FAU Study: Ultra-Processed Foods Linked to 47% Higher Heart Attack and Stroke Risk

FAU's Groundbreaking Study on Ultra-Processed Foods and Cardiovascular Risks

Researchers at Florida Atlantic University's Charles E. Schmidt College of Medicine have published compelling new evidence linking high consumption of ultra-processed foods (UPFs) to a significantly elevated risk of cardiovascular disease (CVD). The study, featured in The American Journal of Medicine, analyzed data from nearly 5,000 U.S. adults and found that those with the highest UPF intake faced a 47% higher likelihood of experiencing a heart attack or stroke compared to those consuming the least. This cross-sectional analysis draws from the National Health and Nutrition Examination Survey (NHANES) 2021-2023, highlighting a pressing public health concern as UPFs now comprise nearly 60% of adults' calories and 70% of children's in the United States.

The multidisciplinary team, led by senior author Charles H. Hennekens, M.D., FACPM, FACC—the First Sir Richard Doll Professor of Medicine and Preventive Medicine—emphasizes that these findings underscore the need for immediate action in clinical practice and policy. Hennekens notes, "These results have major implications for future research as well as clinical care and public policy." This research exemplifies how U.S. universities like FAU are at the forefront of preventive medicine, training the next generation of epidemiologists and public health experts.

Defining Ultra-Processed Foods: The NOVA Classification System

Ultra-processed foods, classified under the NOVA system developed by researchers at the University of São Paulo, represent the most industrially formulated category of edibles. Unlike minimally processed foods (e.g., fresh fruits, vegetables, grains) or processed culinary ingredients (e.g., oils, sugar), UPFs undergo multiple industrial processes and contain additives like emulsifiers, preservatives, artificial flavors, and high-fructose corn syrup. The NOVA framework—adopted globally by organizations including the World Health Organization—categorizes foods into four groups based on the extent and purpose of processing:

• Group 1: Unprocessed or minimally processed foods, such as apples, milk, or nuts.
• Group 2: Processed culinary ingredients like butter or salt used in home cooking.
• Group 3: Processed foods, including canned vegetables or cheese.
• Group 4: Ultra-processed products like sodas, packaged snacks, instant noodles, and ready-to-eat meals.

In the FAU study, UPF consumption was quantified as the percentage of total daily caloric intake, with participants divided into quartiles. This rigorous approach builds on prior university-led validations of NOVA, ensuring reliable dietary assessments from two-day food recalls in NHANES.

🔬 Methodology: How FAU Researchers Analyzed NHANES Data

The FAU team's methodology leveraged the robust, nationally representative NHANES dataset, which combines detailed dietary interviews, physical exams, and self-reported health histories from U.S. civilians. From 2021 to 2023, 4,787 adults aged 18 and older provided at least one day of dietary records. Researchers calculated UPF calorie percentages using validated NOVA coding, then applied logistic regression models adjusted for confounders including age (mean 55 years), sex (55.9% women), race/ethnicity, poverty-to-income ratio, and smoking status.

CVD was defined as a self-reported history of myocardial infarction (heart attack) or stroke. The adjusted relative risk for the highest versus lowest UPF quartile was 1.47 (95% CI: 1.06-2.04; p=0.02), indicating a statistically significant 47% increased risk. This prospective analysis, while cross-sectional in design, controls for key variables and aligns with longitudinal cohort studies from institutions like Harvard T.H. Chan School of Public Health.

Key Findings: Quantifying the 47% Increased CVD Risk

The study's headline result reveals a clear dose-response relationship: higher UPF intake correlates with greater CVD prevalence. Participants in the top quartile derived over 26% of calories from UPFs on average, facing nearly 50% higher odds of heart events compared to the bottom quartile. This holds after multivariable adjustments, isolating UPFs' independent effect amid America's obesity epidemic.

Supporting evidence includes elevated inflammation markers like high-sensitivity C-reactive protein (hs-CRP) in prior FAU work, linking UPFs to metabolic syndrome precursors such as hypertension and dyslipidemia. UPFs contribute through mechanisms like rapid glycemic spikes, gut microbiome disruption, and excessive sodium/sugar intake—each straining the cardiovascular system step-by-step: from endothelial damage to plaque buildup and thrombosis.

(Adapted from study data; exact quartiles derived from sample distribution.)

Meet the FAU Research Team Driving Nutrition Science Forward

Spearheaded by Charles H. Hennekens, a pioneer in preventive cardiology with decades at Oxford and Harvard before FAU, the team blends expertise. Co-author Allison H. Ferris, M.D., FACP, chairs FAU's Department of Medicine, focusing on faculty development and internal medicine. Chengwu Yang, M.D., Ph.D., provides biostatistical rigor as professor of population health.

Impressively, students contributed: Yanna Willett (Virginia Tech undergrad), John Dunn and Katerina Benson (FAU med students), and Kevin Sajan (Geisinger). Tim Dye, Ph.D., chairs population health. This collaboration showcases FAU's commitment to hands-on training, preparing students for research assistant jobs and beyond in academia.

Hennekens stresses environmental changes: "Addressing UPFs isn’t just about individual choices—it’s about creating environments where the healthy option is the easy option." Explore faculty profiles like Dr. Hennekens for inspiration.

U.S. Dietary Landscape: Why UPFs Dominate American Plates

UPFs surged from 50% of U.S. calories in the early 2000s to 60% today, driven by affordability, convenience, and marketing. Children consume 70%, per NHANES trends analyzed at Johns Hopkins Bloomberg School of Public Health. Economic factors exacerbate this: UPFs cost 52% less per calorie than whole foods, per Yale studies, hitting low-income households hardest.

Regional context: Southern states like Florida see higher processed meat intake, aligning with FAU's locale. Stakeholder views vary—food industry cites fortification benefits, while academics like those at NIH advocate front-of-pack labeling modeled on Chile's success, reducing UPF purchases by 24%.

Mechanisms of Harm: How UPFs Fuel Heart Disease Step-by-Step

UPFs harm via multiple pathways. First, hyper-palatability (engineered bliss point of fat/salt/sugar) promotes overeating, leading to obesity. Second, additives disrupt gut microbiota, triggering systemic inflammation (elevated hs-CRP). Third, high glycemic loads cause insulin resistance and endothelial dysfunction. Finally, excess sodium (2-3x daily needs) raises blood pressure.

• Obesity: UPFs linked to 1-2 lb annual gain in cohort studies.
• Inflammation: FAU prior work showed 20-30% hs-CRP rise in high consumers.
• Hypertension: Processed meats alone contribute 10% of U.S. sodium intake.

Real-world case: Post-NHANES modeling estimates UPF reduction could avert 100,000+ CVD cases yearly.

Broader Implications: From Campus Cafeterias to National Policy

For higher education, this resonates: Universities influence diets via dining halls serving UPF-heavy meals. FAU's findings spur campuses to adopt healthier menus, as seen at NYU where UPF audits cut intake 15%. Public health majors now prioritize UPFs in curricula.

Policy angles: Echoing tobacco control, experts call for UPF taxes (Mexico's soda levy dropped sales 10%) and subsidies for produce. Allison Ferris links UPFs to GI diseases like colorectal cancer, rising in young adults—a trend university gastroenterology departments track closely. Interested in leading such research? Check higher ed research jobs.

University-Led Solutions: Practical Steps and Actionable Advice

FAU researchers advocate swapping UPFs: Replace sodas with water-infused fruits; choose nuts over chips. Step-by-step swap plan:

1. Audit intake: Track two days via apps like MyFitnessPal, NOVA-coded.
2. Shop perimeter: Focus on fresh produce, lean proteins.
3. Meal prep: Batch-cook minimally processed meals.
4. Read labels: Avoid >5 ingredients or additives.
5. Policy engage: Support campus healthy vending initiatives.

Universities like Tufts Friedman School model this, with student-led farms supplying dorms. Clinical trials underway at NIH test UPF reduction's CVD reversal.

Future Outlook: Ongoing University Research and Career Opportunities

Prospective cohorts like Harvard's Nurses' Health Study extend FAU's work longitudinally. Emerging: Plant-based UPFs' risks (e.g., faux meats), per recent Yale reviews. FAU calls for randomized trials to confirm causality.

Careers boom: Nutrition epidemiologists earn medians $90K+, with academic CV tips key for prof roles. Platforms like Rate My Professor highlight mentors in public health. Postdocs in diet-CVD thrive amid funding from AHA/NSF.

Conclusion: Empowering Healthier Choices Through Research and Action

FAU's study galvanizes a shift: From awareness to accessible nutrition. By reducing UPFs, individuals cut CVD risk substantially, while universities drive systemic change. Explore higher ed jobs, university jobs, and career advice to join this vital field. Share your thoughts below—your campus could be next.