For decades, nutritional guidance has focused on the “what”—the grams of saturated fat, the milligrams of sodium, and the total count of calories. But a comprehensive new report suggests that the “how”—specifically, how our food is processed—may be just as critical to heart health as the nutrients themselves.
A clinical consensus statement published Thursday in the European Heart Journal warns that ultra-processed foods (UPFs) are now fundamentally linked to an increased risk of cardiovascular disease and premature death. The report, authored by a coalition of cardiology experts across Europe, argues that the industrialization of the modern diet has created a public health gap: while we know these foods are harmful, the standard medical advice given to patients in clinics has not yet caught up to the science.
As a physician, I have seen this disconnect firsthand. Patients often arrive with “healthy” diets on paper—low fat or low sugar—yet they are consuming a steady stream of industrial formulations that mimic whole foods. This new consensus from the European Society of Cardiology’s Council for Cardiology Practice and the European Association of Preventive Cardiology seeks to bridge that gap, urging doctors to treat food processing as a primary risk factor alongside smoking and sedentary lifestyles.
The biological cost of industrial processing
Ultra-processed foods are not simply “processed” foods. While canned beans or frozen vegetables are processed for preservation, UPFs are industrial formulations. They typically contain substances not used in home kitchens, such as hydrogenated oils, high-fructose corn syrup, flavor enhancers, and emulsifiers.
According to Dr. Marialaura Bonaccio, one of the report’s leads, the danger of UPFs is not just about the presence of salt and sugar. The very structure of the food is altered. “UPFs tend to be high in sugar, salt, and unhealthy fats,” Dr. Bonaccio noted, but she emphasized that additives and contaminants can trigger systemic inflammation, metabolic disruption, and changes to the gut microbiome.
This “altered food structure” often leads to overeating because these foods are engineered to be hyper-palatable and are absorbed more quickly by the body, causing spikes in blood glucose and insulin. Over time, this biological stress manifests as a cluster of cardiovascular risk factors, including obesity, type 2 diabetes, hypertension, and the accumulation of unhealthy fats in the bloodstream.
Quantifying the risk: A European perspective
The report synthesizes a decade of research, revealing a stark correlation between the volume of UPFs in a diet and the likelihood of heart failure or death. The data suggests that those with the highest consumption of these foods face significantly worse outcomes than those who stick to minimally processed diets.
The findings highlight a worrying trend: the prevalence of these foods varies wildly across Europe, often mirroring the degree of industrialization in the local food system. In Northern Europe, where convenience foods have deeply penetrated the market, the percentage of daily calories derived from UPFs is alarmingly high.
| Country | Percentage of Calories from UPFs |
|---|---|
| Netherlands | 61% |
| United Kingdom | 54% |
| Spain | 25% |
| Portugal | 22% |
| Italy | 18% |
The health implications of these numbers are significant. The consensus report finds that adults with the highest UPF intake have up to a 19% higher risk of heart disease and a 13% higher risk of atrial fibrillation. Most strikingly, the risk of cardiovascular death increases by up to 65% compared to those with the lowest consumption levels.
The ‘Health Halo’ and the gap in clinical care
One of the most critical points raised by Professor Luigina Guasti and her colleagues is the danger of the “health halo.” Many products marketed as “healthy”—such as certain protein bars, low-fat sweetened yogurts, or plant-based meat alternatives—are, by definition, ultra-processed. Because they may be fortified with vitamins or low in fat, they often bypass the scrutiny of patients and doctors alike.
Current national dietary guidelines largely prioritize nutrient-based recommendations. If a product is low in sodium, This proves often flagged as “heart-healthy,” regardless of whether it contains a dozen industrial additives. The authors of the report argue that this approach is outdated.
To combat this, the experts are calling for a shift in how doctors approach patient consultations. Instead of merely asking about “fat intake” or “sugar,” the report recommends that physicians specifically ask about the degree of processing in a patient’s diet. The goal is to move patients toward whole or minimally processed foods—such as whole grains, legumes, fruits, and vegetables—which naturally lack the inflammatory triggers found in industrial formulations.
What remains unknown
Despite the consistency of the data, the authors maintain a necessary scientific caution. The majority of the evidence currently available comes from observational studies, which identify correlations but cannot definitively prove that UPFs cause heart disease in every individual. There are few long-term interventional trials—studies where one group is strictly limited to whole foods while another continues eating UPFs under controlled conditions.
Dr. Bonaccio noted that further research is required to isolate the effects of specific additives and processing compounds. Understanding exactly which chemical additive triggers inflammation or which structural change disrupts the microbiome will be the next frontier in preventive cardiology.
The next phase for the medical community involves integrating UPF awareness into routine care. The authors hope that this consensus statement will lead to updated food labeling and stricter regulations on industrial additives. The immediate goal is for clinicians to begin treating the “processing” of food as a clinical biomarker for cardiovascular risk.
Do you think food labeling should clearly mark “ultra-processed” items? Share your thoughts in the comments or share this article with your healthcare provider.
