Which Ultra-Processed Foods Are the Worst in Driving the Association with Death and Disease?

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Only two categories of ultra-processed foods have been associated with premature death.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Even a small increase in the consumption of ultra-processed foods is associated with an increased risk of developing several diseases. And for each additional daily serving, the risk of dying prematurely may increase by two percent. Are there any babies we’d be throwing out with the bathwater if we avoided ultra-processed foods? Are there any that haven’t been associated with disease?

It’s such a big category; what we need are studies that break it down, and here we go. The Framingham Offspring study: Higher consumption of ultra-processed foods is associated with increased risk of cardiovascular disease. But was it because of the burgers or the bagels? The link between ultra-processed foods and disease was largely driven by the ultra-processed meat—the sausage, bologna, salami, hot dogs, and burgers. Breakfast cereals, nearly all of which are ultra-processed, were associated with lower risk––presumably because cereal eaters were eating less bacon and eggs.

In another US study, this one 30 times larger, researchers came to the same conclusion: the more ultra-processed, the more cardiovascular disease. But which ultra-processed foods? Soft drinks, both regular and diet; meat, specifically burgers, fried chicken, fried fish, and meat pizza; salty snacks like corn chips and potato chips; and candy.

Ultra-processed food consumption and high blood pressure driven mostly by soda and meat. If we excluded soda and meat, would there still be an association between ultra-processed foods and cardiovascular disease? We can turn to the three big Harvard cohorts—200,000 people followed for decades. And yes, total intake of ultra-processed foods is associated with cardiovascular risk; but that was driven by soda and meat. Sugar-sweetened beverages and processed red meat, poultry and fish––like fish sticks. What if we exclude soda and meat? The relationship between ultra-processed foods and cardiovascular disease disappears. So, nutritional advice for cardiovascular health should consider the differential consequences of group-specific ultra-processed foods. And specifically, that means soft drinks and processed meats should be discouraged.

You know what else is an ultra-processed food? Vodka, so when you look at food processing and cancer risk, if you exclude alcoholic drinks, all of a sudden, the link between processed foods and a number of cancers becomes insignificant, suggesting that it was probably the alcohol driving those associations. Though for colorectal cancer risk, soda, ready-to-eat foods like pizza, and ready-to-eat meat, poultry. and fish may also be playing a role.

For pancreatic cancer, the association between ultra-processed foods and pancreatic cancer was really more just an association with foods like donuts, cakes, cookies, and meat and meat products.

Diabetes. You can see the straight line increase in diabetes risk with increasing ultra-processed food intake––but not all ultra-processed foods: mostly animal-based products and the pizza category again.

What about mortality? Those with the most ultra-processed food consumption had a higher risk of dying from all causes put together, but it mattered what kinds of foods. Ready-to-eat red meat, poultry, and seafood products had particularly strong associations with mortality. The worst ultra-processed food when it came to dying prematurely in general— meat/poultry/seafood. The worst when it comes to dying from cancer—meat/poultry/seafood, The worst when it comes to dying from cardiovascular disease—meat/poultry/seafood. The worst when it comes to dying from lung diseases like emphysema—meat/poultry/seafood. The worst when it comes to dying from neurodegenerative diseases—ice cream. And the worst when it comes to dying from other causes—meat/poultry/seafood.

The bottom line is that the major factors contributing to the harmful influence of ultra-processed foods on mortality are soda and processed meat, including poultry and fish. That’s what a systematic review and meta-analysis of all such studies showed: higher mortality associated with drinking more sugar-sweetened beverages like soda, including diet soda, and eating more processed meat, or eating any processed meat at all. So, the ultra-processed foods problem may really just be a soda and meat problem.

There was one ray of sunshine in this study, though. The researchers found one ultra-processed dessert that was associated with lower mortality—dark chocolate.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Even a small increase in the consumption of ultra-processed foods is associated with an increased risk of developing several diseases. And for each additional daily serving, the risk of dying prematurely may increase by two percent. Are there any babies we’d be throwing out with the bathwater if we avoided ultra-processed foods? Are there any that haven’t been associated with disease?

It’s such a big category; what we need are studies that break it down, and here we go. The Framingham Offspring study: Higher consumption of ultra-processed foods is associated with increased risk of cardiovascular disease. But was it because of the burgers or the bagels? The link between ultra-processed foods and disease was largely driven by the ultra-processed meat—the sausage, bologna, salami, hot dogs, and burgers. Breakfast cereals, nearly all of which are ultra-processed, were associated with lower risk––presumably because cereal eaters were eating less bacon and eggs.

In another US study, this one 30 times larger, researchers came to the same conclusion: the more ultra-processed, the more cardiovascular disease. But which ultra-processed foods? Soft drinks, both regular and diet; meat, specifically burgers, fried chicken, fried fish, and meat pizza; salty snacks like corn chips and potato chips; and candy.

Ultra-processed food consumption and high blood pressure driven mostly by soda and meat. If we excluded soda and meat, would there still be an association between ultra-processed foods and cardiovascular disease? We can turn to the three big Harvard cohorts—200,000 people followed for decades. And yes, total intake of ultra-processed foods is associated with cardiovascular risk; but that was driven by soda and meat. Sugar-sweetened beverages and processed red meat, poultry and fish––like fish sticks. What if we exclude soda and meat? The relationship between ultra-processed foods and cardiovascular disease disappears. So, nutritional advice for cardiovascular health should consider the differential consequences of group-specific ultra-processed foods. And specifically, that means soft drinks and processed meats should be discouraged.

You know what else is an ultra-processed food? Vodka, so when you look at food processing and cancer risk, if you exclude alcoholic drinks, all of a sudden, the link between processed foods and a number of cancers becomes insignificant, suggesting that it was probably the alcohol driving those associations. Though for colorectal cancer risk, soda, ready-to-eat foods like pizza, and ready-to-eat meat, poultry. and fish may also be playing a role.

For pancreatic cancer, the association between ultra-processed foods and pancreatic cancer was really more just an association with foods like donuts, cakes, cookies, and meat and meat products.

Diabetes. You can see the straight line increase in diabetes risk with increasing ultra-processed food intake––but not all ultra-processed foods: mostly animal-based products and the pizza category again.

What about mortality? Those with the most ultra-processed food consumption had a higher risk of dying from all causes put together, but it mattered what kinds of foods. Ready-to-eat red meat, poultry, and seafood products had particularly strong associations with mortality. The worst ultra-processed food when it came to dying prematurely in general— meat/poultry/seafood. The worst when it comes to dying from cancer—meat/poultry/seafood, The worst when it comes to dying from cardiovascular disease—meat/poultry/seafood. The worst when it comes to dying from lung diseases like emphysema—meat/poultry/seafood. The worst when it comes to dying from neurodegenerative diseases—ice cream. And the worst when it comes to dying from other causes—meat/poultry/seafood.

The bottom line is that the major factors contributing to the harmful influence of ultra-processed foods on mortality are soda and processed meat, including poultry and fish. That’s what a systematic review and meta-analysis of all such studies showed: higher mortality associated with drinking more sugar-sweetened beverages like soda, including diet soda, and eating more processed meat, or eating any processed meat at all. So, the ultra-processed foods problem may really just be a soda and meat problem.

There was one ray of sunshine in this study, though. The researchers found one ultra-processed dessert that was associated with lower mortality—dark chocolate.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

If you missed the previous videos in this series, check out What Are Ultra-Processed Foods? and How Bad Are Ultra-Processed Foods? Stay tuned for the rest of the videos, coming out over the next several months.

If you don’t want to wait for each video to be released, we’ve compiled all the information into a brand-new book, Ultra-Processed Foods: Concerns, Controversies, and Exceptions.

If you haven't yet, you can subscribe to our free newsletter. With your subscription, you'll also get notifications for just-released blogs and videos. Check out our information page about our translated resources.

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