Some ultra-processed foods can increase the risk of cancer, heart disease

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A Cargill food factory worker inspects chicken nuggets before they are breaded as they exit the conveyor belt at the factory in Orléans, central France, on October 9, 2023. Image Credit: GUILLAUME SOUVANT/Getty Images
  • A diet rich in ultra-processed foods is linked to the development of multiple chronic diseases, according to a new study.
  • Particularly likely to lead to concomitant cancers, diabetes and heart problems are highly processed animal-based and artificially processed foods. sugar-sweetened beverages.
  • Although this study found no such link between ultra-processed foods such as breads, cereals or plant-based alternatives, experts caution against overconsumption.
  • The problem with identifying ultra-processed foods is that they are usually categorized by their degree of processing, with less emphasis on nutritional value.

The consumption of ultra-processed foods is linked to various individual chronic diseases such as crabdiabetes and cardiovascular diseases. Now a large study confirms that they are also associated with co-morbidities or combinations of such diseases.

The study found that there was a 9% increase in the likelihood of developing cardiovascular and cardiometabolic comorbidities for those whose diet consisted of a significant amount of ultra-processed foods.

The biggest increase in risk, according to the study, was for animal-based products and artificially sugar-sweetened beverages.

The researchers found no similar association between ultra-processed breads and cereals, plant-based alternatives and co-morbidities.

The study is an analysis of data from the European Prospective Investigation into Cancer and Nutrition (EPIC). This is an ongoing prospective cohort study of the relationships between cancer and other diseases and lifestyle, diet, genetic and environmental risk factors.

For the new study, researchers looked at data from 266,666 participants. The foods they eat are ranked according to the degree of processing according to the NOVA index. There was an average of 11.2 years of follow-up to track the development of chronic diseases.

The study was published in The Lancet Regional Health – Europe.

There is no universal agreement on exactly what attributes define problematic processed food. This is largely due to the fact that most modern foods, unless obtained directly from where they were grown, involve some degree of processing.

Processed foods can include such healthy foods as tofu, plain bread, canned tuna, or beans and cheese. The biggest concern, however, is ultra-processed foods, or UPF.

The standard adopted by most researchers is the NOVA index, developed by Carlos Monteiro and colleagues at the University of São Paulo in Brazil.

The principal investigator of the new study, Dr. Heinz Freisling, a nutrition and metabolism scientist at the World Health Organization, explained how the index works:

“NOVA classifies foods not by their nutritional profile but by their degree of processing into four categories: fresh or minimally processed, culinary ingredients, processed and ultra-processed.”

Michelle Rutenstein, a preventive cardiology nutritionist at, who was not involved in the study, describes the latter category as “foods that are made exclusively through a combination of industrial processes.”

Since degree of processing alone doesn’t tell the whole story—ingredients matter, too—there’s room for personal opinions on the matter.

For Dr. Freisling, “[u]Intra-processed foods are foods that cannot be prepared at home due to a lack of both the machinery required for preparation and the ingredients that are characteristic of ultra-processing. Examples of such ingredients are colorings, artificial sweeteners, food preservatives, etc.

Why can consuming highly processed foods lead to co-morbidities? “This is a hot topic of research right now because it’s still not clear why ultra-processed foods show this strong association with a wide range of conditions,” Dr. Freisling said.

He suggested that perhaps this is related to the availability and lower cost of such foods to the consumer. Made for taste – and imperishability – people tend to overeat them.

“For example, plain boiled corn on the cob is no competition to a bag of tortilla chips,” Dr. Freisling said.

He also suggested that additives, including artificial sweeteners, may play a role.

“The sheer lack of dietary fiber and the modified food matrix — the natural matrix or form of food at the microscopic level — may play an important role,” he added.

Rutenstein noted that the processing methods themselves could also be responsible. She said ultra-processing methods create byproducts in food that can promote disease.

“For example, advanced glycation end products (AGEs) are formed as a byproduct of the production of certain foods and can lead to inflammation and oxidative stress, negatively contributing to a wide range of health conditions,” Rutenstein pointed out.

“AGE levels are highest per gram in ultra-processed foods that use dry heat, such as crackers, chips and cookies,” she further noted..

Although the study found no link between ultra-processed breads and grains and plant-based alternatives, Dr. Freisling does not believe this means they should be considered a healthy component of the diet.

“I continue to be concerned because people who eat a diet high in ultra-processed foods tend to eat these foods everywhere,” he said.

Additionally, while the study looked at co-morbidities, such foods have been linked to individual chronic diseases in previous studies.

Routhenstein suggested several easily prepared foods that can take the place of ultra-processed foods in the diet.

“An easy swap you can make is to switch out the fruit-flavored yogurts and make your own yogurt and fruit bowl,” Rutenstein said.

Another yogurt-related improvement would be to replace whey protein powder, which contains emulsifiers, flavor enhancers, and isolates, with ¾ cup unflavored/unsweetened Greek yogurt.

Routhenstein provided a few other tips, such as swapping out ultra-processed meats like bacon for a homemade tempeh and mushroom version.

Plant-based recipe

“Adding coconut aminos, apple cider vinegar, and a little maple syrup with a little smoked paprika to chopped tempeh and shiitake mushrooms is a way to cut back on processed meats and add nutrient-dense protein that’s good for your heart, gut, and bones.” It can also help reduce oxidative stress, the opposite of what ultra-processed foods do!”
— Michelle Rutenstein

“We have shown that a risk factor – here high consumption of ultra-processed foods – is not only associated with a higher risk of a serious disease, for example diabetes, but can increase the risk of [experiencing] a combination of diseases known as multimorbidity,” said Dr. Freisling.

“Second,” he said, “I think it’s important to communicate to the public that certain subsets of ultra-processed foods should be preferred over others. For example, plant-based versus animal-based.”

Rutenstein agreed with this second point, saying, “This sheds light on the need to assess nutritional value such as fiber to offset the harmful effects of ultra-processed foods as determined by the NOVA classification scale.”

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