Fruit-flavoured yogurt, topped with packet granola and a glass of shop-bought juice may sound like a nutritious start to your day, but it could increase your risk of serious heart problems, if they are all ultra-processed.
That’s according to a recent study in the European Heart Journal, which found that people who ate the most preservatives – often added to ultra-processed foods (UPFs) to increase their shelf-life – faced a 29 per cent higher risk of high blood pressure and up to 22 per cent increased risk of heart attack and stroke, compared to those who ate the least. The scientists behind the finding believe that preservatives may cause oxidative stress, a process that damages our cells, paving the way for heart problems.
It comes after a separate study found that people who ate nine daily portions of UPFs had a 67 per cent higher risk of suffering a heart attack, stroke or dying from coronary heart disease, compared to those who had one – even if they didn’t consume any extra calories.
“I think there are two things driving this,” says Amier Haidar, a doctor and cardiology fellow at the University of Texas, who led that research. The first is visceral fat, the type stored around our organs, and the second is inflammation. “Both are associated with UPF intake and worse heart health outcomes,” he notes.
Dr Federica Amati, head nutritionist at nutrition science company ZOE, thinks that UPFs nudging heart-healthy foods out of our diet is also to blame. “It’s the foods that are lacking [like vegetables, fruits and whole grains] that are driving the diseases, more so than the number of UPFs you’re eating,” she says.
“We’ve been sold this idea that the time we spend preparing and cooking food is an expendable thing and it’s not. We’ve evolved over millions of years, spending our entire lives hunting, gathering, sharing and preparing food as tribes.
“Now, we’ve got to the stage where we’re all just running around trying to remove the time spent on providing nutrition for ourselves as much as possible, but we need to prioritise it.”
Here are her six swaps to reduce your UPF intake and protect your heart health.
Swap supermarket sauces for tinned tomatoes and coconut milk
Shop-bought sauces are frequently ultra-processed, as they are pumped full of ingredients like artificial smoke flavouring and preservatives. Sodium nitrite (E250), for example, is a preservative found in some sauces and has been linked to high blood pressure.
They are also high in salt and saturated fat, with the worst offenders containing a fifth of your daily salt limit and a quarter of your maximum saturated fat intake.
The combination, eaten often, can be a disaster for heart health.
“In an ideal world, everyone would just make their own sauces,” Dr Amati says. “Tomato sauce is super simple – it’s a tin of tomatoes, basil, salt and pepper. A sofrito base would make it even better, that’s cooking down some carrots, onion, celery and garlic.
“Once you learn how to make a tomato sauce or that you can combine coconut milk with some spices to make a delicious curry base, you won’t buy sauces anymore.”
However, you can stick with shop-bought and offset the impact on your heart health by making smarter pairings. “If you’re combining your jar of curry sauce with lentils and chickpeas, or your jar of pasta sauce with mushrooms and spinach, it’s a way for you to eat more vegetables. On balance, that’s great.”
Swap ham for chicken breast
“Eating processed meat like ham, sausages and bacon is going to have a net negative effect on your health,” Dr Amati says. Unlike whole cuts of meat, these types undergo extra processes, such as curing, and have added ingredients, like stabilisers. Ham often contains sodium nitrite (E250), which the European Heart Journal study linked with high blood pressure.
Studies have linked eating processed meat with a higher risk of heart disease, likely due to their high salt and saturated fat content. They are also known to increase the risk of bowel cancer.
“The more you eat, the higher your risk of heart disease and cancer,” she explains. “These foods are very high in sodium, so can raise blood pressure, which is the number one risk factor for heart disease.”
Poultry doesn’t have the same health risks as processed and red meat, so Dr Amati suggests swapping to chicken or turkey when you can. “Using chicken breast to make a sandwich instead of ham would be a good start,” she says.
“You don’t have to cut processed meat out altogether but just be aware that it shouldn’t be our everyday diet,” Dr Amati says. “When you do have processed meat, it should be intentional and no more than twice a week.”
“Sausages and bacon are harder to swap than ham,” she says. However, to limit their impact on your heart health, she suggests reining in your portion size and serving them with whole grains and vegetables.
“Sometimes, I’ll make an English breakfast on the weekend and I’ll buy bacon or sausages, not both,” she says. “I’ll serve it with eggs, mushrooms, baked beans and whole grain toast. Then, actually, it’s a balanced meal. It’s about how we consume these meats.”
Swap flavoured yogurt for plain with fruit
“Flavoured yogurts often have sweeteners, emulsifiers and other flavours,” she notes. “It’s the cocktail effect of these additives that are problematic.”
Emulsifiers, in particular, have sparked concern among scientists. They’re frequently used in yogurts to prevent the creamy liquid from separating, but they are thought to interfere with the mucus layer that lines our gut, weakening our gut barrier as a result.
“They’re disrupting the gut microbiome, which leads to increased inflammation which has downstream effects on the cardiovascular system, which is very sensitive to inflammation,” she explains.
As with cereal, flavoured yogurts are often high in sugar, which is known to harm our heart.
“The easiest thing is to buy Greek, natural or plain yogurt – any that don’t have flavours or sugars,” Dr Amati recommends. “Make sure to read the label. Sometimes they’ll say natural, flavoured yogurt and will have sugar in it.
“You can blend the unflavoured yogurt with frozen berries, a pear or a banana, for example, and add half a tablespoon of honey, if you prefer a sweeter taste,” she says. “That’s going to be a lot better for you – you’ve got fibre and micronutrients from adding in fruit.”
Swap crisps and snack bars for fruit, nuts and olives
UPFs frequently sneak into our diet in the form of our favourite snacks.
Crisps, for example, tend to be high in salt and contain sweeteners and flavour-enhancers. This can spell disaster for our heart, as they are easy to overconsume and inflammatory. Some also contain the preservative extracts of rosemary (E392), linked to high blood pressure.
Snack and protein bars, meanwhile, are often high in sugars, sweeteners and emulsifiers. “The worst ultra-processed foods are the ones that have all the added sugars and fats, like protein bars,” Haidar says. Most ingredients ending in “-ose” are sugars, as well as those described as a syrup or nectar, for example, fructose corn syrup.
“A swap that is useful when you’re tempted to grab food on the go is fruit and nuts,” Dr Amati says. “Having a tub of mixed nuts and a piece of fruit like an apple, which survives well in your bag, means that if you get peckish, you don’t have to pick up food. You can carry on until you’re home and have a proper meal.
“It’s more of an insurance policy than a swap but it also means you’re having your handful of nuts a day. Nuts and seeds are the second group of foods, after whole grains, that are most lacking from our diets. They pack so much nutrition that supports heart health.”
If you’re tempted to eat some crisps, there are ways to make this snack healthier, she says.
“Try to buy a good-quality option that is just made with potatoes, oil and salt and serve them with some nuts and olives as well. You’ll be scratching your itch but also getting some beneficial fats from the nuts and olives, which will support heart health.”
Swap cereal for porridge
Sweeteners, emulsifiers and artificial flavours are the sort of ingredients found in cereals that make them ultra-processed. Some, like Honey Cheerios and Crunchy Nut, are especially unhelpful for our heart health, Dr Amati notes. Even seemingly healthy granolas from Kellogg’s, Quaker and Fuel are ultra-processed, as they contain emulsifiers.
“They are based on refined carbohydrates and have added free sugars,” she explains. “We know sugar is bad for the vascular system.” It can raise blood pressure, increase chronic inflammation, contribute to weight gain – all factors that increase heart attack and stroke risk.
“Be wary of those that are sweetened and instead opt for the ones that are more basic in flavour,” she suggests. However, even opting for less processed options, like Weetabix or All Bran, is still only a “neutral” option rather than a heart-healthy breakfast, Dr Amati says.
“It’s fine sometimes when you’re in a rush,” she says. Even then, consider adding fruit, nuts, and seeds for a hit of heart-healthy fats, polyphenols and antioxidants, which will make the cereal more satiating.
Meanwhile, porridge is a source of whole grains, which have been linked to reduced risk of cardiovascular disease. “We are chronically under-eating whole grains and it is driving a huge number of deaths, especially from cardiovascular disease,” Dr Amati says. Research has linked a low intake of whole grains with three million deaths globally per year.
“Eating oats for breakfast will increase your wholegrain intake,” she says. “Not the quick-cook porridge, ideally steel-cut oats or the jumbo rolled oats, which have a bit more fibre. It’s about including more of the foods that we know drive good health.”
Oats, and other whole grains, contain dozens of different types of fibre, including soluble, insoluble and viscous, which help to support a healthy weight and lower “bad” LDL cholesterol and blood pressure. “They contain micronutrients that are important for good health, like B vitamins, including folate,” Dr Amati says.
Swap white supermarket bread for seeded bread or sweet potato
Supermarket sliced breads are ultra-processed and can contain up to 19 ingredients, despite the fact a loaf can be made from just four – flour, water, salt and yeast. Ascorbic acid (E300) is one preservative found in certain loaves and was linked to high blood pressure and cardiovascular disease.
However, from a heart health perspective, the main concern is that they are a type of refined carbohydrate, which increases the risk of heart disease and high blood pressure.
“Unless you’re someone who only buys traditional dark, rye bread, your bread will be a source of refined carbohydrates in your diet,” Dr Amati says.
“I don’t think we should brand all bread as evil,” she says. “There are absolutely some supermarket breads that do a really good job.” Opt for loaves that are higher in heart-healthy fibre and contain seeds, she suggests.
However, it is better for your heart health to replace refined carbohydrates, like bread, with complex carbohydrates, like wholegrains, sweet potatoes and legumes, which contain compounds that support heart health, Dr Amati notes.
“Be mindful that bread is not the majority of your intake of carbohydrates,” she adds. “Eating shop-bought bread is absolutely fine but it shouldn’t be at every meal.”
