Association of ultra-processed food consumption and MRI-based carotid plaque characteristics: results from the Atherosclerosis Risk in Communities study

Background: Ultra-processed food and beverage consumption has been linked with adverse cardiovascular events, yet its association with sub-clinical disease remains less explored. Methods: A total of 768 white participants from the Carotid MRI visit (2004–2005) in the Atherosclerosis Risk in Communit...

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Main Authors: Shutong Du, Valerie K. Sullivan, Kunihiro Matsushita, Seamus P. Whelton, Lyn M. Steffen, Michael Fang, Lawrence J. Appel, Bruce A. Wesserman, Casey M. Rebholz
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:American Journal of Preventive Cardiology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666667725001400
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author Shutong Du
Valerie K. Sullivan
Kunihiro Matsushita
Seamus P. Whelton
Lyn M. Steffen
Michael Fang
Lawrence J. Appel
Bruce A. Wesserman
Casey M. Rebholz
author_facet Shutong Du
Valerie K. Sullivan
Kunihiro Matsushita
Seamus P. Whelton
Lyn M. Steffen
Michael Fang
Lawrence J. Appel
Bruce A. Wesserman
Casey M. Rebholz
author_sort Shutong Du
collection DOAJ
description Background: Ultra-processed food and beverage consumption has been linked with adverse cardiovascular events, yet its association with sub-clinical disease remains less explored. Methods: A total of 768 white participants from the Carotid MRI visit (2004–2005) in the Atherosclerosis Risk in Communities (ARIC) study were included. Participants were selected via stratified sampling to enrich for informative plaques while preserving population-level reference. Dietary intake was assessed using a 148-item food frequency questionnaire, with items classified by Nova processing levels. Carotid artery imaging was conducted via MRI and analyzed with semiautomated software. Weighted multivariable linear and logistic regression models assessed associations between quartiles of ultra-processed food intake and plaque measurements or lipid core presence. Results: Higher ultra-processed food consumption was associated with unfavorable carotid plaque characteristics. Participants in quartile 4 of ultra-processed food consumption had greater total wall volume (standardized difference: β = 0.28, 95% CI, 0.07, 0.49), total lipid core volume (β = 0.55, 95% CI, 0.17, 0.92), maximum segmental wall thickness (β = 0.23, 95% CI, 0.01, 0.45), and maximum lipid core area (β = 0.49, 95% CI, 0.12, 0.86) vs. quartile 1. Replacing one daily serving of ultra-processed food with unprocessed or minimally processed food was associated with a reduction in total wall volume (β = -0.02, 95% CI, -0.05, -0.00). Conclusions: Higher intake of ultra-processed food was associated with a greater burden of atherosclerotic plaque in the carotid artery. Our findings support the need for further investigation into the potential impact of ultra-processed food on atherosclerotic changes and the underlying mechanisms by which it may increase the future risk of cardiovascular disease development.
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spelling doaj-art-db71d9fea3b04ae390ddbb0d1c7e29c02025-08-20T03:57:58ZengElsevierAmerican Journal of Preventive Cardiology2666-66772025-09-012310106510.1016/j.ajpc.2025.101065Association of ultra-processed food consumption and MRI-based carotid plaque characteristics: results from the Atherosclerosis Risk in Communities studyShutong Du0Valerie K. Sullivan1Kunihiro Matsushita2Seamus P. Whelton3Lyn M. Steffen4Michael Fang5Lawrence J. Appel6Bruce A. Wesserman7Casey M. Rebholz8Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USAWelch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USAWelch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USACiccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USAWelch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USAWelch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USARussell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USAWelch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Corresponding author at: Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins University, 2024 E. Monument Street, Suite 2-600, Baltimore, Maryland 21205.Background: Ultra-processed food and beverage consumption has been linked with adverse cardiovascular events, yet its association with sub-clinical disease remains less explored. Methods: A total of 768 white participants from the Carotid MRI visit (2004–2005) in the Atherosclerosis Risk in Communities (ARIC) study were included. Participants were selected via stratified sampling to enrich for informative plaques while preserving population-level reference. Dietary intake was assessed using a 148-item food frequency questionnaire, with items classified by Nova processing levels. Carotid artery imaging was conducted via MRI and analyzed with semiautomated software. Weighted multivariable linear and logistic regression models assessed associations between quartiles of ultra-processed food intake and plaque measurements or lipid core presence. Results: Higher ultra-processed food consumption was associated with unfavorable carotid plaque characteristics. Participants in quartile 4 of ultra-processed food consumption had greater total wall volume (standardized difference: β = 0.28, 95% CI, 0.07, 0.49), total lipid core volume (β = 0.55, 95% CI, 0.17, 0.92), maximum segmental wall thickness (β = 0.23, 95% CI, 0.01, 0.45), and maximum lipid core area (β = 0.49, 95% CI, 0.12, 0.86) vs. quartile 1. Replacing one daily serving of ultra-processed food with unprocessed or minimally processed food was associated with a reduction in total wall volume (β = -0.02, 95% CI, -0.05, -0.00). Conclusions: Higher intake of ultra-processed food was associated with a greater burden of atherosclerotic plaque in the carotid artery. Our findings support the need for further investigation into the potential impact of ultra-processed food on atherosclerotic changes and the underlying mechanisms by which it may increase the future risk of cardiovascular disease development.http://www.sciencedirect.com/science/article/pii/S2666667725001400ARIC studyNOVA classificationUltra-processed foodsCarotid MRIArtery plaques
spellingShingle Shutong Du
Valerie K. Sullivan
Kunihiro Matsushita
Seamus P. Whelton
Lyn M. Steffen
Michael Fang
Lawrence J. Appel
Bruce A. Wesserman
Casey M. Rebholz
Association of ultra-processed food consumption and MRI-based carotid plaque characteristics: results from the Atherosclerosis Risk in Communities study
American Journal of Preventive Cardiology
ARIC study
NOVA classification
Ultra-processed foods
Carotid MRI
Artery plaques
title Association of ultra-processed food consumption and MRI-based carotid plaque characteristics: results from the Atherosclerosis Risk in Communities study
title_full Association of ultra-processed food consumption and MRI-based carotid plaque characteristics: results from the Atherosclerosis Risk in Communities study
title_fullStr Association of ultra-processed food consumption and MRI-based carotid plaque characteristics: results from the Atherosclerosis Risk in Communities study
title_full_unstemmed Association of ultra-processed food consumption and MRI-based carotid plaque characteristics: results from the Atherosclerosis Risk in Communities study
title_short Association of ultra-processed food consumption and MRI-based carotid plaque characteristics: results from the Atherosclerosis Risk in Communities study
title_sort association of ultra processed food consumption and mri based carotid plaque characteristics results from the atherosclerosis risk in communities study
topic ARIC study
NOVA classification
Ultra-processed foods
Carotid MRI
Artery plaques
url http://www.sciencedirect.com/science/article/pii/S2666667725001400
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