Heavily processed foods can increase the risk of heart disease beyond poor nutrition alone

A new review links ultra-processed foods and their additives to higher cardiovascular risk, pointing to large human studies and inflammation-related mechanisms that may help explain why a heavily processed diet can harm heart health.

Review: Processed Foods and Food Dyes: What Are We Eating and What Are the Cardiovascular Risks? Image Credit: beauty-box / Shutterstock

A recent review published in the journal Cardiology in Review has been summarized accumulating linking evidence UPFs you CVDdrawing on large-scale cohort and meta-analytic data. This is an industrial formulation, high in additives, sugar, fat, and salt, which is associated with an increased risk of CVD, stroke, and cardiovascular mortality, with several cohort studies and meta-analyses supporting the dose-response relationship.

Impact of Diet on Global Cardiovascular Health

The review also highlights proposed mechanisms, including disruption of the gut microbiome, chronic inflammation driven by NF-κB activation, and oxidative stress linked to specific additives. So reducing UPF intake can represent a modifiable strategy for cardiovascular prevention and population health.

Cardiovascular disease places a considerable burden on individuals and health care systems worldwide. These diseases reduce quality of life and cause long-term economic strain through the cost of care.

In this context, diet has emerged as a key modifiable risk factor, with growing evidence highlighting the role of processed foods in disease development. UPFs, usually industrial formulations with high additive content and low food content, are increasingly linked to adverse cardiometabolic outcomes.

Reducing UPF intake offers a simple and practical dietary strategy that individuals can adopt to support cardiovascular health and lower disease risk.

In this review, the authors examine the epidemiological evidence and biological mechanisms linking UPF intake to CVD risk.

Inflammatory Pathways and NF-κB Activation

Emerging evidence suggests that UPF additives may increase CVD risk through interconnected inflammatory and oxidative pathways. Preservatives, emulsifiers, and synthetic dyes can disrupt gut microbial balance by reducing beneficial bacteria while promoting pro-inflammatory species. This dysbiosis can damage barrier integrity, promote endotoxemia, and trigger systemic immune activation.

The key mechanism is NF-κB activation, a central regulator of inflammatory gene expression. Once activated, NF-κB drives the release of inflammatory cytokines, incl IL-6 and TNF-αsustaining chronic inflammation. These inflammatory actions promote endothelial dysfunction, increase monocyte adhesion, and accelerate early atherogenesis.

Oxidative Stress and Mechanisms of Vascular Damage

Oxidative stress further enhances these effects. rose produced in response to certain additives strengthen NF-κB signaling, creating a self-perpetuating cycle of inflammation and vascular injury.

Over time, this cascade contributes to plaque formation, which increases the risk of hypertension, thrombosis, and progressive CVD. Evidence from adolescent and adult populations links higher UPF intake to elevated C-reactive protein (CRP) levels and biomarkers related to NF-κB.

Metabolic Effects and Additive-Driven Risk

Beyond inflammation, observational studies link high intake of UPF additives with obesity, diabetes, and other cardiometabolic outcomes. Compounds such as nitrates, synthetic dyes, and antioxidant preservatives may further contribute through oxidative stress, gut dysbiosis, and endothelial dysfunction. Collectively, these pathways converge on NF-κB-driven inflammation, placing this additive as a plausible contributor to long-term cardiovascular risk.

Cohort Study Linking UPF to Cardiovascular Disease

Large prospective cohort studies have consistently demonstrated a positive association between UPF consumption and CVD risk. In the NutriNet-Santé cohort in France, including more than 105,000 participants, a 10% increase in energy intake from UPFs was associated with a 12% higher risk of CVD events. [hazard ratio (HR), 1.12]. The association remained significant after adjustment for key confounders, including sex, age, body mass index (BMI), and physical activity.

Researchers have seen similar patterns in other populations. Data from the Framingham Heart Study Offspring cohort showed that each additional serving of UPF per day was associated with a higher risk of cardiovascular events, coronary heart disease (CHD), and mortality related to CVD (HR, 1.07-1.09), regardless of diet quality.

Analyzes were collected from major United States (USA) cohorts, including participants in the Health Professional Follow-up Study (HPFS) and the Nursing Health Study (NHS), further support this finding. Participants in the highest quintile of UPF intake showed an increased risk of CVD and CHD by 11% and 16%, respectively, compared with the lowest quintile.

Meta-Analysis and Dose-Response Evidence

Meta-analytic evidence reinforces this association and supports a dose–response relationship. A recent systematic review, including 22 prospective studies and over a million participants, reported that UPF consumption was linked to a 17% greater CVD risk. A 10% increase in energy intake from UPFs is associated with a roughly 1.6% to 2.2% increase in CVD-related events, and an increased risk of cardiovascular mortality and stroke.

The Role of Additives and Non-Nutritional Factors

Importantly, this link remained even after adjusting for overall nutritional profiles, suggesting that non-nutritional factors may contribute. Among NutriNet-Santé study participants, higher consumption of emulsifiers, including carboxymethylcellulose, trisodium phosphate, and fatty acid-derived glycerol esters, was associated with an increased risk of CVD events (HRs, 1.03-1.07).

Emerging evidence also links artificial sweeteners to cardiovascular risk through metabolic and microbiome-related effects, although direct review of prospective evidence on cardiovascular events remains limited.

Dietary Recommendations and Public Health Implications

Overall, consistent evidence links high consumption of ultra-processed foods with an increased risk of cardiovascular disease, supported by epidemiological studies and NF-κB-driven inflammatory mechanisms.

Additives such as preservatives, dyes, and sweeteners can worsen the risk through gut dysbiosis and oxidative stress. These findings highlight the importance of shifting towards minimally processed diets to support cardiovascular health.