# Ultra-Processed Food Consumption and Subclinical Cardiac Biomarkers: A Cross-Sectional Analysis of U.S. Adults in NHANES 2001–2004

## TL;DR

This study finds that higher consumption of ultra-processed foods is linked to signs of early heart strain in U.S. adults.

## Contribution

The study is the first to link ultra-processed food intake with subclinical cardiac biomarkers like NT-proBNP.

## Key findings

- Higher ultra-processed food intake in grams was associated with elevated NT-proBNP levels.
- The association with NT-proBNP weakened after adjusting for clinical factors.
- No consistent link was found between ultra-processed food and troponin biomarkers.

## Abstract

Background/Objectives: Ultra-processed food consumption has been shown to be linked with clinical cardiovascular disease. This study aims to examine the associations of ultra-processed food consumption with biomarkers for subclinical-level myocardial damage [high-sensitivity cardiac troponin I and T (hs-cTnI and hs-cTnT)] and myocardial stretch (NT-proBNP) in U.S. adults. Methods: We used data from 6615 U.S. adults aged ≥20 years without prevalent cardiovascular disease from the National Health and Nutrition Examination Survey 2001–2004. We identified ultra-processed food by applying the Nova classification to dietary recall data, and we divided participants into quartiles based on their consumption, expressed as a proportion of total daily energy (%kcal) and gram intakes (%grams). We defined elevated cardiac biomarkers as hs-cTnI > 12 ng/L in men and >10 ng/L in women, hs-cTnT ≥ 14 ng/L for all participants, and NT-proBNP ≥ 125 pg/mL for age < 75 y and ≥450 pg/mL for age ≥ 75 y. We used multivariable logistic regression with adjustment for socio-demographic, total energy intake, behavioral, and clinical characteristics. Results: Higher ultra-processed food intake in %grams was associated with elevated NT-proBNP [odds ratio (OR) for quartile 4 vs. 1: 1.27, 95% CI: 1.00–1.61] when socio-demographic characteristics and total energy intake were adjusted for, but this was not the case with hs-cTnI or hs-cTnT. Further adjusting for clinical characteristics attenuated the association with NT-proBNP (OR: 1.26, 95% CI: 0.98, 1.61). There was no consistent association between ultra-processed food in %kcal and elevated NT-proBNP, hs-cTnT, or hs-cTnI. Conclusions: Ultra-processed food consumption is associated with subclinical myocardial stretch, a precursor to early heart failure. This supports the potential risks of subclinical cardiovascular disease associated with consuming ultra-processed food.