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Step aside, MAHA. The country’s largest heart-health organization has just released its long-awaited guidelines for the consumption of ultraprocessed foods, or UPFs.
The new scientific advisory statement from the American Heart Association comes just days before the arrival of the second “Make America Healthy Again” or MAHA Commission report, spearheaded by US Health and Human Services Secretary Robert F. Kennedy Jr.
The first MAHA report, released in May, described how ultraprocessed foods were contributing to chronic illnesses in children. The second installment, due by Tuesday, is expected to lay out proposed policy changes.
The American Heart Association’s key message is not surprising: Most ultraprocessed foods are terrible for health, including heart health, and it is high time the food industry stopped producing them and regulators stopped letting them, the nonprofit says.
But surprisingly, the AHA also dives nose first into the hotly debated question: Are all ultraprocessed foods unhealthy?
Maybe not, according to the new guidelines released Friday in the journal Circulation. In reality, however, it’s just a few categories, like “certain whole grain breads, low-sugar yogurts, tomato sauces, and nut or bean-based spreads,” the report states. Even those “healthy” options, the report adds, should be monitored to ensure they remain that way.
That’s no reason to celebrate, says Christopher Gardner, who is vice chair of the AHA report’s writing group. “Let’s not give the industry a write-off 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.
“We have tons of evidence that too much salt, sugar and fat are harmful — we’ve known that since the days of junk food,” said Gardner, Rehnborg Farquhar Professor of Medicine at Stanford University, who directs the Stanford Prevention Research Center’s Nutrition Studies Research Group.
“But today’s junk food is ultraprocessed with cosmetic additives that lead to overeating and tons of health issues,” he added. “That’s the problem. Can we please double down on those?”
Guidance from the AHA is highly regarded by medical professionals and policy makers, and experts say tackling the issue of ultraprocessed food couldn’t come at a better time. New data released Thursday by the US Centers for Disease Control and Prevention found Americans over the age of 1 get 55% of their daily calories from ultraprocessed food. That number jumped to 62% for children between 1 and 18 years old.
That’s concerning, the AHA report said, because research has found a dose-response relationship between ultraprocessed foods and heart attacks and stroke, type 2 diabetes, obesity and all-cause mortality.
Just one extra serving a day of ultraprocessed food led to some 50% higher risk of cardiovascular disease-related death, according to a February 2024 review of 45 meta-analyses on almost 10 million people. Eating more ultraprocessed foods may also increase the risk of obesity by 55%, sleep disorders by 41%, development of type 2 diabetes by 40% and the risk of depression by 20%, according to the review.
To counter these potential health harms, the AHA says Americans should stop eating as many of the most harmful UPFs as possible — especially those high in unhealthy fats, added sugars and salt — while allowing “a small number of select, affordable UPFs of better diet quality” to be eaten as part of a healthy diet.
Marion Nestle, the Paulette Goddard professor emerita of nutrition, food studies and public health at New York University, was disappointed with the guidance.
“The emphasis on ‘healthy’ UPFs is not helpful for two reasons,” Nestle said in an email. “The small number of foods in that category (of healthy UPFs), and the recent research demonstrating that even ‘healthy’ UPFs induce people to eat more calories than they would if they were eating minimally processed foods.”
Nestle, who was not involved with the report, is referencing an August 4 study in which people in the United Kingdom lost twice as much weight eating meals typically made at home than they did when eating store-bought ultraprocessed food considered healthy.
The research, which was one of the largest and longest randomized controlled clinical trials of UPFs to date, tried to create a healthy ultraprocessed diet. Ultraprocessed foods in the study included a recommended number of fruits, veggies and fiber as well as lower levels of salt, sugar and saturated fats. Yet, the study found, whole foods cooked at home still won the day when it came to weight loss.
While science attempts to find out just what it is about UPF additives or processing that contributes to such findings, the AHA has provided some basic advice by assigning ultraprocessed foods into one of three categories: least healthy, moderately healthy and healthy.
Healthier choices included fresh and frozen fruits and vegetables without added sugar or salt; whole grains such as 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 meat and dairy that was low in added sugar, salt and fats were also considered healthy.
Moderately healthy foods included 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; and low sodium, low fat soups. Store-bought meals made with choices from the healthy group above were also in the category.
The unhealthy group contained the usual culprits — high fat red meat, pork, processed meats (chicken nuggets, hot dogs, sausage), butter, lard and tropical oils such as coconut. Sour cream and 100% fruit juice made the list, as did sugar, honey, maple syrup, crackers, sweetened dried and canned fruit, tortilla or potato-based chips and French fries.
Refined grain breads, rolls and tortillas were included as unhealthy, as were sugar-sweetened beverages (which included energy drinks), liquid cheese products, cookies, crackers, candies, gummy fruit snacks, ice cream, boxed macaroni, instant noodles, pizza, some canned or instant soups and canned fruits in syrup.
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