Ultraprocessed Food Intake Linked to Increased Cardiovascular Risk, Especially Among Black Americans
New research presented at the American College of Cardiology (ACC) Annual Scientific Session & Expo (ACC.26) and published in JACC: Advances reveals a significant association between higher consumption of ultraprocessed foods (UPFs) and an increased risk of atherosclerotic cardiovascular disease (ASCVD) events. The study, based on data from the Multiethnic Study of Atherosclerosis (MESA), found this association to be particularly pronounced among Black Americans.
What is the MESA Study?
The Multiethnic Study of Atherosclerosis (MESA) is a long-term research project sponsored by the National Heart, Lung, and Blood Institute (NHLBI) that began in 1999. It examines the early stages of atherosclerosis – the buildup of plaque in the arteries – in a diverse group of over 6,800 participants from six U.S. Communities. As of March 2026, MESA has contributed to over 2,600 published papers.
Study Findings: UPFs and ASCVD Risk
Researchers analyzed data from 6,814 adults aged 45-84 who were enrolled in the MESA study and initially free of clinically apparent cardiovascular disease. Participants completed food questionnaires to assess their daily intake of UPFs, categorized using the NOVA classification system. This system classifies foods based on their degree of processing, ranging from unprocessed to ultraprocessed.
The study revealed a clear dose-response relationship: those in the highest quintile of UPF consumption averaged 9.3 servings per day, compared to 1.1 servings per day in the lowest quintile. Compared to those in the lowest quintile, individuals in the highest quintile were 67% more likely to experience a cardiovascular event, including coronary heart disease, stroke, heart attack, or resuscitated cardiac arrest.
“We controlled for a lot of factors in this study,” said Amier Haidar, MD, lead study author. “Regardless of the amount of calories you consumed per day, regardless of the overall quality of your diet, and after controlling for common risk factors like diabetes, high blood pressure, high cholesterol and obesity, the risk associated with higher UPF intake was still about the same.”
Each additional daily serving of UPFs was associated with a 5.1% increased risk of adverse cardiac events overall. Yet, this risk was significantly amplified among Black Americans, with a 6.1% increase in risk per serving compared to a 3.2% increase among non-Black individuals.
Why the Disparity?
Researchers suggest that inequities in UPF consumption and associated health impacts among different racial groups may be linked to factors such as targeted food marketing towards minority communities and limited access to less-processed foods in certain neighborhoods.
Study Limitations
The researchers acknowledge several limitations. The MESA study was not specifically designed to collect detailed data on UPF intake, relying instead on self-reported dietary questionnaires that assessed processed food consumption by number of servings. The study likewise did not investigate the underlying biological mechanisms linking UPF consumption to cardiovascular risk.
Implications and Future Directions
According to Heidar, reducing risk involves paying closer attention to food choices and carefully reviewing food labels. Kim Allan Williams Sr., MD, MACC, emphasized the need for structural solutions, including transparent front-of-package labeling that provides clear and biologically meaningful information to consumers. A recent report from the ACC highlights the potential of such labeling to increase consumer awareness and promote healthier food choices.
This research underscores the importance of addressing dietary disparities and promoting access to nutritious, minimally processed foods to improve cardiovascular health for all populations.