Study links lower UPF intake to improved cardiovascular health, experts caution findings

A study has estimated the cardiovascular disease (CVD) burden from ultra-processed food (UPF) intake among Canadian adults to be between 23–38%, equivalent to 58,200 to 96,000 cases of CVD and 10,600 to 17,400 deaths related to the disease. 

Canada’s latest population-representative nutrition data was collected in 2015, showing that 43.4% of Canadians’ energy intake came from UPFs.

The study argues that reducing UPF consumption by 20–50% could have prevented up to 45,900 new cases and up to 8,300 deaths related to CVD in 2019.

The authors mention that although the current analysis focuses on CVD, the overall health burden from UPF consumption is “likely underestimated,” as it did not include other associated outcomes such as type 2 diabetes, cancer, gastrointestinal diseases, and mental health. 

Critics react

Independent researchers have criticized the study and have stated that the numbers are probably overestimated.

Kevin McConway, emeritus professor of Applied Statistics, Open University, UK, comments: “This is an interesting attempt at modeling potential health effects of UPF consumption in one country (Canada) — but I wouldn’t want to put much trust in the detailed estimates it presents.”

“I’m not trying to claim that reducing UPF consumption in Canada would have no effect on CVD and death. It might well do so, but any reduction could be substantially smaller than the figures in this paper, or indeed larger. And the measure used in the research, deaths and disease attributable to one specific risk factor (UPF consumption), can be awkward to interpret,” he argues.

“It sounds as if it means ‘deaths caused by UPF consumption,’ but it doesn’t mean that, particularly not for a disease like CVD that has many potential causes that can interact with one another.”

Need for public health intervention

Published in the American Journal of Preventive Medicine, the study applied a comparative risk assessment model to estimate CVD impact, including stroke, heart disease, fatal cases, and disability-adjusted life-years.

The authors found that reducing UPF consumption may help CVD burden in the country.It used national data from 2015, including adults aged 20 and above. Model inputs also included national health statistics on CVD and data from the Global Burden of Disease Study from 2019.

The authors found that reducing UPF consumption may help reduce a large, and preventable, burden of CVD in the country.

“These findings suggest that reducing UPF consumption could yield meaningful population health benefits, as even modest reductions (such as 20%) may substantially decrease CVD burden. Achieving this will likely require coordinated, multisectoral strategies aimed at reducing UPF exposure and supporting healthier dietary patterns,” reads the study. 

The authors note that “these findings reinforce the need for clinical and public health interventions aimed at reducing UPF intake as a key component of CVD prevention.”

Skepticism on results

Tom Sanders, professor emeritus of Nutrition and Dietetics, King’s College London, UK, is another independent expert commenting on the study.

“The conclusions regarding dietary intake are based on the 2015 national survey. Participants were asked to recall what they ate on the previous day. Estimates of CVD were for different participants. This analysis is based on associations, not on data from controlled trials,” he says.

Sanders stresses the importance of taking lifestyle factors into consideration.Sanders stresses the importance of taking lifestyle factors into consideration. He says that a high intake of UPF is associated with low socioeconomic status, unhealthy behaviors such as smoking, and social deprivation.

“Although UPFs accounted for 43% [of energy intake] in this study, it probably has not increased over the last few decades in Canada. In contrast, death from CVD has fallen by about 80% over the past twenty years in Canada, and the consensus view is that this has been due to improvements in diet as well as the better management of CVD (blood pressure and cholesterol-lowering medication).” 

“In my opinion, the claim that halving the intake of UPFs would have a substantial impact on CVD is speculative,” Sanders says.

Meanwhile, a previous study found that diets rich in plant-based products with low or no processing had a 40% lower risk of CVD than diets lower in plant-based products and higher in animal-based ones.

Another study published earlier this year associated dietary risk factors with 5.91 million cardiovascular deaths in 2023, including data from 204 countries and territories. The researchers called for more population-specific contextualized dietary strategies, such as low-sodium reformulation initiatives and prioritizing nutritious food affordability.