Substitution Models of Non-Ultra-Processed Food Alternatives for Ultra-Processed Foods: Association With Cardiovascular Disease in Three Prospective US Adult Cohorts

Kenny Mendoza; Alan Espinosa; Jean‐Philippe Drouin‐Chartier; Zhangling Chen; Stephanie A. Smith‐Warner; Sinara Laurini Rossato; Neha Khandpur; JoAnn E. Manson; Lu Qi; Eric B. Rimm; Kenneth Jay Mukamal; Walter Churchill Willett; Molin Wang; Frank B. Hu; Josiemer Mattei; Qi Sun

doi:10.1016/j.cdnut.2026.108966

July 1, 2026Current Developments in NutritionOpen Access

Substitution Models of Non-Ultra-Processed Food Alternatives for Ultra-Processed Foods: Association With Cardiovascular Disease in Three Prospective US Adult Cohorts

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Key result

Replacing ultra-processed foods with minimally processed alternatives is linked to lower cardiovascular disease risk.

Why the study?

Associations between replacing ultra-processed food groups with non-ultra-processed food alternatives and cardiovascular outcomes were not well established in prospective US cohorts.

Does replacing ultra-processed food (UPF) groups with non-UPF alternatives reduce cardiovascular disease (CVD), coronary heart disease (CHD), and stroke risk in US adults?

Key Points

To assess associations between replacing ultra-processed food groups with non-ultra-processed alternatives and the risks of cardiovascular disease, coronary heart disease, and stroke.
Evaluated dietary substitution models across three prospective cohorts of US adults.
Modeled the nutritional replacement of specific ultra-processed food categories with minimally processed or unprocessed alternatives.
Evaluated prospective relationships between dietary replacement of ultra-processed foods and incidents of cardiovascular disease, coronary heart disease, and stroke.

Structured PICO

Does replacing ultra-processed food (UPF) groups with non-UPF alternatives reduce cardiovascular disease (CVD), coronary heart disease (CHD), and stroke risk in US adults?

P

Population

US adults across 3 prospective cohorts

I

Intervention

Replacing ultra-processed food (UPF) groups with non-UPF alternatives

O

Outcome

Cardiovascular disease (CVD), coronary heart disease (CHD), and stroke riskhard clinical

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Answers are grounded in this paper and cite their sources.

Implication

Should not yet alter dietary advice; hypothesis-generating for whole-food substitution benefits in US adults.

Abstract

Objectives: To assess associations between replacing ultra-processed food (UPF) groups with non-UPF alternatives and cardiovascular disease (CVD), coronary heart disease (CHD), and stroke risk in 3 prospective US adult cohorts.

Discussion

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Cite This Study

Mendoza et al. (2026) studied this question. Replacing ultra-processed food groups with non-ultra-processed alternatives was evaluated for its association with cardiovascular disease risk in three prospective US adult cohorts.

synapsesocial.com/papers/6ad0fc3a15427f6a84040021 https://doi.org/10.1016/j.cdnut.2026.108966

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Substitution Models of Non-Ultra-Processed Food Alternatives for Ultra-Processed Foods: Association With Cardiovascular Disease in Three Prospective US Adult Cohorts

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Substitution Models of Non-Ultra-Processed Food Alternatives for Ultra-Processed Foods: Association With Cardiovascular Disease in Three Prospective US Adult Cohorts

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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