P is for Processed Foods and U is for Ultra-Processed Foods

Simple, Practical, Science-Based Tips for a Long Healthy Life from Experts in Nutrition and Exercise Science

“What’s the difference between processed and ultra-processed foods?” That was the question on the minds of my fellow exercisers at the YMCA last week. I immediately thought there must be another study with alarming headlines warning against the dangers of processed foods. And, since I had just returned from a conference where the title of my talk was “Are Ultra-Processed Foods the Latest Dietary Villian: Understanding processed and ultra-processed foods, what we know, what we don’t know, and what the headlines get wrong.” I was ready to explain, but the aerobics class started so we had to stop talking!

About 15 years ago Brazilian researchers developed a new food classification system based solely on processing. This was a departure from classifying foods based on nutrients or food patterns. This system, called NOVA (NOVA is not an acronym) groups foods according to the nature, extent, and purpose of the processing, divides foods into four categories. Here’s the classification with examples of foods in each category.

Group 1. Unprocessed or minimally processed foods. This includes vegetables, fruits, grains, seeds, nuts, eggs, milk, animal protein. Minimally processed foods preserve natural foods for storage or food safety. These might be thought of as the original whole foods.

Group 2. Processed culinary ingredients. This group includes oils, butter, vinegars, sugar, and salt. They are not meant to be consumed by themselves and are normally used in combination with Group 1 foods to make freshly prepared dishes at home or in a restaurant.

Group 3. Processed foods. Examples are cheese, fresh breads, canned or frozen vegetables and fruits, canned fish, smoked or cured meats, bacon, salted nuts, beer, and wine. Processed foods usually have two or three ingredients which are edible by themselves or used in combination with group 1 and 2 foods. Processing is used mainly for preservation.

Group 4. Ultra-processed foods. This groups includes soft drinks, sweet or savory packaged snacks, pre-pared frozen or packaged dishes, cereals, and plant-based meat and dairy substitutes. Many of the ingredients in ultra-processed foods are derived from food additives and include nutrients extracted from foods such as whey, casein, soy, lactose, or gluten and include colors, dyes, and additives to improve the taste and sensory qualities of the item. Generally ultra-processed foods are high in sugar, salt, and fat and the ingredients used to make these foods are not found in a home kitchen. According to some estimates, 60% of our calories come from ultra-processed foods.

A little quiz. Which of the following are classified as ultra-processed based on the NOVA categories?

1. Oat milk
2. Tofu
3. Candy
4. Soft drinks
5. Infant formula
6. Whey protein powder

The answer is all of the above! Which is why I encourage you to look at nutrients in a food, not just processing.

Using NOVA criteria, my usual breakfast of Cheerios, Fiber One, Fairlife ultra-filtered milk and frozen blueberries contain three-fourths ultra-processed foods and one processed food. (Disclosure, I am not a brand spokesperson or paid by any of the companies that make these foods…. I just like them.)

The most cited study on ultra-processed foods found that when ultra- processed foods were eaten more calories were consumed with weight gain as the result. The study of 20 adults who lived in a controlled research unit, were given a diet high in ultra-processed foods or unprocessed foods. They were given meals of equal calories of either ultra-processed or unprocessed foods. They could eat as much or as little as they wanted at mealtimes. The group eating the ultra-processed foods ate about 500 calories more than when they were given the unprocessed food diet. During the ultra-processed diet phase, average weight gain was a couple of pounds, whereas participants lost a couple of pounds when eating the unprocessed foods. Why this is so remains unclear, but people speculate that the ultra-processed foods are tastier, are eaten more quickly, or alter the hunger and satiety hormones.

On the other side, researchers recently published a paper showed that a carefully selected meal pattern with more than 80% of the calories coming from ultra-processed foods could be included in a healthy meal plan and still receive a high diet quality score. This paper was a modeling study and was not studied for its effect on health outcomes, but it showed that UPF can contribute to a nutrient-rich meal plan.

The part that makes all this confusing to consumers is the adoption of the many plant-based options on the market today. I dare say all of them…. from Impossible or Beyond Meat Burgers to oat milk to whey and soy protein powders are classified as ultra-processed yet most people would consider them healthy options.

So, how do we make sense of it? Do we have to give up processed and ultra-processed foods and make all meals from scratch? For some, that might be an option, but for many with limited access to fresh foods, working parents with hectic schedules, busy students, or those on limited budgets who depend on convenience packaged foods, it is not easy to a eat a diet of all unprocessed foods.  

What Does It Mean For You?

• Not all foods categorized as ultra-processed are created equal. Focus on the nutrients, not the processing.
• All the research, except for the one study cited above, are observational studies meaning that they show ultra-processed food consumption is linked to an increased risk of disease….it doesn’t show that they cause health problems.
• Don’t think that organic packaged foods are unprocessed. Organic is an agricultural practice, not a health claim. An organic cookie is still a cookie.
• Any food containing concentrated protein from soy, pea, or wheat is classified by NOVA as ultra- processed, so a scoop of protein powder added to a smoothie is classified as ultra-processed. Again, think about nutrients, not processing.
• For older adults who are trying to get needed protein (older adults should aim for about 25 grams of protein per meal), adding a scoop of protein powder in a smoothie (be it whey, soy, or pea protein), is an efficient way to get protein without excess calories. For those whose appetites are low, protein powder provides nutrition in a small portion size.
• Don’t fall for the “natural” is better sentiment. Most foods in our modern diet are processed and have been for centuries so it is unrealistic to eliminate all processed foods. Processing improves shelf life, food safety, and enhances nutrient content of many foods. It also helps prevent food waste.

Lastly, don’t let the headlines scare you. As Dr. Steven Novella, a Yale researcher and science communicator says, “making big diet recommendations on observational or preliminary data causes ‘alarm fatigue’ in the public. If every week they are hearing about another thing they are supposed to avoid it all becomes impossible to manage.”

In our last post, I promised to write about C is for Culinary Herbs but I got sidetracked with the processed food question. So, stay tune for that one!

Dr. Chris Rosenbloom and Dr. Bob Murray, co-authors of Food & Fitness After 50, use their expertise and education in nutrition and exercise to translate science into easy-to-digest bites to inform and enlighten readers on all things healthy aging. Chris, a nutrition professor emerita, a registered dietitian, and a gerontologist, and Bo, an exercise physiologist, researcher, and hydration expert, believe it is never too late to eat well, move well, and be well.