states are now following suit with their own versions of these regulations.
EWG is co-sponsoring Assembly Bill 1264, a bill that the California Senate is considering, which would ban the most harmful ultra-processed foods from being served in public schools.
What you can do
For many families, food decisions are shaped by affordability, availability and convenience – and UPF options often check all three boxes. This is complicated by the fact that as many as 70% of grocery store shelves are stocked with UPF.
To lower your own consumption of UPF, here are a few steps you can take:
Know what to look for. Read the full ingredient list. Long lists filled with chemical-sounding names are a red flag. Choose products with simple, recognizable ingredients.
Swap when you can. When they’re available and affordable, replace heavily processed items with whole food or minimally processed alternatives, such as fruits and vegetables, whole grains, beans, nuts and unprocessed meats.
Processed doesn’t always mean bad. Not all processed foods are bad. Items like plain yogurt, prepared pasta sauce or frozen veggies can be nutritious and convenient.
Don’t chase perfection. Focus on reducing overall UPF intake, not cutting every processed food from your diet. Avoiding ultra-processed junk food high in unhealthy fats, added sugars and salt should be the first step.
Use trusted tools. EWG offers helpful resources to support healthier shopping, including:
The Food Scores database rates over 150,000 food and beverage products based on nutritional content, ingredient safety, and processing level so you can stay informed. We recently added a flag for “unhealthy ultra-processed food,” so you can easily see which foods are and aren’t.
The Healthy Living app enables you to scan products to see how they compare to one another, letting you choose the best option every time.