RIIIING, the alarm goes off, it’s Monday, I have a packed day, full of commitments.
It’s summer, it’s hot, I don’t feel like cooking.
Yesterday, Sunday, I took the chance to relax a bit with my family, but I forgot to do the grocery shopping.
Today, the day hasn’t even started, and I’m already late.
I pour my plant-based drink into the cup, add two spoonfuls of red berry granola; meanwhile I turn on the air fryer and cook the only things left in my empty fridge: a plant-based burger and half an eggplant cut into chunks. I then fill my meal box and add a few crackers to my backpack.
It’s mid-morning, I’m at work, I take the chance for a break and scroll through Instagram.
There’s a post from REFOOD. It talks about the NOVA classification and processed foods.
Reading it, I realize I used ultra-processed products for the two meals I prepared today. Will they harm me? Am I doing everything wrong?
The answer isn’t so obvious; today let’s see how to manage them without going into a panic.
If a food is ultra-processed, does that automatically mean it’s harmful?
An ultra-processed food is not automatically harmful; however, scientific evidence indicates that a dietary pattern high in ultra-processed foods (UPF) is consistently associated with adverse health outcomes. The issue is very nuanced, since the health impact depends on the type of product, the amounts and frequency of consumption, as well as the overall dietary context.
Are all ultra-processed foods the same?
A series of articles published in the scientific journal The Lancet highlights how the NOVA group 4, that is, the one that contains ultra-processed products, is extremely heterogeneous. Not all UPFs are the same: group 4 of the NOVA classification is extremely broad and includes products with very different nutritional profiles, some of which (yogurt, whole grain cereals, packaged bread) are better than others (sugary drinks, snacks, reconstituted meats). However, regardless of the subgroup, the minimally processed version of a food is generally preferable to its ultra-processed counterpart.
A critical review of the NOVA system highlighted that its binary nature (ultra-processed vs non-ultra-processed) does not take into account nutritional composition, the benefits of fortification, and cultural food traditions, creating inconsistencies in classification: indeed, according to scientific evidence, sugary drinks are consistently associated with adverse outcomes, while fortified cereals and some dairy products show neutral or protective effects.
The new expert opinion from the American Heart Association explicitly points out that some whole-grain ultra-processed products, low-fat dairy products, and commercial plant-based foods can be part of a healthy diet.
Speaking of this, we often come across plant-based ultra-processed products on supermarket shelves; how can we assess their quality? If you’re interested, I invite you to read the dedicated article.
A study compared four food product classification systems — including NOVA — to analyze the health effects of certain foods, reaching similar conclusions; all classification systems confirm that certain ultra-processed products are linked to lower nutrient quality, certain social groups, and risks to heart and metabolic health. However, the authors reiterate the need for a standardized and more nuanced classification system.
To this end, alternatives to the NOVA system have been proposed, such as the PFI (Processed Food Intake) classification, which classifies different products based on possible different chemical engineering actions; however, it is not a tool capable of providing an overall judgment and, having been proposed in 2025, it still lacks evidence in practical application.
In conclusion, the question “are all UPFs the same?” receives an unequivocal answer from the literature: no, and treating them as such risks producing imprecise nutritional recommendations, potentially counterproductive and socially unfair. The future challenge is to develop classification systems that integrate the degree of processing with nutritional quality.
Why have ultra-processed foods ended up at the center of scientific debate?
Ultra-processed foods are at the center of scientific debate because much evidence consistently associates them with an increased risk of chronic non-communicable diseases, mental disorders, and all-cause mortality. Because of these health effects, scientific societies such as the American Heart Association (AHA) and the European Society of Cardiology (ESC) have formulated specific recommendations to reduce their consumption.
A 2024 systematic review, published in the British Medical Journal, identified direct associations between the consumption of ultra-processed foods, particularly for cardiovascular mortality, obesity, type 2 diabetes, anxiety disorders and common mental disorders.
Another 2025 systematic review, published in The Lancet, confirmed a positive association between an ultra-processed dietary pattern and the risk of chronic diseases.
Beyond purely clinical data, global prevalence also explains the growing attention: in the US and in the United Kingdom, consumption of ultra-processed foods can approach 70% of daily caloric intake, contributing up to 14% of premature mortality depending on the country.
Given that the food industry always tries to keep up with the times, in recent years the plant-based offering has been enormously expanded; this is certainly good news, even though very often these products are ultra-processed and lose many of the advantages of their original nutritional profile, while also acquiring notable disadvantages. How can we recognize them and possibly limit them? If you’re interested, I invite you to read the dedicated article.
Is the degree of processing the only thing that matters?
The degree of processing, essential in the NOVA classification, is an essential element in evaluating a food.
As shown by an analysis conducted on data collected over twenty years, food processing adds an independent risk beyond nutrient composition. Some studies indeed suggest that the degree of processing may contribute to the observed associations even beyond the nutritional profile, although it remains unclear how much of this risk is attributable to processing itself, how much to nutritional quality, and how much to their interaction.
Another important key concept lies in the food matrix — that is, the physical and chemical structure of the food, which determines how nutrients are released, digested and absorbed.
As highlighted by one of the most important systematic reviews on this topic, industrial processing can destroy the original matrix of the food, leading to the breakdown of fibers and plant cell walls and the loss of bioactive compounds (polyphenols, carotenoids, phytosterols).
Beyond the damage at these levels, industrial processing introduces potentially harmful elements that do not appear in the conventional nutritional profile: cosmetic and functional additives, process neoformed compounds — acrylamide, polycyclic aromatic hydrocarbons, advanced glycation end products (AGEs) generated by high-temperature cooking, packaging contaminants — phthalates, bisphenols, PFAS that migrate from packaging into the product.
However, experts in the field are not unanimous in establishing that health damage should be attributed exclusively to processing itself, and some point mainly to the unfavorable nutritional profile of this category of products.
In fact, as this scientific article points out, when analyzing ultra-processed foods by subcategory, sugary drinks and reconstituted meats drive most of the negative associations, while packaged whole grain cereals and dairy products show neutral or protective effects — a finding that reflects differences in nutritional composition rather than degree of processing.
So, in conclusion, the degree of processing is not the only thing that matters, but it plays an important role in synergy with the nutritional profile; neither fully explains the observed associations, as also acknowledged by the European Society of Cardiology.
Can we evaluate a food without considering the entire diet?
A single food cannot be meaningfully evaluated without considering the overall diet; as proposed by Jacobs and colleagues, with the concept of food synergy, no food is good or bad on its own; the health impact depends on how it’s made, how often you eat it, what it replaces, and what you put next to it on the plate.
The reductionist paradigm — which reduces foods to the sum of their nutrients — has contributed to confusion in nutritional communication and has led to the demonization or exaltation of single nutrients (cholesterol, saturated fats, gluten) without considering the food context.
For example, numerous trials on isolated nutrients (such as vitamin supplements) have produced null or even harmful results for health, while the same nutrients consumed within whole foods show benefits.
Replacing one nutrient with another in the diet, at equal calories, can significantly change the effect on health; for example, replacing part of caloric intake from saturated fats with polyunsaturated fatty acids reduces the risk of coronary heart disease, but replacing it with refined carbohydrates produces no benefit. Similarly, the isocaloric substitution of 5% of animal protein with plant protein is associated with a significant reduction in total and cardiovascular mortality.
The holistic evaluation of the diet captures the interactions between foods and nutrients that studies on single components cannot capture.
Meta-analyses of dietary patterns such as the Mediterranean diet, the DASH diet and the Planetary Health Diet show consistent reductions in total and cardiovascular mortality (up to 20-28%).
Even meal frequency and timing influence cardiometabolic outcomes. Eating frequently at different times, without proper attention and planning, is a behavior riskier for cardiovascular health; furthermore, in a nutritional assessment it is superficial to consider only the meals of the last 24 hours; one should evaluate the quality of the entire overall diet.
The recommendation that emerges from the literature is to shift the focus towards the overall dietary pattern, favoring food variety, minimally processed products and synergistic combinations.
So should ultra-processed foods always be avoided?
Although the evidence is robust in linking dietary patterns high in ultra-processed foods to adverse outcomes, the answer most consistent with the complexity of the topic is nuanced and takes into account the heterogeneity of the category, the socioeconomic context, and the overall diet.
As already stated previously, not all UPFs are harmful, and we need to distinguish which of them can be part of a healthy diet.
Moreover, analyzing the issue only from a nutritional point of view is reductive, since it is also a socioeconomic problem.
Ultra-processed foods are often the most accessible option for populations with economic, time, and culinary infrastructure constraints.
Recommending absolute avoidance without addressing these structural inequalities risks blaming those with fewer resources and being clinically inapplicable, but the population must be educated to enable everyone to make an informed choice.
The most balanced position to take toward these products requires three actions: reduce the overall share, differentiate between the various subgroups, don’t demonize.
So let’s learn to evaluate the overall picture with a bit of method, analyzing five key aspects:
- The nature of the product: is it really an ultra-processed food, or simply a processed product that can make our life easier?
- The nutritional profile: what does it actually contain in terms of fat, salt, fiber and protein?
- Frequency: is it an exception due to a rough Monday, or a constant throughout our week?
- Substitution: what are that plant-based burger and those crackers taking the place of? A carefully prepared home-cooked meal, or a skipped meal altogether?
- The overall context: how does all this fit into our overall diet and lifestyle?
Health isn’t determined solely by a single emergency meal, but day after day. And the good news is that, with awareness, there’s always room for an off Monday.
