Ultra-processed foods: what they are and how to live with them without panicking

Ultra-processed foods (UPF according to Nova) are food from an industrial “laboratory”: in addition to the usual ingredients, they often contain additives that you don’t use at home – emulsifiers, flavor enhancers, flavorings, sweeteners, modified starches, etc. Thanks to processing, such products last longer, are cheaper, and seem tastier – it’s no wonder that in the US people get more than half of their calories from them. The study was published in the journal Circulation.

Why are doctors sounding the alarm?

Large observational studies show that the more UPF in the diet, the higher the risk of obesity, type 2 diabetes, cardiovascular disease, and death. And it's not just sugar, salt, and saturated fat:

• Energy density and “hyper-delicacy” speed up the meal and imperceptibly increase calories.
• The destruction of the food “matrix” (refining, grinding) changes absorption: glucose surges – more hunger.
• Additives and packaging can influence microbiota and metabolism; UPF consumers have higher markers of exposure to bisphenols, phthalates and microplastics.

In RCTs where calories/salt/sugar/fiber were matched, the UPF menu still resulted in more spontaneous overeating.

But not everything is black and white

UPF is an umbrella, and under it are different foods. Most of them are outright junk (sweet drinks, candies, cookies, chips, sausages, refined snacks). But there is also a narrow group of accessible UPF with a decent composition: some whole grain breads, unsweetened yogurts, sugar-free tomato sauces, nut and bean pastes. They cannot be automatically equated with harm.

Practice for the common man

• Cut out the obvious junk UPF. Sugary drinks, processed meats, sugary baked goods, and chips are the first to go.
• Fill your plate with “real” foods: vegetables, fruits, whole grains, legumes, nuts/seeds, fish/seafood, vegetable oils; optionally, low-fat dairy, poultry, and meat.
• When choosing “convenient” products, read the ingredients: less sugar/salt/saturated fat, more fiber, short list, no “cosmetic” additives for the sake of appearance/taste.
• Minimum guideline: It is useful to keep the UPF share low. A number of studies hint at a threshold of ~10–15% of calories (or ≤2 servings per day), but the exact boundaries are still being clarified.
• Cook “semi-home”: The “pre-made + whole ingredients” mash-up strategy (e.g., bag of frozen trail mix + beans + olive oil + spices) helps reduce your UPF without spending ages at the stove.

What should systems do?

The Association of Cardiologists suggests not demonizing everything, but prioritizing:

• Policies: Front labeling and taxes on foods with excess sugar/salt/saturated fat, restrictions on aggressive marketing to children.
• Industry: reformulation (less sugar/salt/fat, clear ingredients), transparency on additives and processing technologies.
• Science: more mechanistics (contribution of additives, texture, packaging), better nutritional accounting (databases that show additives and degree of processing), modernization of food additive oversight.

What is still unclear

• Which UPF subgroups are the most harmful and which are neutral/beneficial?
• Is there a safe “threshold” for UPF and is it the same for different population groups?
• How much harm is explained by additives and technology, not just nutrients?

Authors' comments

• Not “ban everything ultra-processed.” The main goal is to reduce HFSS-UPF (high sugar/salt/saturated fat) and replace them with mostly minimally processed foods.
• There is a narrow “allowed” window. A small proportion of available UPFs with a decent nutritional profile (some whole grain breads, unsweetened yogurts, sauces, spreads) can remain in the diet - with monitoring and reformulation if necessary.
• Nova is useful but not sufficient. A policy-friendly definition of UPF is needed: degree of processing + nutritional profile + consideration of “cosmetic” additives and ingredients “outside home cooking.”
• Mechanisms go beyond nutrients. Matrix breakdown of food, hyperattractiveness and speed of eating, additive/packaging effects, and microbiota all play a role—direct mechanistic studies are needed.
• The threshold is a working hypothesis. A UPF proportion of ~10–15% of calories (≈≤2 servings/day) seems a reasonable guideline, but needs to be confirmed prospectively.
• Equity and access. Policies should not worsen nutrition security: in parallel with HFSS-UPF restrictions, ensure accessible, culturally acceptable healthy food and curb aggressive marketing to children and vulnerable groups.
• Additive regulation is outdated. Modernization of FDA oversight is needed: re-evaluation of GRAS, mandatory reporting of additives and their quantities; in the meantime, the precautionary principle for additives of public risk.
• Policy instruments. Front labelling and fiscal measures - on HFSS-UPF; stimulate industry reformulations and development of databases/metrics of the degree of processing (including with ML).
• Act now. There is enough evidence of the harm of HFSS-UPF to take immediate action, while clarifying the grey areas of “quality” UPF to avoid making erroneous or harmful decisions.

Conclusion without hysteria

It's not the "ultra-processed" label that's important, it's the quality of the diet. Cut down on the obviously harmful UPFs, focus on whole foods, and keep a small portion of the "convenient" processed foods to a reasonable amount of options. It's a realistic strategy that actually reduces heart and metabolic risks.