Are All Ultra-Processed Foods Unhealthy?

By: Monica Nagele

In recent years, ultra-processed foods (UPFs) have gained notoriety in nutrition. Although the classification of UPFs dates back to 2009, their prominence has only recently surged, largely due to the influence of social media. The critical question is whether all ultra-processed foods are inherently unhealthy.

To understand UPFs, we turn to the NOVA classification system, which categorizes foods based on the extent of industrial processing. This classification encompasses physical, biological, and chemical techniques applied post-harvest but pre-consumption.

NOVA classifies foods into four groups:

• Unprocessed and minimally processed foods (e.g., fruits, vegetables, meat, water)
• Processed culinary ingredients (e.g., oil, butter, sugar, salt)
• Processed foods (e.g., canned vegetables, canned fish, freshly baked bread)
• Ultra-processed foods (e.g., soft drinks, packaged snacks, candies, cereals, hot dogs, baby formula)

Critics argue that UPFs often elevate the intake of added sugar, saturated fat, trans fat, sodium, and energy density while reducing protein, dietary fiber, potassium, and phytoestrogens. These foods have also been linked to increased calorie consumption, obesity, cardiovascular diseases, type 2 diabetes, cancer risk, and depression.

However, in a notable study published in August 2023 in the Journal of Nutrition, titled “Dietary Guidelines Meet NOVA: Developing a Menu for A Healthy Dietary Pattern Using Ultra-Processed Foods,” researchers explored whether a high-UPF diet could align with US dietary guidelines. The menu consisted of 91% of calories from UPFs, with an average daily intake of 2025 kcal. Macronutrient distribution adhered to recommended ranges, with 22% protein, 54% carbohydrates, and 26% fat (with less than 10% from saturated fat and added sugar).

While the menu lacked some micronutrients (Vitamins D, E, and Choline), it met Dietary Reference Intakes (DRIs) for most others. Despite its UPF content, the menu scored 86 out of 100 on the Healthy Eating Index (HEI), surpassing the average HEI for Americans (57). The only shortcomings were excess sodium and inadequate whole grains.

This study emphasized that healthy dietary patterns can incorporate a substantial UPF share while maintaining diet quality and providing essential nutrients. Notably, the NOVA scale neglects nutrient content and food groups, unlike the Healthy Eating Index, which considers these factors. This raises the question of whether UPFs, when consumed thoughtfully, can be part of a healthy diet.

Although Americans are growing more cautious about processed foods, the overall Healthy Eating Index remains at 57, underscoring the importance of reading nutrition labels and making informed choices based on the content rather than catchy marketing terms. Perfection isn’t the goal; balance is.

Surprisingly, many foods, including yogurt, baby formula, high-fiber breakfast cereals, plant-based burgers, protein bars, tortillas, liquid egg whites, canned beans, oatmeal, whole wheat toast, canned fish, gluten-free pasta, rotisserie chicken, peanut butter, lunch meat, tofu, and soy products, are classified as UPFs according to the NOVA Scale.

In conclusion, while it’s crucial to be wary of high-fat, high-sugar, and high-salt foods like chips and Twinkies, snubbing UPFs may deprive us of nutritious and affordable options. The key is making informed dietary choices, considering nutrient content, and striving for balance. Rather than vilifying entire food groups, let’s focus on thoughtful choices guided by the available evidence. If you are interested in learning more, tune in to Bite-by-Bite Nutrition for Life podcast this month as we dig deep into the world of Ultra Processed Foods.

– Monica Nagele is the County Extension Director and educator of health and human science for the Montgomery County Purdue Extension.