The American Heart Association Releases New Guidelines on Ultraprocessed Foods
The American Heart Association (AHA) has released its latest scientific advisory statement, focusing on the consumption of ultraprocessed foods (UPFs). This development comes at a time when public health concerns around these foods are growing. While the AHA’s main message is clear—most UPFs are detrimental to heart health and should be avoided—the report also addresses a controversial question: Are all ultraprocessed foods unhealthy?
According to the guidelines published in the journal Circulation, not all UPFs are inherently bad. However, only a few categories, such as certain whole grain breads, low-sugar yogurts, tomato sauces, and nut or bean-based spreads, may be considered healthier options. Even these items, the report cautions, should be monitored to ensure they maintain their nutritional value.
Christopher Gardner, vice chair of the AHA report’s writing group, emphasized that while some UPFs might be slightly better than others, this does not mean the food industry should be excused for producing harmful products. “Let’s not give the industry a pass just because there’s a few things that are a bit healthier than the vast majority of ultraprocessed foods full of sugar, salt, and fat,” he said.
Gardner, who is also the Rehnborg Farquhar Professor of Medicine at Stanford University, pointed out that the problem with today’s junk food lies in its ultraprocessing. “It includes cosmetic additives that lead to overeating and numerous health issues,” he added. “We need to focus more on these harmful aspects.”
A Growing Public Health Concern
The AHA’s guidance is particularly timely, given the increasing prevalence of UPFs in the American diet. Recent data from the U.S. Centers for Disease Control and Prevention (CDC) revealed that Americans aged one and older consume 55% of their daily calories from ultraprocessed foods. For children between the ages of 1 and 18, this figure rises to 62%.
This trend is alarming, as research shows a strong link between UPF consumption and chronic conditions such as heart disease, stroke, type 2 diabetes, obesity, and even depression. A February 2024 review of 45 meta-analyses involving nearly 10 million people found that an extra serving of UPFs per day increased the risk of cardiovascular disease-related death by about 50%. Other risks include a 55% increase in obesity, 41% in sleep disorders, 40% in type 2 diabetes, and 20% in depression.
To address these risks, the AHA recommends reducing the intake of the most harmful UPFs, especially those high in unhealthy fats, added sugars, and salt. It also allows for a small number of select UPFs that offer better diet quality to be included in a balanced eating plan.
Criticism and Controversy
Despite the AHA’s efforts, some experts have expressed disappointment with the guidelines. Marion Nestle, a professor emerita at New York University, criticized the emphasis on “healthy” UPFs. She argued that the category is too narrow and that recent studies show even “healthy” UPFs can lead to higher calorie consumption compared to minimally processed foods.
Nestle referenced a large randomized controlled trial conducted in the UK, which found that individuals lost twice as much weight when eating meals made at home compared to store-bought ultraprocessed foods labeled as healthy. The study included UPFs with recommended amounts of fruits, vegetables, and fiber, but still, homemade meals outperformed them in terms of weight loss.
Categorizing Ultraprocessed Foods
To help consumers make informed choices, the AHA has categorized UPFs into three groups: least healthy, moderately healthy, and healthy. Here’s a breakdown of each:
Healthy Choices
- Fresh and frozen fruits and vegetables without added sugar or salt
- Whole grains like oats and brown rice
- Unsalted seeds and nuts
- Dried beans and legumes
- Plant oils
- Low-fat plain milk or yogurt
- Lean, unprocessed meat and dairy
- Unsweetened beverages and water
- Plant-based meats and dairy that are low in added sugar, salt, and fats
Moderately Healthy Foods
- White rice and pasta
- Full-fat dairy
- Freshly made refined grain bread
- Salted nuts
- Canned fruits in light syrup
- Canned beans with salt
- Hard cheeses
- Egg replacements
- Low sodium, low-fat soups
- Store-bought meals made from healthy ingredients
Unhealthy Choices
- High-fat red meat, pork, and processed meats (e.g., chicken nuggets, hot dogs)
- Butter, lard, and tropical oils (e.g., coconut oil)
- Sour cream and 100% fruit juice
- Sugar, honey, maple syrup, crackers, and sweetened dried or canned fruits
- Tortilla or potato-based chips, French fries, and refined grain breads
- Sugar-sweetened beverages (including energy drinks)
- Liquid cheese products, cookies, candies, gummy fruit snacks, ice cream, boxed macaroni, instant noodles, pizza, some canned or instant soups, and canned fruits in syrup
As the debate around UPFs continues, the AHA’s guidelines aim to provide clarity and actionable steps for individuals and policymakers alike.