Abstract

Abstract Background The consumption of ultra-processed food (UPF) has been suggested to be associated with cardiovascular events risk, but their dose-response relationship have not reached a consensus. Methods We searched PubMed, EMBASE, Cochrane Library, and Web of Science databases for manuscripts published from inception to November 17, 2021, which reported the relationship between UPF consumption and cardiovascular events risk. A total of ten studies were included with 325,403 participants and 38,720 cardiovascular events cases. Using the fixed/random-effects models, hazard ratios of pooled outcomes were estimated. Results A non-linear relationship of UPF consumption with cardiovascular events risk was identified (P for heterogeneity = 0.013, P for dose-response < 0.001, P for non-linearity = 0.013). Compared with the lowest UPF consumption category, the third highest pooled HR for cardiovascular events risk was 1.02 (95% CI, 0.98 to 1.05), the second highest was 1.08 (95% CI, 1.04 to 1.12) and the highest was 1.24 (95% CI, 1.16 to 1.32). A linear association between UPF consumption and coronary heart disease (CHD) risk was identified (P for heterogeneity = 0.110, P for dose-response < 0.001, P for non-linearity = 0.202). A 10% increase in UPF consumption in daily calorie intake was associated with a 6% increase in CHD risk. UPF consumption was non-linearly associated with cerebrovascular disease (CeVD) risk (P for heterogeneity = 0.001, P for dose-response < 0.001, P for non-linearity = 0.026). Conclusions There was a nonlinear relationship between UPF consumption and cardiovascular events. Moderate intake of UPF was associated with a lower risk of cardiovascular events, with the lowest risk at <15%/day of UPF consumption out of total calorie intake. Heavy UPF consumption was significantly and positively associated with increased risk of cardiovascular events.

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