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Association between ultraprocessed food consumption and cardiovascular disease risk: MESA (Multiethnic Study of Atherosclerosis)
Ultraprocessed foods (UPFs) have been linked to adverse cardiometabolic outcomes and an increased risk of atherosclerotic cardiovascular disease (ASCVD). However, previous research has primarily examined homogenous populations, lacking in racial and ethnic diversity. This study aims to explore the longitudinal relationship between UPF consumption and ASCVD risk, and to determine if these associations vary by race/ethnicity, sex, or socioeconomic status. Using data from the Multiethnic Study of Atherosclerosis (MESA), a prospective cohort study involving 6,814 U.S. adults aged 45 to 84 years without clinically apparent CVD, UPF consumption was classified according to the Nova classification system. Multivariable Cox proportional hazards models were employed to assess the association between UPF intake and incident CVD events, which included nonfatal myocardial infarction, resuscitated cardiac arrest, coronary heart disease mortality, stroke (excluding transient ischemic attack), and stroke-related mortality.
Each additional daily serving of UPF was associated with a 5.1% increase in ASCVD event risk (HR: 1.051; 95% CI: 1.011-1.093). Participants in the highest quintile of UPF consumption had a 66.8% higher risk compared with those in the lowest quintile (HR: 1.668; 95% CI: 1.196-2.325). A significant multiplicative interaction was identified between UPF intake and Black race (P = 0.010), with stratified analyses revealing a heightened ASCVD risk among Black Americans (HR: 1.061; 95% CI: 1.016-1.108) compared to non-Black Americans (HR: 1.032; 95% CI: 1.001-1.065).
In this extensive multiethnic cohort, elevated UPF consumption was significantly correlated with an increased risk of ASCVD events, with a more pronounced association observed among Black Americans. [NPID: Ultraprocessed food, UPF, cardiometabolic, ASCVD]
Year: 2026
