Processed and Ultra-Processed Foods

Processed foods and ultra-processed foods (UPFs) have been buzz words in nutrition and health discussions in the last decade and even more recently. Reducing ultra-processed foods is something I encourage all my patients to do for improving overall health, but what does that actually mean and how do we do that? Let’s talk about it.

What exactly are processed foods?

The definition of a processed food is any food that is cooked, seasoned, preserved, or combined with other foods, or is altered from its raw state. That’s pretty broad. That could be something as minimally processed as a pre-cut vegetable, to pasteurized milk, to the bread we buy at the grocery store, to the flour that has been milled to make the bread we buy at the grocery store…you see where I am going with this.

Ultra-processed foods are industrially manufactured foods that contain little or no whole foods and are often high in added sugars, fats and sodium. They include items such as ready-to-eat meals, snacks, and sugar-sweetened, and artificially sweetened beverages. “Frankenfoods” if you will.

But how do we define the degree to which a food is processed?

Right now, there is little consensus on that, but there are a few groups that have tried to do so. Currently there are multiple different food classification systems based on food processing. The most utilized classification system worldwide is the NOVA classification system, which was developed by researchers from the Centre for Epidemiological Studies in Health and Nutrition at the School of Public Health, University of São Paulo in Brazil and was updated in 2015. Currently, due to the lack of consistency in defining what constitutes a processed food and the degree of processing, the research can vary as to the specific health outcomes of consuming them.

A large portion of the foods we eat day to day are processed in some way. The degree in which a food has been processed is certainly something to consider, but also, what happens to the foods during and after processing. Are there any changes to the nutrient content of the food? What types of ingredients are added to the food to make it what it is and why? Do the benefits of a particular food outweigh the negatives of one of the ingredients? There are many good reasons for us to have some processing in our food system – food preservation, convenience, fortification with certain vitamins or minerals that are lacking in specific populations, but there are also some drawbacks to processing – reduction in nutrient content, addition of sugar and salt, addition of unhealthy oils, and hyperpalatability, to name a few.

The NOVA classification system breaks down food into 4 groups based on the level of processing:

• Group 1 - Unprocessed or minimally processed foods (fruit, vegetables, eggs, meat, milk, etc.)

• Group 2 - Foods processed in the kitchen with the aim of extending their shelf life. In practice, these are ingredients to be used in the kitchen such as fats, aromatic herbs, etc. to be kept in jars or in the refrigerator to be able to use them later.

• Group 3 - Processed foods. These are the foods obtained by combining foods of groups 1 and 2 to obtain the many food products for domestic use (bread, jams, etc.) made up of a few ingredients.

• Group 4 - Ultra-processed foods. They are the ones that use many ingredients including food additives that improve palatability, processed raw materials (hydrogenated fats, modified starches, etc.) and ingredients that are rarely used in home cooking such as soy protein or mechanically separated meat. These foods are mainly of industrial origin and are characterized by a good pleasantness and the fact that they can be stored for a long time. (1)

The question is, is it merely the fact that the food is processed or the poor dietary quality of the processed food itself that causes the negative health outcomes?

I think the research is pointing to the latter. There is a general consensus in the research of a few truths:

1.      Many ultra-processed foods contain refined carbohydrates causing rapid spikes in blood sugar and insulin levels, which can lead to insulin resistance, changes in hormones that control appetite, inflammation, diabetes and heart disease.

2.      Many ultra-processed foods contain unhealthy oils and fats that can increase inflammation, elevate cholesterol levels, and contribute to development of heart disease.

3.      Ultra-processed foods contain high amounts of sodium. According to the American Heart Association, more than 70% of the sodium we eat comes from processed and restaurant foods. Overtime, high sodium diets can lead to high blood pressure, heart disease, stroke, and kidney damage. It also contributes to water retention and weight fluctuations.

4.      Numerous studies have shown that ultra processed food consumption leads to increased daily calorie consumption. A 2019 National Institutes of Health study found that individuals consuming ultra-processed foods tended to overeat and gain more weight compared to those consuming minimally processed diets. Both groups were given three daily meals and were instructed to consume as much or as little as desired. The meals were designed to be well matched across diets for total calories, macronutrients, fiber, sugars, and sodium. They found that those consuming the ultra-processed foods consumed an average of 500 calories more per day and their diets were higher in carbohydrates, sodium and fat and lower in fiber. (2)

5.      Studies have also linked higher ultra-processed food consumption with increased risk of depression, most likely due to low nutrient quality of these foods and the effects of ultra-processed foods on the gut microbiome. (3)(4)

6.      Research also shows that ultra-processed foods are associated with increased risk for certain types of cancer, primarily hormone and GI-related cancers, due to their poor nutritional quality (i.e. lacking vitamins, minerals, and fiber), increased risk for obesity, and high content of unhealthy additives. (5)

So what do we do?

When thinking about reducing or avoiding processed foods, my recommendation is to focus on reducing specifically, the ultra-processed foods, which are most strongly correlated with negative health outcomes and, as always, to lean on the idea of overall balance and moderation.

I can’t give you a magic number of ingredients that your food should have or not have. I am not going to say, “Only eat foods with less than 7 ingredients.” That doesn’t make any sense. However, I think it is safe to say that as a rule, if you can choose foods without a laundry list of ingredients and you can recognize most of the ingredients in the food you are choosing, that is a good place to start.

However, there are a couple key ingredients I do recommend specifically to look for and try to reduce.

1.      High fructose corn syrup – Chemically processed in a lab, this sweetener is made from corn starch that gets processed into corn syrup, which is a simple sugar known as glucose. Then, enzymes are added that convert some of the glucose into another type of sugar called fructose. It becomes a liquid that is added to all kinds of packaged and processed foods. It is cheaper, sweeter, and more shelf stable than sugar. Overconsumption of fructose through ingestion of HFCS has been associated with increased risk for obesity, insulin resistance, metabolic disfunction, inflammation, high triglycerides, and development of fatty liver. (6)(7) This is not to be confused with naturally occurring fructose you get through eating fresh fruit, which has not been associated with the same health issues. It would be incredibly difficult to eat enough fruit in your diet to result in overconsumption of fructose from fresh fruit vs the overconsumption we see through a diet that is comprised of regular intake of ultra-processed foods. Bottom line – it is helpful to reduce added sugars in your diet coming from all types of sugar. The recommendation is to try to eat <28g per day of added sugars. HFCS, in particular, has been linked to increased risk of negative health outcomes and it is one of the ingredients I would encourage you to try to work to reduce in your overall diet.

2.      Hydrogenated or partially hydrogenated oils – These are trans fats. They are made through a chemical process in which an unsaturated fat (liquid fat) undergoes hydrogenation (addition of hydrogen), which makes it more solid.  Restaurants use these fats to deep fry foods because they can be used over and over again in commercial fryers. Food companies add trans fats to foods to increase shelf life and improve the taste and texture of their products. Trans fats raise your “bad” cholesterol (LDL-C) and lower your “good” cholesterol (HDL-C). They are also associated with increased inflammation and increased risk for heart disease and diabetes. Be careful when reading nutrition labels. According to current guidelines, a company can list a food as 0g Trans Fat if it contains <0.5g trans fat per serving. It is important to read your ingredient lists and look specifically for hydrogenated or partially hydrogenated oils. Reducing the frequency in which you dine out and how much fried food you have can also reduce trans fats in your diet. (8)

With all of this being said…foods are not something to be feared, even those with less healthy ingredients. I would be extremely suspicious of anyone who claims that any food is “poison” to your body or any particular food or food additive is going to kill you or be the sole reason you are having a difficult time with your weight or managing your health. With the exception of extreme food allergies, or food borne illnesses, this is just simply not the case. It is our cumulative dietary choices that make the most difference in our health. That is, it is what you do most of the time that matters. If you aim to, most of the time, eat whole foods that are minimally processed, you will reap the benefits. If you, most of the time, eat foods that are ultra processed and dine out regularly, you could be putting yourself at risk for these various health consequences and stifling your progress toward your health goals.

My best advice?

If you want to have an (insert ultra processed food here), have it. Slow down while you eat it, savor the flavor, the texture and mouthfeel. Take the time to really enjoy it. You may find you like it as much as you thought you did and can continue to enjoy it as part of your healthy, flexible diet. You may even find you are satisfied with less of that food because you took the time to enjoy it. Or, you may find you actually don’t like it as much as you thought you did and can put it on the mental list of foods you don’t really enjoy. Often times, when we have labeled a food as “bad” we tend to eat it quickly, like we’re doing something wrong, and not savor it. This doesn’t allow us to really tap into our senses and make a full assessment of the food and our body’s response to it, both emotionally and physically. I think you’ll be surprised if you try this a few times with some of your favorite “sinful” foods.

Also, I am a big fan of promoting health through addition rather than restriction. Instead of thinking about what you shouldn’t or cant have, lets think about what we could eat more of. It is a mental game, but research shows restriction backfires so by focusing on addition, it can be a really helpful place to start.

Tips to help you reduce packaged and ultra-processed foods:

1.      Prioritize whole foods. Fresh fruits and vegetables most often don’t come with food labels because they are one, whole ingredient. Prep your fruits and veggies for the week to make them easy to pack for snacks and to cut down on prep time when cooking.

2.      Practice meal planning and prepping. This helps to reduce the need to grab more ready-made, more processed foods, by planning your meals and snacks ahead of time. I have a whole blog post with helpful tips for meal planning here.

3.      Take your time in the store and read your nutrition labels. Sometimes, even just taking the time to pick up a few more bottles or boxes of (insert food here) can help you find a better option that has less ingredients and additives that will work for you. Once you find the products you like, it is easy to know what to grab moving forward.

4.      Pair your more unhealthy choices with healthier ones so you can eat less, but still feel satisfied and eat the foods you love. You love Cheetos? The next time you have them, create a little charcuterie board with a small amount of Cheetos, grapes, cheese, cucumbers and hummus.

5.      Create your own salad dressings. Store bought dressings can be chalk full of unnecessary ingredients and it is unbelievably easy to make your own.

6.      Find copycat recipes online for your favorite restaurant items – if you make it in your own kitchen, you have the control over what goes into it.

If you need help with learning more about nutrition label reading, figuring out your calorie and macronutrient needs, meal planning, goal setting and anything else health and nutrition related, click here to schedule a visit with us today!

Best of health,

Elise Smith, RD, LRD, CPT

Registered Dietitian and Certified Personal Trainer

References:

1.      Morea, Nicola. “Ultra‑Processed Foods: NOVA Classification.” Regulatory Mérieux NutriSciences, 25 Mar. 2021, regulatory.mxns.com/en/ultra-processed-foods-nova-classification.

2.      Hall, Kevin D., et al. “Ultra‑Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake.” Cell Metabolism, vol. 30, no. 1, 2 July 2019, pp. 67–77.e3, doi:10.1016/j.cmet.2019.05.008.

3.      Adjibade, Mireille, et al. “Consumption of Ultraprocessed Food and Risk of Depression: A Cohort Study.” JAMA Network Open, vol. 6, no. 9, 2023, p. e2809727, doi:10.1001/jamanetworkopen.2023.09727.

4.      Zheng, Liwen, et al. “Ultra‑Processed Food Is Positively Associated With Depressive Symptoms Among United States Adults.” Frontiers in Nutrition, vol. 7, 2020, article 600449, doi:10.3389/fnut.2020.600449.

5.      Chen, Yujie, et al. “Ultra‑Processed Food Consumption and Cancer Risk: A Systematic Literature Review.” Clinical Nutrition, 2023, doi:10.1016/j.clnu.2023.02.048.

6.      “High Fructose Intake and the Route Towards Cardiometabolic Diseases.” Clinical Nutrition, 2020. PubMed, https://pubmed.ncbi.nlm.nih.gov/32800834/.

7.      Bellissimo, Natalie, Paolo A. di Bonito, and Nahomi Tsuboyama-Kasaoka. “The Negative and Detrimental Effects of High Fructose on the Liver.” Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, vol. 12, 2019, pp. 207–217. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549781/.

8.      American Heart Association. “Trans Fats.” Healthy Living: Healthy Eating, American Heart Association, n.d. Web. 11 June 2025.