Multiethnic cohort study reveals: ultraprocessed foods exacerbate existing health inequities

By A Representative 

Dr. Arun Gupta, Founder of the Breastfeeding Promotion Network of India (BPNI), Convenor of Nutrition Advocacy for Public Interest (NAPi), and former member of the Prime Minister’s Council on India’s Nutrition Challenges, has issued an urgent call to the Ministry of Health and Family Welfare (MOHFW) to take immediate action on the burgeoning threat of ultraprocessed foods (UPFs). 

Dr. Gupta’s appeal comes in response to a definitive study published in JACC: Advances by Haidar et al. (2026), which provides longitudinal evidence linking these industrial food formulations to a significant increase in cardiovascular disease risk. He emphasizes that the government must recognize UPF consumption as a major modifiable risk factor and move toward policy-driven strategies, such as the regulation of targeted marketing and the promotion of minimally processed alternatives, to protect public health.  

​The research highlighted by Dr. Gupta utilized data from the Multiethnic Study of Atherosclerosis (MESA), following 6,531 adults aged 45 to 84 who were initially free of clinically apparent cardiovascular disease. According to the study, each additional daily serving of ultraprocessed food—defined by the Nova classification system as industrial formulations containing flavors, colors, and emulsifiers—is associated with a 5.1% increased risk of incident atherosclerotic cardiovascular disease (ASCVD) events, including myocardial infarction and stroke. 

The findings were particularly stark for those in the highest quintile of consumption, who faced a 66.8% higher risk compared to those in the lowest quintile. The authors of the paper explicitly state that "higher UPF consumption was significantly associated with an increased risk for ASCVD events," a conclusion that remained consistent even after adjusting for overall diet quality using the Alternative Healthy Eating Index.  

​A critical aspect of the Haidar et al. paper is the identification of a "significant multiplicative interaction" between UPF intake and race, revealing that these foods disproportionately harm specific populations. The study notes that "Black Americans had a 6.1% increased risk of CVD events for every serving of UPF consumed, compared to a 3.2% increased risk among non-Black Americans". 

This disparity is compounded by the fact that Black participants had the highest dietary proportion of UPFs at 32% and were often the subjects of targeted marketing by food companies for unhealthy, high-calorie products. Dr. Gupta pointed out that the paper attributes these outcomes to socioenvironmental factors and chronic stress rather than inherent biological differences, reinforcing the need for structural interventions in the food environment.  

​The study further elucidates the biological mechanisms behind these risks, noting that "UPFs might influence cardiometabolic health through multiple mechanisms and pathways including increasing energy intake, altering the gut microbiome, interfering with gut-brain satiety signaling, and hormonal effects". 

These pathways can lead to insulin resistance, hypertension, and oxidative stress. While the risk was broad across the category, sugary ultraprocessed foods were most consistently linked to higher disease risk, with a hazard ratio of 1.12. 

Given that UPFs now account for over 50% of calorie intake for many individuals, the authors argue—and Dr. Gupta concurs—that current dietary guidelines must be updated to specifically aim at reducing the consumption of these ultraprocessed products to mitigate the global burden of heart disease.