ArticleThe international journal of behavioral nutrition and physical activity2021
Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study.
Article in The international journal of behavioral nutrition and physical activity, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
51 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Ultra-Processed Food Consumption and Adult Mortality Risk: A Systematic Review and Dose-Response Meta-Analysis of 207,291 Participants.Nutrients · 2021Pooled it
- A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms.Nutrients · 2021Pooled it
- Nutritional quality of foods according to the Nova food classification system after a behavioral economics intervention in food pantries.Frontiers in public health · 2025Trial
- Trial
- Review
- Contribution of Nova-classified ultraprocessed foods to energy and nutrient intakes in very old people: the Newcastle 85+ Study.BMJ open · 2026Observational
- Association Between Ultraprocessed Food Consumption and Cardiovascular Disease Risk: MESA (Multiethnic Study of Atherosclerosis).JACC. Advances · 2026Article
- Associations between food insecurity and Supplemental Nutrition Assistance Program participation with ultra-processed food acquisitions for home consumption in US households.Public health nutrition · 2026Article
- Ultra-processed food consumption and body mass index from adolescence to early adulthood: multi-trajectory analysis using data from the 1993 Pelotas (Brazil) birth cohort.Cadernos de saude publica · 2026Article
- Consumption of ultra-processed foods and risk of all-cause and cause-specific mortality: the Singapore Chinese health study.Nutrition journal · 2025Article
- Ultra-processed foods, plant and animal sources, and all-cause, cardiovascular, and cancer mortality in older adults in the United States: results from the Cardiovascular Health Study.The American journal of clinical nutrition · 2025Article
- Association Between Ultra-processed Food Consumption and Mortality Among US Adults: Prospective Cohort Study of the National Health and Nutrition Examination Survey, 2003-2018Journal of the Academy of Nutrition and Dietetics · 2025Article
- Ultra-Processed Diets and Endocrine Disruption, Explanation of Missing Link in Rising Cancer Incidence Among Young Adults.Cancers · 2025Review
- Impact of Ultra-processed Foods on Food Sustainability: Exposure Assessment and Health Implications.Recent advances in food, nutrition & agriculture · 2025Review
- Ultra-processed food consumption and renal cell carcinoma incidence and mortality: results from a large prospective cohort.BMC medicine · 2024Article
- Food contamination and cardiovascular disease: a narrative review.Internal and emergency medicine · 2024Review
- Ultra-processed foods and cardiovascular disease: analysis of three large US prospective cohorts and a systematic review and meta-analysis of prospective cohort studies.Lancet regional health. Americas · 2024Article
- Validity and Reliability of the Turkish Version of the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF).Nutrients · 2024Article
- The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata.BMC public health · 2024Article
- Ultra-processed food consumption and risk of chronic respiratory diseases mortality among adults: evidence from a prospective cohort study.European journal of nutrition · 2024Article
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUltra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed foods and cardiovascular outcomes are scarce in the US population. We aimed to examine the association of ultra-processed food consumption with cardiovascular mortality in a US population.
methodsA population-based cohort of 91,891 participants was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary data were collected through a validated 137-item food frequency questionnaire. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. Restricted cubic spline regression was used to test nonlinearity. Subgroup analyses were conducted to identify the potential effect modifiers.
resultsAfter an average follow-up of 13.5 years (1,236,049.2 person-years), 5490 cardiovascular deaths were documented, including 3985 heart disease deaths and 1126 cerebrovascular deaths. In the fully adjusted model, participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HR
conclusionsHigh consumption of ultra-processed foods is associated with increased risks of overall cardiovascular and heart disease mortality. These harmful associations may be more pronounced in women. Our findings need to be confirmed in other populations and settings.
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