Avoid ultra-processed foods? That's how we lose fiber and whole grains

Many nutrition guides urge us to eat more whole grains, backed by a solid body of observational meta-analyses: higher whole grain consumption is associated with lower risks of all-cause mortality, type 2 diabetes, cardiovascular disease, and colorectal cancer. At the same time, another slogan is spreading around the world: “avoid ultra-processed foods (UPF),” according to the NOVA classification. The problem is that NOVA classifies most of the familiar grain products (bread, tortillas, breakfast cereals) as UPF, so people are simultaneously advised to eat more of them and… avoid them. A new review in Nutrients examines where this conflict arose, what the science actually says, and how to avoid throwing out the main sources of fiber along with the “ultra-processed” label from your diet.

What the author did: analyzed the validity of the "processing level assessment" approach; compared the quality of evidence on the benefits of whole grains and the harm of UPF; analyzed menu modeling and "real" diets: is it possible to follow the recommendations for whole grains if you physically exclude all the products that NOVA calls UPF. The conclusion is inconvenient, but important: up to 90-95% of whole grain products sold on the market are labeled by NOVA as UPF, although they are the ones that increase fiber consumption and improve the quality of the diet. Including an unconditional "avoid UPF" in guides means confusing people and risking a further decline in whole grain consumption.

Background of the study

Over the past two decades, dietary guidelines have increasingly called for increasing the proportion of whole grains: high consumption of whole grains is consistently associated with lower risks of overall mortality, CVD, type 2 diabetes, and colorectal cancer. At the same time, in most countries, grains (including industrially produced bread, tortillas, porridge, and cereal) are the main source of dietary fiber, the deficiency of which remains a widespread problem.

At the same time, the “avoid ultra-processed foods (UPF)” concept according to the NOVA system has gained momentum. It classifies many familiar grain products as UPF due to the number of ingredients, additives, or technologies used. This creates a methodological conflict: healthy eating guides encourage the consumption of whole grains, while anti-UPF formulations actually throw out of the diet a significant part of the very products with which people usually meet their whole grain and fiber plan.

The science is also questionable. The evidence base for whole grains relies on large cohorts and meta-analyses with consistent direction of effects and biological plausibility (fiber, magnesium, phenolics, low glycemic load). The UPF → harm associations are largely observational, dependent on how foods are labeled, and often confounded by lifestyle (sugary drinks and desserts drag down the entire category). Universal stigma based on processing levels risks blocking access to healthy and affordable grain sources of fiber, including fortified foods, which are important for vulnerable groups.

Finally, there is the practical layer: time, cost, availability. For many families, whole grain bread/cereal is the most realistic way to get fiber and micronutrients on a regular basis. So the scientific and regulatory challenge is to consolidate the evidence on the benefits of whole grains and carefully rethink the anti-UPF rhetoric: shifting the emphasis from the “processed label” to the quality of the diet, the content of fiber, added sugars, salt, energy, and clear criteria for a product being “whole grain.”

Key facts and figures backed by evidence

• The benefits of whole grains are better documented than the harms of UPF. Meta-analyses of large cohorts consistently show: more whole grains - lower risks of mortality, CVD, diabetes and a number of cancers (especially colorectal). Moreover, it is grain fiber that is associated with a lower risk of colorectal cancer more significantly than "total fiber". These associations are based on common market products, which NOVA most often classifies as PF/UPF.
• Real-World Sources of Fiber: According to NHANES, grains (both whole and refined) provide all the “grain” and more than half the total dietary fiber in the American diet. By eliminating them because of the UPF label, you are almost guaranteed to “drop” the fiber.
• The conflict of recommendations is not a theory. The abstract states directly: NOVA considers ≈90% of whole grain products UPF; prohibitive “avoid UPF” formulas jeopardize efforts to increase fiber and whole grain consumption - after all, there are few “processed” breads, flatbreads, tortillas, and cereals in the modern Western diet.

The review shows that much of NOVA rests on assumptions that are either not supported by data or are too vague to be useful for policy.

What are the "cornerstones" of NOVA that raise questions:

• Ingredient count as a criterion for "harmfulness". Bread with 12-17 ingredients automatically "jumps" into the UPF, although it may be better in nutrition than a product with four. A long composition in itself does not equal poor health - this has not been proven.
• “Presence of additives” as a stop signal. Preservatives and emulsifiers can improve the safety, shelf life, and even availability of healthy options (e.g., whole grains) without compromising the nutritional quality of the menu. The authors show that a blanket ban on additives incorrectly transfers the “harm” to all products containing them.
• Salt/sugar/fat as an "automatic" UPF label. The diet is assessed as a whole, not for a single product; recommendations for sugar and salt are daily, not "per unit of product". Transferring daily limits to the label is a methodological error.
• Place and scale of production. The home kitchen is automatically “healthier” than the factory: professional processes often have better control over safety and quality stability; most foodborne illness outbreaks occur outside of industrial production.

Why "Just Cook Everything at Home" Isn't Always the Option

Even if we assume that “minimally processed” is better, there is a practicality barrier: time, skills, equipment and money. USDA analyses show that menus composed primarily of minimally processed foods are more expensive, and attempts to replace the usual enriched bread/cereals with rarely used and more expensive grains (farro, quinoa) come up against budget and availability. For low-income families and busy people, the prohibitive interpretation of NOVA is hardly feasible.

What does this change for people and for those who write recommendations?

• For readers/consumers: Don't throw whole grains out of your diet because of the "processed" label. Look at the diet as a whole: do you have enough whole grains (≈45-50 g of whole grain per day - "minimum benefit" from reviews), do you have enough fiber, do you "eat" bread with sweet drinks and confectionery.
• For guide writers: “Avoid UPF” level formulations without exemptions for staple grains are methodologically flawed and counterproductive: they reduce compliance with whole grain and fiber recommendations. A more correct way is to have targeted restrictions on sugar/salt/fat, energy density and added sugars, as well as clear criteria for the whole grain content of breads/cereals. MDPI
• For science and policy. Categorization affects outcomes. In modeling and with different labeling (four systems), the same food data yielded different associations with diseases - so the method and definitions matter. We need standardized, nutrient-informed approaches, not "black and white" labels.

Limitations and context

This is a narrative review/positional analysis: it compiles the literature and critiques NOVA's assumptions, but does not conduct new randomized grain-versus-UPF trials. However, its main message is already useful today: whole-grain buns and sugary sodas cannot be equated just because they both fall into the same "ultra-processed" bucket. And if public policy is to embrace NOVA language, it needs exceptions and clarifications for the grains that are the basis of diets, and greater precision in the terms.

Conclusion

The "avoid UPF" slogan in its current form hits what is proven to be good for you - whole grains and fiber. Refocusing on diet quality, fiber content, and realistic recommendations is healthier than hunting for long lists.

Source: Jones JM Should Grain-Based Staple Foods Be Included in Admonitions to “Avoid Processed and Ultra-Processed Food”? Nutrients. 2025;17(13):2188. https://doi.org/10.3390/nu17132188