Skip to main content
SpringerLink
Log in

Ultra-processed Foods and Cardiometabolic Health Outcomes: from Evidence to Practice

Current Atherosclerosis Reports volume 24, pages 849–860 (2022)Cite this article

Abstract

Purpose of Review

Poor diet quality is the leading risk factor related to the overall cardiometabolic disease burden in the USA and globally. We review the current evidence linking ultra-processed foods and cardiometabolic health risk and provide recommendations for action at the clinical and public health levels.

Recent Findings

A growing body of evidence conducted in a variety of study populations supports an association between ultra-processed food intake and increased risk of metabolic syndrome, hypertension, type 2 diabetes, overweight and obesity trajectories, and cardiovascular disease. The strongest evidence is observed in relation to weight gain and obesity among adults, as this association is supported by high-quality epidemiological and experimental evidence.

Summary

Accumulating epidemiologic evidence and putative biological mechanisms link ultra-processed foods to cardiometabolic health outcomes. The high intake of ultra-processed foods in all population groups and its associated risks make ultra-processed foods an ideal target for intensive health promotion messaging and interventions.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol. 2017;70(1):1–25.

    Article  PubMed  PubMed Central  Google Scholar 

  2. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1151–210.

  3. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics-2020 Update: a report from the American Heart Association. Circulation. 2020;141(9):e139–596.

    Article  PubMed  Google Scholar 

  4. Micha R, Penalvo JL, Cudhea F, Imamura F, Rehm CD, Mozaffarian D. Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States. JAMA. 2017;317(9):912–24.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Murray CJ, Atkinson C, Bhalla K, Birbeck G, Burstein R, Chou D, et al. The state of US health, 1990–2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310(6):591–608.

    Article  CAS  PubMed  Google Scholar 

  6. Collaborators GBoDD. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;393(10184):1958–72.

  7. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e596–646.

    PubMed  PubMed Central  Google Scholar 

  8. American Diabetes A. 3. Prevention or delay of type 2 diabetes: standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S32-S6.

  9. Mozaffarian D. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review. Circulation. 2016;133(2):187–225.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Weaver CM, Dwyer J, Fulgoni VL 3rd, King JC, Leveille GA, MacDonald RS, et al. Processed foods: contributions to nutrition. Am J Clin Nutr. 2014;99(6):1525–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B. Ultra-processed products are becoming dominant in the global food system. Obes Rev. 2013;14(Suppl 2):21–8.

    Article  PubMed  Google Scholar 

  12. Cutler DM, Glaeser EL, Shapiro JM. Why have Americans become more obese? J Econ Perspect. 2003;17(3):93–118.

    Article  Google Scholar 

  13. Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr. 2019;22(5):936–41.

    Article  PubMed  Google Scholar 

  14. Baraldi LG, Martinez Steele E, Canella DS, Monteiro CA. Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study. BMJ Open. 2018;8(3):e020574.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lustig RH. Processed food-an experiment that failed. JAMA Pediatr. 2017;171(3):212–4.

    Article  PubMed  Google Scholar 

  16. Micha R, Shulkin ML, Penalvo JL, Khatibzadeh S, Singh GM, Rao M, et al. Etiologic effects and optimal intakes of foods and nutrients for risk of cardiovascular diseases and diabetes: systematic reviews and meta-analyses from the Nutrition and Chronic Diseases Expert Group (NutriCoDE). PLoS ONE. 2017;12(4):e0175149.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010;121(21):2271–83.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Xi B, Huang Y, Reilly KH, Li S, Zheng R, Barrio-Lopez MT, et al. Sugar-sweetened beverages and risk of hypertension and CVD: a dose-response meta-analysis. Br J Nutr. 2015;113(5):709–17.

    Article  CAS  PubMed  Google Scholar 

  19. Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. N Engl J Med. 2006;354(15):1601–13.

    Article  CAS  PubMed  Google Scholar 

  20. Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695–704.

    Article  PubMed  Google Scholar 

  21. Elizabeth L, Machado P, Zinocker M, Baker P, Lawrence M. Ultra-processed foods and health outcomes: a narrative review. Nutrients. 2020;12(7).

  22. Moubarac JC, Batal M, Louzada ML, Martinez Steele E, Monteiro CA. Consumption of ultra-processed foods predicts diet quality in Canada. Appetite. 2017;108:512–20.

    Article  PubMed  Google Scholar 

  23. Adams J, White M. Characterisation of UK diets according to degree of food processing and associations with socio-demographics and obesity: cross-sectional analysis of UK National Diet and Nutrition Survey (2008–12). Int J Behav Nutr Phys Act. 2015;12:160.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Rauber F, da Costa Louzada ML, Steele EM, Millett C, Monteiro CA, Levy RB. Ultra-processed food consumption and chronic non-communicable diseases-related dietary nutrient profile in the UK (2008(-)2014). Nutrients. 2018;10(5).

  25. Louzada M, Ricardo CZ, Steele EM, Levy RB, Cannon G, Monteiro CA. The share of ultra-processed foods determines the overall nutritional quality of diets in Brazil. Public Health Nutr. 2018;21(1):94–102.

    Article  PubMed  Google Scholar 

  26. Machado PP, Steele EM, Levy RB, Sui Z, Rangan A, Woods J, et al. Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study. BMJ Open. 2019;9(8):e029544.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Machado PP, Steele EM, Louzada M, Levy RB, Rangan A, Woods J, et al. Ultra-processed food consumption drives excessive free sugar intake among all age groups in Australia. Eur J Nutr. 2020;59(6):2783–92. https://doi.org/10.1007/s00394-019-02125-y.

    Article  CAS  PubMed  Google Scholar 

  28. Costa Louzada ML, Martins AP, Canella DS, Baraldi LG, Levy RB, Claro RM, et al. Ultra-processed foods and the nutritional dietary profile in Brazil. Rev Saude Publica. 2015;49:38.

    PubMed  Google Scholar 

  29. Martinez Steele E, Baraldi LG, Louzada ML, Moubarac JC, Mozaffarian D, Monteiro CA. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open. 2016;6(3):e009892.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Martinez Steele E, Popkin BM, Swinburn B, Monteiro CA. The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study. Popul Health Metr. 2017;15(1):6.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Juul F, Simoes BDS, Litvak J, Martinez-Steele E, Deierlein A, Vadiveloo M, et al. Processing level and diet quality of the US grocery cart: is there an association? Public Health Nutr. 2019;22(13):2357–66.

    Article  PubMed  Google Scholar 

  32. Srour B, Fezeu LK, Kesse-Guyot E, Alles B, Mejean C, Andrianasolo RM, et al. Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Sante). BMJ. 2019;365: l1451.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Fardet A. Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: a preliminary study with 98 ready-to-eat foods. Food Funct. 2016;7(5):2338–46.

    Article  CAS  PubMed  Google Scholar 

  34. • Zinocker MK, Lindseth IA. The Western diet-microbiome-host interaction and its role in metabolic disease. Nutrients. 2018;10(3). This publication summarizes recent evidence concerning how a Western-style diet high in ultra-processed foods may promote both structural and behavioral changes in the resident microbiome, which in turn may promote diverse forms of inflammatory disease.

  35. Nettleton JE, Reimer RA, Shearer J. Reshaping the gut microbiota: impact of low calorie sweeteners and the link to insulin resistance? Physiol Behav. 2016;164(Pt B):488–93.

    Article  CAS  PubMed  Google Scholar 

  36. Zhang Y, Huang M, Zhuang P, Jiao J, Chen X, Wang J, et al. Exposure to acrylamide and the risk of cardiovascular diseases in the National Health and Nutrition Examination Survey 2003–2006. Environ Int. 2018;117:154–63.

    Article  CAS  PubMed  Google Scholar 

  37. Calvo MS, Moshfegh AJ, Tucker KL. Assessing the health impact of phosphorus in the food supply: issues and considerations. Adv Nutr. 2014;5(1):104–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Jacobs DR Jr, Tapsell LC. Food, not nutrients, is the fundamental unit in nutrition. Nutr Rev. 2007;65(10):439–50.

    Article  PubMed  Google Scholar 

  39. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–5.

    Article  CAS  PubMed  Google Scholar 

  40. Lavigne-Robichaud M, Moubarac JC, Lantagne-Lopez S, Johnson-Down L, Batal M, LaouanSidi EA, et al. Diet quality indices in relation to metabolic syndrome in an indigenous Cree (Eeyouch) population in northern Quebec. Canada Public Health Nutr. 2018;21(1):172–80.

    Article  PubMed  Google Scholar 

  41. Martinez Steele E, Juul F, Neri D, Rauber F, Monteiro CA. Dietary share of ultra-processed foods and metabolic syndrome in the US adult population. Prev Med. 2019;125:40–8.

    Article  PubMed  Google Scholar 

  42. Tavares LF, Fonseca SC, Garcia Rosa ML, Yokoo EM. Relationship between ultra-processed foods and metabolic syndrome in adolescents from a Brazilian Family Doctor Program. Public Health Nutr. 2012;15(1):82–7.

    Article  PubMed  Google Scholar 

  43. Nasreddine L, Tamim H, Itani L, Nasrallah MP, Isma’eel H, Nakhoul NF, et al. A minimally processed dietary pattern is associated with lower odds of metabolic syndrome among Lebanese adults. Public Health Nutr. 2018;21(1):160–71.

    Article  PubMed  Google Scholar 

  44. Rinaldi AE, Gabriel GF, Moreto F, Corrente JE, McLellan KC, Burini RC. Dietary factors associated with metabolic syndrome and its components in overweight and obese Brazilian schoolchildren: a cross-sectional study. Diabetol Metab Syndr. 2016;8(1):58.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Mendonca RD, Lopes AC, Pimenta AM, Gea A, Martinez-Gonzalez MA, Bes-Rastrollo M. Ultra-processed food consumption and the incidence of hypertension in a Mediterranean cohort: The Seguimiento Universidad de Navarra Project. Am J Hypertens. 2017;30(4):358–66.

    PubMed  Google Scholar 

  46. Scaranni P, Cardoso LO, Chor D, Melo ECP, Matos SMA, Giatti L, et al. Ultra-processed foods, changes in blood pressure and incidence of hypertension: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Public Health Nutr. 2021:1–9.

  47. Monge A, Silva Canella D, Lopez-Olmedo N, Lajous M, Cortes-Valencia A, Stern D. Ultraprocessed beverages and processed meats increase the incidence of hypertension in Mexican women. Br J Nutr. 2021;126(4):600–11.

    Article  CAS  PubMed  Google Scholar 

  48. Melo ISV, Costa C, Santos J, Santos AFD, Florencio T, Bueno NB. Consumption of minimally processed food is inversely associated with excess weight in adolescents living in an underdeveloped city. PLoS ONE. 2017;12(11):e0188401.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Srour B, Fezeu LK, Kesse-Guyot E, Alles B, Debras C, Druesne-Pecollo N, et al. Ultraprocessed food consumption and risk of type 2 diabetes among participants of the NutriNet-Sante prospective cohort. JAMA Intern Med. 2019.

  50. Llavero-Valero M, Escalada-San Martin J, Martinez-Gonzalez MA, Basterra-Gortari FJ, de la Fuente-Arrillaga C, Bes-Rastrollo M. Ultra-processed foods and type-2 diabetes risk in the SUN project: a prospective cohort study. Clin Nutr. 2021;40(5):2817–24.

    Article  PubMed  Google Scholar 

  51. Costa CS, Rauber F, Leffa PS, Sangalli CN, Campagnolo PDB, Vitolo MR. Ultra-processed food consumption and its effects on anthropometric and glucose profile: A longitudinal study during childhood. Nutr Metab Cardiovasc Dis. 2019;29(2):177–84.

    Article  CAS  PubMed  Google Scholar 

  52. Donat-Vargas C, Sandoval-Insausti H, Rey-Garcia J, Moreno-Franco B, Akesson A, Banegas JR, et al. High consumption of ultra-processed food is associated with incident dyslipidemia: a prospective study of older adults. J Nutr. 2021;151(8):2390–8.

    Article  PubMed  Google Scholar 

  53. Rauber F, Campagnolo PD, Hoffman DJ, Vitolo MR. Consumption of ultra-processed food products and its effects on children’s lipid profiles: a longitudinal study. Nutr Metab Cardiovasc Dis. 2015;25(1):116–22.

    Article  CAS  PubMed  Google Scholar 

  54. Leffa PS, Hoffman DJ, Rauber F, Sangalli CN, Valmórbida JL, Vitolo MR. Longitudinal associations between ultra-processed foods and blood lipids in childhood. Br J Nutr. 2020;124(3):341–8.

    Article  CAS  PubMed  Google Scholar 

  55. Zhang Z, Jackson SL, Martinez E, Gillespie C, Yang Q. Association between ultraprocessed food intake and cardiovascular health in US adults: a cross-sectional analysis of the NHANES 2011–2016. Am J Clin Nutr. 2020.

  56. Yang Q, Zhang Z, Steele EM, Moore LV, Jackson SL. Ultra-processed foods and excess heart age among U.S. adults. Am J Prev Med. 2020;59(5):e197-e206.

  57. Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake. Cell Metab. 2020;32(4):690. https://doi.org/10.1016/j.cmet.2020.08.014This rigorously conducted randomized controlled trial investigated ad libitum food intake and weight change in participants randomized to ultra-processed versus unprocessed diets for 14 days each. The ultra-processed diet caused increased ad libitum energy intake and weight gain despite being matched to the unprocessed diet for presented calories, sugar, fat, sodium, fiber, and macronutrients.

    Article  CAS  PubMed  Google Scholar 

  58. Konieczna J, Morey M, Abete I, Bes-Rastrollo M, Ruiz-Canela M, Vioque J, et al. Contribution of ultra-processed foods in visceral fat deposition and other adiposity indicators: Prospective analysis nested in the PREDIMED-Plus trial. Clin Nutr. 2021.

  59. Mendonca RD, Pimenta AM, Gea A, de la Fuente-Arrillaga C, Martinez-Gonzalez MA, Lopes AC, et al. Ultraprocessed food consumption and risk of overweight and obesity: the University of Navarra Follow-Up (SUN) cohort study. Am J Clin Nutr. 2016;104(5):1433–40.

    Article  PubMed  Google Scholar 

  60. Beslay M, Srour B, Méjean C, Allès B, Fiolet T, Debras C, et al. Ultra-processed food intake in association with BMI change and risk of overweight and obesity: a prospective analysis of the French NutriNet-Santé cohort. PLoS Med. 2020;17(8):e1003256.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Rauber F, Chang K, Vamos EP, da Costa Louzada ML, Monteiro CA, Millett C, et al. Ultra-processed food consumption and risk of obesity: a prospective cohort study of UK Biobank. Eur J Nutr. 2021;60(4):2169–80.

    Article  PubMed  Google Scholar 

  62. Canhada SL, Luft VC, Giatti L, Duncan BB, Chor D, Fonseca M, et al. Ultra-processed foods, incident overweight and obesity, and longitudinal changes in weight and waist circumference: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Public Health Nutr. 2020;23(6):1076–86.

    Article  PubMed  Google Scholar 

  63. Cordova R, Kliemann N, Huybrechts I, Rauber F, Vamos EP, Levy RB, et al. Consumption of ultra-processed foods associated with weight gain and obesity in adults: a multi-national cohort study. Clin Nutr. 2021;40(9):5079–88.

    Article  CAS  PubMed  Google Scholar 

  64. Silva FM, Giatti L, de Figueiredo RC, Molina M, de Oliveira CL, Duncan BB, et al. Consumption of ultra-processed food and obesity: cross sectional results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort (2008–2010). Public Health Nutr. 2018;21(12):2271–9.

    Article  PubMed  Google Scholar 

  65. Louzada ML, Baraldi LG, Steele EM, Martins AP, Canella DS, Moubarac JC, et al. Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med. 2015;81:9–15.

    Article  PubMed  Google Scholar 

  66. Juul F, Martinez-Steele E, Parekh N, Monteiro CA, Chang VW. Ultra-processed food consumption and excess weight among US adults. Br J Nutr. 2018;120(1):90–100.

    Article  CAS  PubMed  Google Scholar 

  67. Chang K, Khandpur N, Neri D, Touvier M, Huybrechts I, Millett C, et al. Association between childhood consumption of ultraprocessed food and adiposity trajectories in the avon longitudinal study of parents and children birth cohort. JAMA Pediatr. 2021;175(9):e211573.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Cunha DB, da Costa THM, da Veiga GV, Pereira RA, Sichieri R. Ultra-processed food consumption and adiposity trajectories in a Brazilian cohort of adolescents: ELANA study. Nutr Diabetes. 2018;8(1):28.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Costa CDS, Assuncao MCF, Loret de Mola C, Cardoso JS, Matijasevich A, Barros AJD, et al. Role of ultra-processed food in fat mass index between 6 and 11 years of age: a cohort study. Int J Epidemiol. 2021;50(1):256–65.

  70. Vedovato GM, Vilela S, Severo M, Rodrigues S, Lopes C, Oliveira A. Ultra-processed food consumption, appetitive traits and BMI in children: a prospective study. Br J Nutr. 2021;125(12):1427–36.

    Article  CAS  PubMed  Google Scholar 

  71. Juul F, Vaidean G, Lin Y, Deierlein AL, Parekh N. Ultra-processed foods and incident cardiovascular disease in the Framingham Offspring Study. J Am Coll Cardiol. 2021;77(12):1520–31.

    Article  PubMed  Google Scholar 

  72. Kim H, Hu EA, Rebholz CM. Ultra-processed food intake and mortality in the USA: results from the Third National Health and Nutrition Examination Survey (NHANES III, 1988–1994). Public Health Nutr. 2019;22(10):1777–85.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Zhong GC, Gu HT, Peng Y, Wang K, Wu YQ, Hu TY, et al. Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study. Int J Behav Nutr Phys Act. 2021;18(1):21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Du S, Kim H, Rebholz CM. Higher ultra-processed food consumption is associated with increased risk of incident coronary artery disease in the atherosclerosis risk in communities study. J Nutr. 2021;151(12):3746–54.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Bonaccio M, Di Castelnuovo A, Costanzo S, De Curtis A, Persichillo M, Sofi F, et al. Ultra-processed food consumption is associated with increased risk of all-cause and cardiovascular mortality in the Moli-sani Study. Am J Clin Nutr. 2021;113(2):446–55.

    Article  PubMed  Google Scholar 

  76. FAO. Guidelines on the collection of information on food processing through food consumption surveys. Rome; 2015.

  77. Truman E, Lane D, Elliott C. Defining food literacy: a scoping review. Appetite. 2017;116:365–71.

    Article  PubMed  Google Scholar 

  78. The Edible Shoolyard Project 2020 [Available from: https://edibleschoolyard.org.

  79. USDA. Dietary Guidelines for Americans, 2020–2025. 9th Edition.: U.S. Department of Agriculture and U.S. Department of Health and Human Services.; 2020.

  80. Harnack L, Oakes JM, Elbel B, Beatty T, Rydell S, French S. Effects of subsidies and prohibitions on nutrition in a food benefit program: a randomized clinical trial. JAMA Intern Med. 2016;176(11):1610–8.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Van Horn L, Carson JA, Appel LJ, Burke LE, Economos C, Karmally W, et al. Recommended dietary pattern to achieve adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: a scientific statement from the American Heart Association. Circulation. 2016;134(22):e505–29.

    PubMed  Google Scholar 

  82. •• Lichtenstein AH, Appel LJ, Vadiveloo M, Hu FB, Kris-Etherton PM, Rebholz CM, et al. 2021 Dietary guidance to improve cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2021;144(23):e472–87. This scientific statement from the American Heart Association specifies to choose minimally processed foods instead of ultra-processed foods as one of 10 key evidence-based dietary pattern recommendations to improve cardiovascular health.

    Article  PubMed  Google Scholar 

  83. Fagerhoi MG, Rollefstad S, Olsen SU, Semb AG. The effect of brief versus individually tailored dietary advice on change in diet, lipids and blood pressure in patients with inflammatory joint disease. Food Nutr Res. 2018;62.

  84. Aggarwal M, Grady A, Desai D, Hartog K, Correa L, Ostfeld RJ, et al. Successful implementation of healthful nutrition initiatives into hospitals. Am J Med. 2020;133(1):19–25.

    Article  PubMed  Google Scholar 

  85. Downer S, Berkowitz SA, Harlan TS, Olstad DL, Mozaffarian D. Food is medicine: actions to integrate food and nutrition into healthcare. BMJ. 2020;369:m2482.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Astrup A and Monteiro CA. Does the concept of “ultra-processed foods” help inform dietary guidelines, beyond conventional classification systems? NO. Am J Clin Nutr 2022; Jun 7:nqac123

  87. Mozaffarian D, El-Abbadi NH, O’Hearn M, et al. Food Compass is a nutrient profiling system using expanded characteristics for assessing healthfulness of foods. Nature Food. 2021;2(10):809–18.

    Article  Google Scholar 

  88. Levy RB, Rauber F, Chang K, et al. Ultra-processed food consumption and type 2 diabetes incidence: A prospective cohort study. Clin Nutr. 2021;40(5):3608–14.

Download references

Author information

Authors and Affiliations

  1. Department of Public Health Policy and Management, School of Global Public Health, New York University, 708 Broadway, NY, 10003, New York, USA

    Filippa Juul

  2. Public Health Nutrition Program, School of Global Public Health, New York University, New York, NY, USA

    Andrea L. Deierlein & Niyati Parekh

  3. Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA

    Andrea L. Deierlein & Niyati Parekh

  4. Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA

    Georgeta Vaidean

  5. Department of Health Sciences, Boston University, Boston, MA, USA

    Paula A. Quatromoni

Authors
  1. Filippa Juul
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea L. Deierlein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Georgeta Vaidean
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paula A. Quatromoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Niyati Parekh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Filippa Juul.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Nutrition

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Juul, F., Deierlein, A.L., Vaidean, G. et al. Ultra-processed Foods and Cardiometabolic Health Outcomes: from Evidence to Practice. Curr Atheroscler Rep 24, 849–860 (2022). https://doi.org/10.1007/s11883-022-01061-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11883-022-01061-3

Keywords

search

Navigation