Central adiposity and systemic inflammation partially mediate the association between ultra-processed food consumption and cardiovascular disease risk, according to a study published Sept. 30 in JACC: Advances.

Amier Haidar, MD, MPH; Michael D. Shapiro, DO, MCR, FACC; et al., included 6,531 men and women from the population-based Multi-Ethnic Study of Atherosclerosis (MESA) who were aged 45 to 84 years without cardiovascular disease at baseline. The median follow-up was 16.7 years. The authors sought to identify potential pathways connecting ultra-processed food consumption with incident cardiovascular disease using mediation analyses.

The association between eating ultra-processed food and incident cardiovascular disease was significantly mediated by waist-to-height ratio (mediating 44% of the total association) and interleukin-6 (mediating 13% of the total association). Both mediators retained independent indirect effects when incorporated together in parallel mediation models (mediating 38% and 9% of the total effect, respectively).

The authors acknowledge several study limitations, including that dietary intake data and mediators evaluated were assessed at baseline and may have changed over time. They also point out opportunities for measurement error, within-person variability and residual confounding.

"While much dietary guidance focuses on nutrient composition, our results underscore the relevance of food processing as a determinant of cardiometabolic health," note the authors. "Reducing [ultraprocessed food] consumption may confer cardiovascular benefits by limiting excess adiposity and attenuating chronic inflammation: two key drivers of atherosclerotic cardiovascular disease."