KANSAS CITY, MISSOURI, US — Criticism blaming “ultra-processed foods” (UPF) in recent years for various health problems, including cardiovascular disease, has alarmed leaders of the grain-based foods industry. The inclusion of staples such as bread, pasta and cereals in the UPF category has raised concern that a dangerous new front was opening in the “war on bread.”

Unexpected findings in a new study published in the medical journal The Lancet should help industry executives breathe a little easier.

The study on “Ultra-processed foods and cardiovascular disease” was conducted by a large group of researchers led by Kenny Mendoza of the T.H. Chan School of Public Health at Harvard University. The results, generally positive toward enriched grains, were unexpected because two of the authors, Walter Willett and Frank Hu, have been unrelenting critics of enriched grains for decades.

For data, the researchers tapped three large studies: The Nurses Health Study (1 and 2) and The Health Professionals’ Follow-Up Study. They looked at the association between intake of UPF and cardiovascular disease (CVD), coronary heart disease (CHD) and stroke. More than 250,000 adult participants were recruited between 1976 and 1986 and followed afterward. The researchers also reviewed 19 cohort studies exploring the connection between UPF and CVD risk.

The researchers are not defenders of ultra-processed foods. “Typical UPF contain excess calories, added sugars, sodium and unhealthy fats associated with higher CVD risk,” they said.

At the same time, UPF “encompass a heterogeneous group of products” from whole grain bread to “nutritionally devoid soft (drink) beverages,” they said.

The authors cited data linking intake of soft drinks, processed meats and ready-to-eat foods with higher type 2 diabetes risk while “ultra-processed whole grain bread displays inverse associations.”

The difference prompted the researchers to break UPF into 10 categories for their study, including grains, sauces/condiments, sweets, savory snacks, caloric soft drinks, processed meats, mixed dishes, yogurt/dairy desserts, hard liquor and artificially sweetened beverages.

Two of the categories fared worst.

“Processed meats and sugar-sweetened beverages were significantly associated with a higher risk of the three outcomes,” the researchers said.

Positives were identified across the spectrum of “ultra-processed” grains tracked in the study.

“A higher total intake of bread and cereals was associated with lower stroke risk,” the researchers said. “Cold cereal intake was associated with a lower risk of CVD and CHD; greater consumption of refined bread was only associated with lower stroke risk.”

In the same breath the researchers acknowledge UPF intake is linked to CVD and CHD risk, they add, “nutritional health for cardiovascular health should consider differential consequences of group-specific UPF.”

Bolstering the contention of grains groups that the science of UPF is far too vague to specify the term when offering nutritional guidance, the authors said, “future research must undertake meticulously designed, food-specific isocaloric replacement analyses to scrutinize the associations between the displacement of specific equivalent non-UPF by UPF groups and their role on CVD.”

It is only when such research is completed will nutritionists be able to suggest substitutions of UPF with “less processed and healthier options.”

While the study should help defang UPF critics, the grain-based foods industry still has work to do. In May, a predecessor study from the T.H. Chan school to the one published in The Lancet cautioned that “ultra-processed foods is a diverse category, with many items that are considered healthy.” Apparently, not everyone at Harvard “received the memo.” A month later, Dr. Andrew E. Budson, a neurologist and lecturer at Harvard Medical School, wrote in the medical school newsletter, “Just say no,” when it comes to ultra-processed foods, lumping bread and instant noodles with soda and processed meats.