Association Between Ultraprocessed Food Consumption and Cardiovascular Disease Risk: MESA (Multiethnic Study of Atherosclerosis)
Haidar A, Rikhi R, Watson KE, Wood AC, Shapiro MD
JACC. Advances · 2 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Not stated
Who paid for it
- Funding
- Independent funding
Based on full-text disclosure statement.
Publication
- Published
- 2026-03-17 · JACC Adv · vol. 5 · issue 4 · p. 102516
- Publisher
- Elsevier BV
- Cited
- 0 citations · more than 20% of similar papers · 0.0× the field average
- References
- 46 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Consumer Attitudes and Food Labeling · Nutrition, Genetics, and Disease · Nutritional Studies and Diet
- Keywords
- Disease, Ethnic group, Consumption (sociology), Association (psychology), Food consumption, Obesity, Atherosclerotic cardiovascular disease
5 authors
From US
- Amier HaidarUniversity of California, Los Angeles; University of California System
- Rishi Raj RikhiWake Forest University
- K WatsonUniversity of California, Los Angeles; University of California System
- Alexis C. WoodChildren's Nutrition Research Center at Baylor College of Medicine
- Michael David Shapiro · correspondingWake Forest University
Abstract
Background
Ultraprocessed foods (UPFs) have been linked to adverse cardiometabolic outcomes and increased atherosclerotic cardiovascular disease (CVD) (ASCVD) risk. However, prior research has largely focused on homogenous populations, lacking racial and ethnic diversity.
Objectives
The objectives are to examine the longitudinal relationship between UPF consumption and ASCVD risk and to investigate whether these associations differ by race/ethnicity, sex, or socioeconomic status.
Methods
The MESA (Multiethnic Study of Atherosclerosis) is a prospective cohort study of 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 used to evaluate the association between UPF intake and incident CVD events. Incident CVD events included nonfatal myocardial infarction, resuscitated cardiac arrest, death resulting from coronary heart disease, stroke (not transient ischemic attack), and death resulting from stroke.
Results
Each additional daily serving of UPF was associated with a 5.1% increased risk of ASCVD events (HR: 1.051; 95% CI: 1.011-1.093). Participants in the highest quintile of UPF consumption had a 66.8% higher risk compared to those in the lowest (HR: 1.668; 95% CI: 1.196-2.325). A significant multiplicative interaction was observed between UPF intake and Black race (P = 0.010), with stratified analyses demonstrating a higher ASCVD risk in 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).
Conclusions
In a large, multiethnic cohort, higher UPF consumption was significantly associated with an increased risk for ASCVD events, with a more pronounced association among Black Americans.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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