A new study shows that the high consumption of industrially processed foods significantly increases the risk of second heart attacks or fatal strokes in people who already suffer from cardiovascular diseases.

Ultra-processed foods are a major public health concern for their potential adverse effects on health. A study by the Department of Epidemiology and Prevention of the I.R.C.C.S. Neuromed, in Pozzilli, Italy, has been published in the European Heart Journal, the European Society of Cardiology journal. It explores the health effects of a large dietary share of processed food on people with existing cardiovascular diseases.

The study found that processed foods cause a higher risk of a second heart attack or a fatal stroke. It was further observed that health risks are higher even for individuals following the Mediterranean diet whilst consuming too many excessively processed foods.

The consumption of excessively processed foods
The study followed 1,171 people participating in the Moli-sani epidemiological over a ten-year period.

The Moli-sani study started in March 2005; it involved around 25,000 citizens living in the Molise region. The study aimed to learn about environmental and genetic factors underlying cardiovascular disease, cancer, and degenerative.

All of the participants had already had cardiovascular disease at the time of the study. The researchers focussed on the consumption of excessively processed foods made in part or entirely with substances not routinely used in cooking like hydrolysed proteins that contain various additives such as dyes, preservatives, antioxidants, anticaking agents, flavour enhancers, and sweeteners. This includes sugary and carbonated drinks, pre-packaged meals, spreads, and some unsuspected products such as rusks, breakfast cereal, crackers, and fruit yoghurt. These foods were classified using the NOVA system, which rates foods according to the degree of processing rather than their nutritional value.

Marialaura Bonaccio, a researcher at the Department of Epidemiology and Prevention and first author of the study, explained: “We saw that people with higher consumption of ultra-processed foods have a two-thirds increased risk of a second heart attack or stroke, this time fatal, compared to participants eating these foods less frequently. The probability of dying from any cause is also 40% higher. It is important to underline that the definition of ultra-processed food is not linked to the nutritional content but rather to the process used for its preparation and storage. In other words, even if a food is nutritionally balanced, it might still be considered ultra-processed. Clearly, it is not the single food consumed occasionally that makes the difference, rather a diet that contains too many products coming from supermarket shelves. A diet based on the consumption of fresh, minimally processed products should always be preferred, as the Mediterranean tradition has been teaching us for centuries.”

Understanding nutritional value
The study aims to highlight how the public will typically measure how healthy a food is by the nutritional value; however, it is important that citizens are educated on proper nutrition and how the food processing procedure can be harmful to overall health.

Licia Iacoviello, Director of the Department of Epidemiology and Prevention at Neuromed – said: “This study – says it is time to overcome the distinction between healthy and unhealthy food solely on the basis of the nutrient value. In other words, a person could follow a Mediterranean diet, perhaps rich in legumes or vegetables, a healthy diet, we would say. But the simple definition of ‘Mediterranean’ does not tell us ‘how’ those foods were prepared. Fresh vegetables are not the same as pre-cooked and seasoned vegetables, and the same goes for many other foods. It is a factor to be increasingly considered when advising citizens about proper nutrition. Our proposal is that the level of industrial processing of foods should be added to the front-of-pack labels, which until now only provide nutritional information”.

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