Ultra-processed foods are a cardiologist's No 1 enemy when it comes to heart health. Photo / Getty Images
Ultra-processed foods are a cardiologist's No 1 enemy when it comes to heart health. Photo / Getty Images
Two years ago, the British Heart Foundation declared the country was in “the grip of the worst heart care crisis in living memory” as 39,000 people in England died prematurely of cardiovascular conditions in 2022. Widening health inequalities, the pandemic and long-standing pressure on the NHS all play a part in Britain’s worsening heart health. One thing within people’s control is what they eat and how that protects or harms their heart.
“Heart disease and stroke are still the biggest killers in the western world despite medical advances,” says Dr Neil Srinivasan, a consultant cardiologist specialising in general cardiology and the management of heart rhythm problems. “Obesity, diabetes and a sedentary lifestyle lead to raised cholesterol, high blood pressure and insulin resistance – these are the vast problems in modern life.”
At the centre of all of this, says Dr Srinivasan, who also runs UK Heart Clinic, is “our ready access to food that has gone through a large degree of processing”. Here are the food items that don’t make his shopping basket.
Breakfast cereals
Tucking into a sugary bowl of Kellogg’s is one of the least healthy ways you can start your day. They’re an ultra-processed food (UPF), Dr Srinivasan’s No 1 enemy. He cites a recent study which tracked 10,000 Australian women for 15 years: those with the highest amounts of ultra-processed food in their diet were 39 per cent more likely to develop high blood pressure than those with the lowest.
“These are the foods which have gone through multiple processes during manufacturing,” he explains. “Most foods undergo a ‘process’ in the form of chopping, cooking, baking, straining or canning, but UPFs undergo much more treatment, and one analysis of over a million people showed that those who ate the most UPF were 24 per cent more likely to experience serious heart and circulatory events including heart attacks, strokes and angina.”
Many breakfast cereals are categorised as ultra-processed foods, which can increase your risk of developing several health issues. Photo / 123rf
“These products are made using industrial processing and often contain additives such as colours, flavours, emulsifiers or preservatives, as well as breaking down whole foods into substances including oils, sugars and starches. Baked goods notoriously raise levels of low-density lipoprotein (LDL) cholesterol – the bad cholesterol – which builds up in the artery wall.”
What’s the alternative?
Homemade porridge (not the two-minutes-in-a-microwave kind), fresh fruit, plain yoghurt or high quality, whole-grain bread. “Select dense, chewy, country-style loaves without added sugar or butter,” suggests Dr Srinivasan. “Use olive oil in place of butter on your crusty bread and really only save cakes and biscuits for special occasions.”
Salty meat is delicious, and nothing smells better than a pizza oozing with pepperoni topping. “I do my best to avoid these foods, along with pies and pastry-covered meats like sausage rolls, because they’re just so high in saturated fats,” says Dr Srinivasan.
Many of these meats are fried with oil, butter or sometimes ghee, all of which “are particularly bad for cholesterol handling and heart disease”, he adds. “Sometimes the addition of suet, dripping, deep-frying in lard or wrapping things in bacon might enhance flavour but it’s just heaping on more additives. Red meat and fried foods are notorious for raising bad cholesterol levels. Frying food ups the calorie count and saturated or trans fats and cholesterol are absorbed by the foods during the process.”
What’s more, salami and the like are all packed with salt. Too much sodium pulls water back into our bloodstream. The more water in our blood vessels, the higher our blood pressure gets, increasing our risk of developing heart and circulatory diseases.
What’s the alternative?
You don’t have to be vegetarian, but grill your meat. “Too much protein can be harmful for the kidneys, but not necessarily the heart. So I would say lean protein such as chicken (without the skin) or fish (particularly oily fish) are important parts of a balanced diet.”
Experiment with bulgur, barley, farro, couscous, and whole-grain pasta and add an extra serving of vegetables to both lunch and dinner. Eat at least three servings a week of legumes, such as lentils, chickpeas, beans, and peas, advises Dr Srinivasan.
Crisps
It takes superhuman powers of resistance to stop once a tube of Pringles has been popped but the message from the expert is to avoid, avoid, avoid. “These foods seem to be addictive,” Dr Srinivasan says. Moderating more-ish snacks such as crisps reduces calories and helps avoid huge fluctuations in blood glucose.
Crisps are generally high in trans fats and sodium, and low in potassium and dietary fibre, all characteristics linked to heart disease. Experimental evidence suggests they may contribute to higher energy intakes and weight gain, potentially due to their high energy-density.
Crisps are generally high in trans fats and sodium, and low in potassium and dietary fibre, all characteristics linked to heart disease. Photo / Jeff Siepman, Unsplash
Eating too many of these foods doesn’t just contribute to obesity, he says, but also to atherosclerosis. “It’s the thickening or hardening of the arteries caused by a buildup of plaque in the inner lining of an artery which can rupture and cause heart attacks,” Dr Srinivasan explains. “The latter is a slow, progressive disease that may start as early as childhood.”
What’s the alternative?
Nuts and olives are far healthier nibbles. “Consume a handful of raw nuts every day as a healthy replacement,” Dr Srinivasan suggests. “Farmer’s markets are an excellent source of locally grown, seasonal foods and the Mediterranean diet has one of the best outcomes in terms of cardiovascular health.”
Icecream
Ah, the staple treat of summer… yet it isn’t one that passes this cardiologist’s lips very often. Again, primarily because of the processing procedure. And he warns that even young adults aren’t immune from the perils of omnipresent UPFs.
A study from Spain that followed almost 20,000 university graduates showed a connection between UPF and risk of early death. “Those in the highest intake (four or more servings per day) were 62 per cent more likely to have died after an average of 10 years than people in the low group (people eating two or less servings).”
What’s the alternative?
“Poached or fresh fruit is best, aim for three servings of fresh fruit a day.”
Fizzy drinks
Hooked on Coke, Sprite or Fanta? Or like to hit the Red Bull when you want an energy boost? It’s high time to wean yourself off, there really are no positives to be mined.
“Cut out sugary beverages altogether,” says Dr Srinivasan. “Excessive intakes of sugar from sugar-sweetened beverages are associated with a risk of obesity, hypertension, and Type 2 diabetes.”
Instead of cracking open another can of fizzy drink, opt for a glass of water - it's free and it's hydrating. Photo / 123rf
What’s the alternative?
Water, obviously, is free and best for hydrating. But if that’s really too boring, Dr Srinivasan suggests using soda water flavoured with juice. It’s not all bad news: our morning flat whites and the old glass of claret are still treats we can enjoy guilt-free. “Coffee in moderation (which would be three cups a day max) has not been shown to be harmful to the heart.”
He also says that (some) booze can be drunk too. “Alcohol in moderation is fine, and there is good data to show that red wine in moderation may be beneficial. Replace beer or liquors with wine; no more than two 150ml glasses per day for men, and one glass per day for women.”
