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. 2025 Aug;122(2):523-534.
doi: 10.1016/j.ajcnut.2025.05.033. Epub 2025 Jun 2.

Ultra-processed foods, plant and animal sources, and all-cause, cardiovascular, and cancer mortality in older adults in the United States: results from the Cardiovascular Health Study

Alyssa Feinberg  1 , Casey M Rebholz  2 , Rozenn N Lemaitre  3 , Amanda M Fretts  4 , Kerri Wiggins  5 , Nona Sotoodehnia  3 , Bruce M Psaty  6 , Hyunju Kim  7
Affiliations

Ultra-processed foods, plant and animal sources, and all-cause, cardiovascular, and cancer mortality in older adults in the United States: results from the Cardiovascular Health Study

Alyssa Feinberg et al. Am J Clin Nutr. 2025 Aug.

Abstract

Background: Ultra-processed food (UPF) consumption is associated with adverse health outcomes. Plant- and animal-sourced UPFs have a unique nutritional composition to improve palatability, which may impact health, but evidence is limited.

Objectives: The objective of this study was to investigate the association between UPF intake, plant- and animal-sourced UPF, and mortality outcomes in older adults.

Methods: We conducted prospective analyses of 2582 participants (median age: 77 y) in the Cardiovascular Health Study who completed a food frequency questionnaire (FFQ) in 1995-1996. We used responses from the FFQ to identify UPF and classify UPF based on their source (plant or animal). Cox proportional hazard regression models were used to study the association between UPF, plant- and animal-sourced UPF, and mortality outcomes (all-cause, cardiovascular disease [CVD] related, non-CVD related, and cancer).

Results: Over a median follow-up of 10 y, there were 2242 deaths. After adjusting for sociodemographic characteristics and health behaviors, per standard deviation (SD) higher intake of UPF was associated with 8%-10% higher risk of all-cause mortality (hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 1.02, 1.14), non-CVD related mortality (HR: 1.10; 95% CI: 1.03, 1.18), and cancer mortality (HR: 1.13; 95% CI: 1.08, 1.46). Similarly, per SD, higher intake of plant- and animal-sourced UPFs was associated with a 4%-17% higher risk of all-cause mortality, non-CVD related mortality, and cancer mortality. However, in a model additionally adjusting for clinical factors, the associations between plant-sourced UPF and mortality attenuated, except for cancer mortality. No significant associations were observed for CVD related mortality.

Conclusion: Higher consumption of UPF and plant- and animal-sourced UPFs was associated with higher risk of all-cause, non-CVD related, and cancer mortality. Our findings emphasize the need to consider the impact of food processing, even in plant-sourced foods, to prevent a shorter lifespan in older adults. Findings on plant-sourced UPF and mortality require replication.

Keywords: animal products; food processing; mortality; older adults; plant-based foods; ultra-processed foods.

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Conflict of interest statement

Conflict of interest Hyunju Kim reports that financial support was provided by the National Heart Lung and Blood Institute. All other authors report no conflicts of interest.

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