"Ultra-Processed Foods: A Hidden Threat to Cardiovascular Health"

Story:

• Poor dietary habits are a critical determinant of cardiovascular health and a modifiable risk for cardiovascular disease (CVD).
• Plant-based, Mediterranean, and DASH diets have demonstrated significant cardioprotective benefits.
• The standard American diet remains high in ultra-processed foods (UPF) and low in fruits, vegetables, whole grains, and lean proteins.

What Are Ultra-Processed Foods?

• UPFs are highly processed, calorie-dense, nutrient-poor foods developed for palatability, durability, and affordability.
• They are high in fat, sugar, salt, and preservatives, with little to no nutritional value.
• Examples include prepackaged snacks, processed meats, fried foods, and sweetened beverages.

NOVA Classification System:

• The NOVA system categorizes foods into four groups based on their processing level:
  1. Unprocessed or minimally processed foods: Natural foods altered minimally (e.g., fresh fruits, vegetables, grains, and milk).
  2. Processed culinary ingredients: Extracted substances used for cooking (e.g., oils, butter, sugar, and salt).
  3. Processed foods: Foods modified with ingredients like sugar or salt (e.g., canned vegetables, fruits in syrup, and cheese).
  4. Ultra-processed foods (UPFs): Industrial formulations with little to no whole foods, often containing additives (e.g., soft drinks, packaged snacks, and frozen meals).

The Impact of UPFs on Health:

• High UPF consumption (42.8-49.6% of daily calories) increases the risk of CVD by 17% and coronary heart disease by 23%.
• UPFs disrupt the gut microbiome, impair caloric regulation, and trigger overeating.
• Diets rich in UPFs are linked to hypertension, type 2 diabetes, stroke, and metabolic syndrome.

Social Determinants of UPF Consumption:

• Food insecurity affects 18 million households in the U.S., limiting access to nutritious foods.
• Communities with lower incomes often rely on affordable but nutrient-poor UPFs.
• Residents in food deserts have limited access to grocery stores, relying on convenience stores with fewer fresh options.
• Food marketing disproportionately targets low-income Black and Hispanic communities, promoting sugary drinks and snacks.

Global and U.S. Efforts:

• Some countries regulate UPFs through dietary guidelines, taxes, and warning labels.
• In the U.S., regulations focus on high-fat, sugar, and salt (HFSS) foods but often exclude UPFs.
• Integrating UPF criteria into HFSS regulations could improve efforts to reduce unhealthy food production.

The Way Ahead:

• Replace UPFs in hospital menus (currently 25%) with nutrient-dense meals.
• Educate patients and families through nutritionist-led sessions on affordable, healthy alternatives.
• Advocate for policy changes to improve access to healthy foods in vulnerable communities.
• Raise awareness about the severe health and financial burdens caused by UPFs.

Take-Home Points:

1. Ultra-processed foods are a major contributor to cardiovascular disease and other chronic illnesses.
2. Social and economic factors drive UPF consumption in vulnerable populations.
3. Efforts to reduce UPFs require public health advocacy, education, and regulatory changes.
4. A multi-faceted approach can address the health inequities caused by diet-driven diseases.
5. Targeting UPFs is essential for improving nutrition, reducing healthcare burdens, and promoting health equity.