This prospective cohort study analyzed 7,138 UK civil servants from the Whitehall II study to explore how long-term trajectories of ultra-processed food (UPF) intake relate to cardiovascular disease (CVD) risk and mortality. Dietary data were collected at three points over 10 years (1991–2004) using a validated food frequency questionnaire, and UPF intake was classified using the Nova system.
Three UPF intake patterns emerged: low (20.9%), moderate (52.9%), and high (26.2%). All groups showed slight increases in UPF consumption over time. Over 16–19 years of follow-up, sustained high UPF intake was associated with 23% higher risk of CVD and 32% higher risk of coronary heart disease (CHD) compared to low intake, independent of socio-demographic, lifestyle, diet quality, and clinical factors. No associations were found with CVD/CHD mortality or all-cause mortality.
The study suggests that sustained high UPF intake is a modifiable dietary risk factor for non-fatal CVD and CHD. The authors recommend policy actions such as improved labeling, marketing restrictions, and dietary guideline updates to address high UPF consumption.