BY JANET LIMKE, MD, AND CHERYL WARNER, MD, MMS COMMITTEE ON NUTRITION AND PHYSICAL ACTIVITY MEMBERS
In today’s fast-paced world, convenience often drives our food choices. But what do we sacrifice in the name of speed and shelf life? Ultra-processed foods (UPFs) have become a significant part of modern diets, yet mounting evidence suggests they may
come at a serious cost to our health.
What Are Ultra-Processed Foods?
Ultra-processed foods are industrial formulations made largely or entirely from substances extracted from foods or synthesized in laboratories. These products undergo multiple stages of processing, including extrusion, molding, and milling, and they often
include added preservatives, sweeteners, colorants, flavor enhancers, emulsifiers, and other additives not found in a typical home kitchen
Unlike whole or minimally processed foods, UPFs are not simply modified versions of natural foods. They are typically created from industrial ingredients that have been reassembled to mimic or enhance flavor, texture, and shelf life. These foods are engineered
to be hyper-palatable, intensely appealing, and often addictive, while sacrificing nutritional value. They tend to be high in sugar, salt, and unhealthy fats, and low in dietary fiber and essential nutrients.
Common Examples of UPFs
You may be surprised by how many everyday products fall into the ultra-processed category. Examples include the following:
Sweet snacks and beverages: soft drinks, chocolate, candy, ice cream, sweetened breakfast cereals
Packaged savory items: chips, instant noodles, French fries, chicken nuggets, hot dogs, and sausages
Ready-to-eat meals: frozen pizzas, pasta dishes, and pre-made entrees
Mass-produced baked goods: cakes, biscuits, and packaged bread
Other processed items: flavored yogurts, some alcoholic beverages, and many instant soups
Health Risks Associated with Nutrient-Poor UPFs
A growing body of research has linked the consumption of UPFs to a range of health concerns. These include the following:
Metabolic Syndrome: Characterized by elevated blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. Increased intake of UPFs is associated with a higher risk of developing this condition.
Obesity: Several studies have shown a strong correlation between UPF consumption and rising obesity rates. Their high calorie density and engineered palatability may promote overeating.
Heart Disease and Cancer: Research from the National Institutes of Health (NIH) and Harvard has linked UPFs to an increased risk of heart conditions, including vascular heart disease and heart attacks, as well as higher rates of certain cancers, notably
breast, colon, and prostate cancer.
Increased Mortality: A study published in the British Medical Journal that followed over 22,000 Italians for 14 years found that those with the highest UPF intake had a 19% higher risk of death from all causes and a 27% higher risk of cardiovascular
death.
Cognitive Decline: A JAMA Neurology study found a 28% higher risk of dementia among those with high UPF intake.
How Are UPFs Classified?
The NOVA food classification system, developed by Brazilian researchers, groups foods based on their degree of processing:
Group 1: Unprocessed or minimally processed (e.g., fresh fruits, vegetables, meat, milk)
Group 2: Processed culinary ingredients (e.g., sugar, salt, oils)
Group 3: Processed foods (e.g., canned vegetables, cheese, simple breads)
Group 4: Ultra-processed foods (e.g., soft drinks, packaged snacks, and ready meals)
The NOVA system is widely used in public health communication due to its simplicity and intuitive design, though some scientists debate its scientific precision. The NOVA classification is used to define the degree of processing, but its correlation with
health outcomes is not at all precise.
On August 8, 2025, the American Heart Association released a report pointing out that while most UPFs that are common
in U.S. dietary patterns are unhealthful, not all UPFs are of poor nutritional quality.
In other words, it is important to note that not all UPFs are unhealthy and that not all unprocessed or minimally processed foods are healthy. For example, notice that “meat” is part of Group 1. Meat intake, especially red meat, is associated with higher
rates of disease, including GI cancers, type 2 diabetes, and cardiovascular conditions.
Conversely, there are many healthful UPFs that reduce risk of disease and tend to have one thing in common: they are derived from plants. Plant-based milks (like soy milk and oat
milk), multigrain breads, pasta, canned fruits and vegetables, and plant-based meat substitutes can belong in a healthy diet, especially if they replace animal products.
A new science advisory from the American Heart Association, led by Dr. Christopher Gardner, director of nutrition studies at the Stanford Prevention Research Center, reinforces current dietary guidelines urging patients to:
Reduce the intake of most UPFs, especially those high in saturated fat, added sugars, and sodium, and those that contribute to excessive calories; and
Replace UPF consumption with healthier options like vegetables, fruits, whole grains, beans, nuts, seeds, and lean proteins.
For more information, see this thorough, nuanced discussion about UPFs from Dr. Christopher Gardner.
Finally, a Call for Mindful Eating
Awareness is the first step toward healthier choices. While UPFs offer convenience, they should not be the foundation of a diet. Whenever possible, choose whole or minimally processed foods — those found around the perimeter of the grocery store rather
than the aisles. Cooking at home with fresh ingredients not only improves health outcomes but also reconnects us to the joy of real food.
By reducing intake of nutrient-poor UPFs and focusing on natural, nutrient-dense options, we take a powerful step toward long-term wellness and disease prevention.
