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somedifferences(country,lifestyleofparticipantsgeneticsintakeofultra-processedfoodsetc)bothstudiescometothesameconclusion whichinouropinionprovidesstrongevidence that thereisarelationshipbetweencertainUPFs(iesoft-drinksbreadmeat)andcVDincidencebecauseJuuletals(2021)(18)study,withaduration three-timeslonger,obtainedresults thatcorroborate srouretal.s(2019) study(15)However,inclinicalresearchshort-termandlong-termdefinitionsarenotonlyverysubjectivebutalsohighlydependentonpathology,treatmentandpopulationthereforeanevenlongerstudy withalargesamplesizeoflongitudinaldesignandwithsimilarparameterstothetwostudiesmentionedaboveshouldbecarriedouttotryandcorroboratetheseresultsZhangetals(2021)study(20)showed thatpercentageofcaloriesfromUPFsandcVHhadagradedinverseassociationstudyconcludedthatahigherconsumptionofUPFswasassociatedwithalowercVHobtainingadecreaseof014pointsincVHscoreforevery 5%increaseincalories fromUPF. thisUsrepresentative studyfound theseresultscoincideamong sexeducationageandpovertyto-incomeratiosubgroupscoronaryheartdiseaseisoneoftheentitiesincludedincVD(26)In the studyledby srouretal.(2019)(15)109116125and124per100000person-yearscoronaryheartdiseaseeventswereobtained for firstquartile(lowUPFconsumers)secondquartile thirdquartileand fourthquartile(highconsumers)respectively.specifically,coronaryheartdiseaseriskwasfoundtobeincreasedbyconsumptionofultra-processed fats saucesandmeatsMoreover,a secondanalysisin this study showedapositiveassociationbetweenunprocessedorminimallyprocessed foodandlowerriskofcoronaryheartdiseases this study found thatifUPFs wereincreasedby10%inthedietthiswouldbeassociatedwithastatisticallysignificant13%increasein theincidenceofcoronaryheartdisease Juuletal.(2021)(18)also studied theincidencerates forhardcoronaryheartdiseaseobtaininga 200rateper1000person yearsinparticipantsconsuming theleastUPFs versusa 436rateper1000person-yearsinthosewiththehighestintakesfindingastatisticallysignificantassociation with theintakeofbreadand salty snack foodsinrelationtoincidenthardcoronaryheartdiseaseInthisstudy,everyadditionalservingofUPFwasassociatedwitha9%increasein theriskofhardcoronaryheartdiseaseDifferencesin the foods thatarerelated tocoronaryheartdiseaseobtainedinbothstudies(1518)maybedue to thecompositionofUPFsineachcountry.themaindietaryculpritbelievedtocausecoronaryheartdiseaseis saturated fat(27)Forinstance whilecompositionofmainsaucesinFrancehasahighercontentonsaturated fats(butterinbechamelhollandaise veloutéetc)compositionofmainsaucesinUsishigherinsugar(ketchupbarbecuesauceetc) thiscouldexplain whyinFrenchstudy(15)alinkisatriskofoverallcVDDuringthefollow-upof518208person-yearsthetotalcVDeventratesforsubjectswithhighandlowUPFconsumptionwas277and242per100000person-yearsrespectively.thismeansthatinthehighintakegroup35additionalcardiovasculareventsoccurredevery100000person-yearsMathematicallyspeakingthisisequaltoanadditionaleventevery2857personyearssotoexperienceacardiovascularevent2857peopleneedtofallintothehighestpercentileofUPFintakeduringaone-yearfollow-upperiodoronepersonneeds to fallinto thehighestquarterofUPFintakefor2857years(25)thisprospectivecohortstudy(15)wascarriedoutatthesorbonnePariscitéEpidemiologyand statisticsresearchcenterby13authors(withameanof 216 total studiescarriedoutperauthor)andhasbeencitedbyother63articlesWithallthisitcanbeconcludedthatthestudy(15)isareliablesourceJuuletal.(2021)(18)foundthatUPFconsumptionwasassociatedwithhigherriskofoverallcardiovasculareventsaswellascVDmortality.subjectsinthisstudywereoverweightatbaselinebutstudyhasabMIadjustedmodelhowever, thisreview takesintoconsideration that thiscanhaveamarginoferror. this studyestablisheda statistically significantpositiveassociationbetweenoverallcVDandbreadultraprocessedmeatandlow-calorie softdrinksinmultivariable-adjustedmodelsHowever, for sugar-sweetenedbeverages yoghurts sweetsanddessertsfastfoodsandotherUPFsnostatisticallysignificantassociation withoverallcVD wasobservedtheprospectivestudiesmentionedabove(1518)havethesamemotive(consumptionofUPFsandincidenceofcVD)and wereconductedindevelopedcountries(FranceandUsArespectively)Anotabledifferencebetweenthe two studies(1518)is their samplepopulationand thedurationof the follow-up Although theFrench study(15)hasamuchhighersamplesize thanUsstudy(18) thelatterisbynomeanssmallandiscarriedoutbycredibleauthorsandisconsideredreliableregardingthedurationoffollow-uptimesrouretal.(2019)(15)followedupwithsubjectsfor52yearswhichcouldbeseenasalimitationofthisstudydespiteitslargesamplesizeHowever, Juuletal.(2021)(18)followedupwithsubjectsfor18yearsandbothstudiesconcluded thatconsumptionofUPFsincreases theincidenceofcVDMoreover,despitehavingbeenconductedindevelopedcountriesconsumptionofUPFsdiffers fromonecountry toanother.studyconductedinFrance(15)founda176%and173%meancontributionofultra-processedfoodstooveralldietinmenandwomenrespectivelyAlthoughthestudy(15)itselfmentionsthattheirsubjectshadgenerallyhealthierhabitsthantherestoftheFrenchpopulation(lesssmokinglesslikelytobeoverweightorobeseetc)itisfarfromthe58%contributionofultra-processedfoodsintheUsdietthatJuuletal.(2021)(18)obtainedAlbeit344ANALESRANFwwwanalesranfcomConsumo de alimentos ultraprocesados y enfermedad cardiovascular unarevisión sistemáticaAmeliaMartidelMoral ySofíaAimiArrúeIshiyamaAnRealAcadFarmVol87Nº3(2021)·pp339-350