A new study showed people who eat more than nine servings of ultraprocessed food every day are much more likely to suffer heart attacks and strokes or die from heart disease than those who eat less — a risk that was particularly pronounced among Black Americans.

Previous studies have linked processed foods and cardiac risk, but most were conducted in Europe rather than in more diverse American populations. Amier Haidar, MD, a cardiology fellow at the University of Texas Health Science Center in Houston, sought to fill this knowledge gap by examining data from the Multi-Ethnic Study of Atherosclerosis (MESA).

Haidar and colleagues administered food questionnaires to more than 6800 adult participants without known heart disease and assessed their daily intake of ultraprocessed foods with the NOVA classification system. The system categorizes foods into four groups ranging from unprocessed or minimally processed, such as whole foods like vegetables, to ultraprocessed, which includes many convenience foods like potato chips, frozen dinners, breakfast cereals, and processed meats. 

The study was published in JACC: Advances and will be presented at the American College of Cardiology (ACC) Annual Scientific Session 2026 in New Orleans.

Risk Varies by Race

The results showed that eating more ultraprocessed foods was linked to an increased risk for cardiovascular disease. Participants in the top 20% for this consumption ate on average 9.3 servings per day. They were 67% more likely to die from coronary heart disease or stroke or to experience a nonfatal heart attack, stroke, or resuscitated cardiac arrest than those in the bottom 20%. Those people ate just 1.1 servings per day. Each additional daily serving was associated with a 5.1% increase in the risk of adverse cardiac events.

“While 5% may not sound like a lot, remember that’s per serving. And most people eat multiple servings per day,” Haidar said.

The study also looked at race. Among Black Americans, each additional daily serving increased cardiac risk by 6.1%, compared with 3.2% for non-Black participants. Haidar said systemic and structural factors had an impact.

“We know racial and ethnic disparities in heart disease are largely driven by socio-environmental determinants of health,” he said. Black communities are more likely to be in neighborhoods with limited healthy food options and experience food insecurity, often due to historical racial segregation. Food and beverage companies disproportionately target minorities with advertising for unhealthy products such as ultraprocessed foods.

“When you put all that together, it reinforces and perpetuates these cardiovascular disparities, and I think it is the reason for this finding,” he said.

Highly Processed but Healthy?

Kim Allen Williams Sr, MD, a cardiologist at the University of Louisville School of Medicine in Kentucky and author of an accompanying editorial, said the study offered good evidence establishing the correlation between processed food and cardiovascular risk as well as highlighting the disparity in Black communities. However, he cautioned that the NOVA classification system only evaluates foods based on the extent of industrial processing, not actual effects on heart health.

This can lead to some odd outcomes, Williams said. 

“If you minimally process something but add coconut oil and sodium, your saturated fat and sodium levels are high and it can be terrible for you. But you can take beans, grains, and seeds and put them through the wringer to make a nice veggie burger that’s perfectly healthy and also incredibly highly processed,” he told Medscape Medical News.

Williams said advice to patients should focus less on how foods are processed and more on how much sodium, sugar, cholesterol, and saturated fats they contain. He supports the FDA’s current efforts to implement front-of-packaging nutrition labels to make this information more accessible.

“If we can better inform the public of what’s healthy and unhealthy, it would change things completely,” he said.

Haidar agreed that the inflexibility of the NOVA classification is one of the main limitations and more research is needed to tease out what makes a processed food healthy or unhealthy. But providers can still use the findings to guide clinical care, for example by assessing a patient’s baseline intake, as they do for all other cardiovascular risk factors.

That can then help guide the advice to patients — by offering ways to strategically reduce their intake, suggest simple and affordable options to replace processed foods with whole foods, and how to read nutrition labels to make informed decisions.

Haidar and Williams report no relevant financial relationships.

Brian Owens is a freelance journalist based in New Brunswick, Canada.