Big consumers of ultra-processed foods show most inflammation: study
A new study from researchers at Florida Atlantic University draws a link between consumption of ultra-processed foods such as sugar-sweetened beverages and “significantly elevated” levels of biomarker for cardiovascular disease. File Photo by Kevin Dietsch/UPI | License Photo
New research shows that the biggest consumers of ultra-processed foods have “significantly elevated” levels of a protein associated with systemic inflammation that can signal cardiovascular disease.
A brief, observational study conducted by researchers at Florida Atlantic University in Boca Raton and published in The American Journal of Medicine on Sept. 3 finds a correlation between those whose diets had the most UPFs and worrying levels of high-sensitivity C-reactive protein (hs-CRP), a well-known marker of inflammation and a strong predictor of heart disease, stroke and type 2 diabetes.
The results have “important implications” in understanding the health risks of UPFs, the authors said while urging doctors to “actively engage” with their patients about the risks of UPFs and benefits of increasing whole food consumption.
The definition of ultra-processed foods were based “Group 4” of the NOVA classification system, which includes such products as sugar-sweetened soft drinks, sweet packaged snacks, processed meat products and pre-prepared frozen dishes, usually containing various kinds of additives and preservatives.
The authors, led by Dr. Allison Ferris, a professor and chair of the FAU Department of Medicine, found that after accounting for factors such as age, gender, smoking, physical activity and other health indicators, those who derived between 40% and 79% of their daily calories from UPFs had significantly higher likelihoods of elevated hs-CRP levels than those who consumed fewer UPFs.
High levels of hs-CRP are considered one of the most accurate early indicators of developing cardiovascular disease and atherosclerosis, or hardening of the arteries, in otherwise healthy patients.
The protein is produced by the liver in response to artery inflammation and is closely associated with obesity and metabolic syndrome, a collection of conditions that increase the risk of developing heart disease.
In the study, Ferris and her colleagues looked at the health records of more than 9,000 participants in the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey and, for the first time, correlated participants’ reported data of both UPF intake and hs-CRP measurements.
They found that among the highest UPF intake group — for whom UPFs comprised 60% to 79% of their daily calories — there was an 11% higher likelihood of elevated hs-CRP levels compared to those in the lowest intake group.
Even moderate UPF consumers at 40% to 59% of caloric intake showed a 14% increase in likelihood, while those with 20% to 39% intake had a smaller, nonsignificant 7% increase.
Subgroups such as older adults, obese individuals and current smokers also showed a higher correlation between UPF intake and elevated inflammation in what the authors called evidence that the impact of ultra-processed food “is greatest among individuals already vulnerable to systemic inflammation.”
“To our knowledge, we had not seen any previous data or research that was looking at the connection between hs-CRP and the consumption of ultra-processed foods,” Ferris told UPI. “We did already know that UPFs cause a pretty inflammatory response within our bodies, so in our minds, it made sense that this hypothesis would shake out.”
The results contribute “further supportive evidence that UPFs are not good for us and that we should be mindful as physicians of discussing this with our patients, beyond just telling them to eat a balanced diet low in fat and sodium, with plenty of fruits and vegetables.
“We probably need to be very explicit about the impact of ultra-processed foods simply because in the United States our exposure to these foods are quite high relative to other parts of the world,” Ferris said.
The implicit trade-off with UPFs, she added, is their convenience. The additives and preservatives within them make long shelf lives possible, which fit well into hectic schedules and busy lifestyles.
“But we have to recognize that convenience is a risk,” she said. “I tell people to do two things. Number one, shop the outside edges of a grocery store, because if you think about it, if you go around the outside edges of the store, that’s where the refrigerated stuff is and that’s where your fresh foods are, your produce, and your protein sources.
“In doing that, it is naturally going to reduce the amount of ultra-processed foods you’re putting in your body simply by selecting things that look like what their name is.”
Meanwhile, she said, shoppers should also look at the list of ingredients on a food product, “and if you can visualize what those things are, those are the types of foods you want to go for. But if there are names on that list that you have no idea what they look like, that’s probably something ultra-processed that you should stay away from.”
Ferris also advised that’s not realistic to completely eliminate UPFs from typical diet all at once, “but 80% is great and would be incredible.”
“I don’t expect anybody to be 100% perfect and avoid UPFs, but I think if you can be 80%, that’s pretty impressive. And certainly, if you look at our study, if you’re only consuming 20% of your diet from UPFs, those are the folks that had those lowest levels of high-sensitivity CRP,” she said.
One expert nutritionist not connected to the FAU study said it’s important to note its results merely show a correlation between high levels of hs-CRP and UPF consumption, rather than implying causality.
“By far, the majority of existing studies linking ultra-processed foods and some kind of health outcome are observational,” cautioned Angela Zivkovic, an associate professor of nutrition at the University of California-Davis and researcher on the effects of diets and dietary constituents on inflammation.
She noted that data from the National Health and Nutritional Examination Survey is based on what people reported to have eaten, adding, “We don’t actually know what people are eating, we just know what they are reporting, and this is heavily influenced by what they remember or what they want to report” and can be complicated by irregular eating habits.
“We will keep seeing more and more and more of these observational studies finding links between UPFs and a very broad array of disease outcomes and biomarkers,” Zivkovic told UPI.
“The question is, does this help us actually understand anything or does it just keep confirming the obvious thing we all already know: that people who eat less healthy diets and have less healthy lifestyles are at higher risk for chronic diseases and poor health outcomes?”
It remains an open question, for instance, whether it is the consumption of any particular type of food or whether it is an overall dietary pattern and lifestyle that is actually linked with the poor outcome, she noted.
She added: “Pinning it to the consumption of the UPFs is the popular right now. But we truly don’t know what the real ‘problem’ is. Is it the consumption of the UPFs? Or is it the lack of fiber and micronutrients? Is it the obesity that usually comes with eating these foods, since the one thing we know is that UPFs lead to overconsumption of calories?
“Or is it that the consumption of UPFs is actually just the easiest signal to pick up that describes a generally unhealthy diet/lifestyle pattern and the real culprit is lack of exercise, or poor sleep, or vaping, or stress or socioeconomic factors, et cetera?”