Do you really know what’s in the food you eat? Or are you just being seduced by claims about its healthiness?

In the UK and US, around half of the average diet consists of ultra-processed food, known in the food industry as UPF. This food is produced using multiple industrial processes, often involving breaking down the original food substance completely, and then recombining it in new ways. This food often tastes good—but there is growing evidence that it is harmful for health.

This is a problem, because this food doesn’t (yet) come with a health warning—and it’s not always easy to identify. This page explains more about ultra-processed foods, and provides some clues to help you identify and avoid these substances.

What is Ultra-Processed Food?

What do we really mean by the term ‘ultra-processed food’?

In 2019, a group of scientists published a proposed classification system for foods that they called the NOVA system. This approach classifies foods into four groups by the level of processing that they have undergone:

NOVA Group	Description
Group 1: Unprocessed and minimally processed foods	These are foods that are either unprocessed, or have undergone simple processes such as drying, grinding, roasting, boiling or the removal of inedible or unwanted parts. The key is that these processes do not add anything to the original food. The main purpose of this processing is to extend the life of foods such as grains, legumes, vegetables, fruits, nuts, milk, and meat. This means that they can be stored for longer, or prepared more easily for use. Examples include meat, milk, eggs, fruit and vegetables (including fresh, frozen and dried), flour, plain yoghurt, mushrooms and grains such as couscous or rice.
Group 2: Processed culinary ingredients	These are substances that are obtained directly from unprocessed or minimally processed foods, or direct from nature. They include oils and fats, sugar and salt. They are created using industrial processes such as pressing, refining or mining. Their main use is for preparing, seasoning and cooking of other foods, especially the minimally processed foods in Group 1.
Group 3: Processed foods	These foods are created by combining substances from Group 2 with foods from Group 1. They may then be processed further by preserving them in some way, for example, by canning or bottling, or changed by processes such as fermentation. The purpose of this type of processing is to make foods last longer, and also make them more enjoyable to eat. Examples include freshly baked bread, cheese, tinned fruit and vegetables, smoked fish and salted nuts. Many of these substances are sold as processed foods, but they are also foods that you could make at home if you wanted to do so.
Group 4: Ultra-processed foods	These foods are made from ingredients that are largely created by industrial processes, usually involving several different steps. Processes involved in manufacturing ultra-processed foods include breaking down whole foods into their constituent parts, including sugars, oils and fats, proteins, starches and fibre. These substances then undergo further processing, before being reassembled into ‘food’, with the addition of colours, flavourings and other additives. These foods contain very few whole-food ingredients or foods from Group 1 or 3, although they may contain some substances from Group 2. Examples include packaged snacks, especially flavoured ones, biscuits, cakes, chocolates, sweets and fizzy drinks.

Source: Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J. C., Louzada, M. L., Rauber, F., Khandpur, N., Cediel, G., Neri, D., Martinez-Steele, E. and Baraldi, L. G. (2019). Ultra-processed foods: what they are and how to identify them. Public Health Nutrition, 22(5), 936–941.

It is important to understand that we have been eating foods in the first three groups for many thousands of years.

Our ancestors understood about preserving foods using salt (for example, hams) or sugar (for example, jam or chutney), or by fermenting them. However, ultra-processed foods are a relatively recent addition to our diet—and some scientists now argue that they shouldn’t even be called foods at all.

The real problem is that these ultra-processed foods are cheap to make and expensive to buy. They therefore maximise the profits of food companies. These companies therefore have an incentive to design them to be so much more palatable than the unprocessed or less processed alternatives that we all stop eating the alternatives and simply focus on the ultra-processed foods.

Unfortunately, that’s not necessarily the best outcome for our health.

Identifying Ultra-Processed Foods

How can you recognise ultra-processed foods?

You can recognise some ultra-processed foods simply by the category or nature. Some obvious examples include fizzy drinks, packaged snacks, sweets and chocolate, ice cream, chicken nuggets, biscuits and cakes, sausages and burgers, and many ready meals.

However, there are many others that may be less obvious, including flavoured yoghurts, milk drinks and fruit drinks, many breakfast cereals (though not Shredded Wheat or Ready Brek) and cereal bars, and much baby food.

Surprisingly, many ‘organic’ versions of foods that are ultra-processed, such as ketchup and baked beans, are often NOT ultra-processed. Flavoured snacks are almost always ultra-processed, but plain salted snacks, including both crisps and nuts, are often not.

There is no safety in vegan or vegetarian diets, either. Vegan alternatives to meat, including tofu, mushrooms and beans, are not ultra-processed. However, ‘fake meat’ and vegan cheese are both ultra-processed.

It is therefore worth looking beyond categories, and into the ingredients list.

The group that developed the NOVA system suggested that ultra-processed foods contain two key categories of ingredients:

1. Food substances that are not generally used in home cooking

   These include varieties of sugar (for example, fructose, ‘fruit juice concentrates’, dextrose and maltodextrin), modified oils (generally labelled hydrogenated or interesterified oils) and protein sources (for example, hydrolysed protein, soya protein isolate, or whey protein). These are often found at the beginning or in the middle of the ingredients list, suggesting that they make up quite a large proportion of the weight of the product.

2. Additives that are included to make the final product taste or seem better in the mouth

   These are known as cosmetic additives, and include flavours, flavour enhancers, colours, emulsifiers, sweeteners, thickeners and other agents. These are almost always at the end of the ingredients list, because they are added in small quantities by weight.

   If there are large numbers of ingredients that your grandmother wouldn’t have recognised or used in her kitchen, you can be fairly certain that you are looking at an ultra-processed product.

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Ultra-Processed Foods and Health

We may only have been consuming ultra-processed foods for a relatively short (evolutionary) period of time.
However, the evidence is already building up to show that it is really bad for our health. For example:

• Ultra-processed food significantly raises the risk of heart attacks, stroke, high blood pressure and heart disease

  One study tracked 10,000 women over 15 years, and found that those who ate the highest proportion of ultra-processed food were nearly 40% more likely to develop high blood pressure than those who ate the lowest proportion. Worryingly, this was found to be true even after adjusting for the effect of salt, sugar and fat—which suggests that it is not the level of these that is the problem with ultra-processed food.

  Another study was a meta-analysis of studies involving more than 325,000 men and women. It found that people who ate the most ultra-processed foods were 24% more likely to experience cardiovascular problems such as strokes, heart attacks, and angina. The study found that if you increase your consumption of ultra-processed foods by just 10%, your risk of having heart disease goes up by 6%.

• Ultra-processed food is also linked to a higher risk of developing and dying from cancer.

  A study from Imperial College, London examined the UK Biobank records to explore the diet of 200,000 middle-aged adults.

  Over a 10-year period, eating more ultra-processed food was associated with a higher risk of developing cancer overall, and especially ovarian and breast cancers. It was also associated with a higher risk of dying from cancer, especially breast and ovarian cancers. The link was especially stark for ovarian cancer: a 10% increase in ultra-processed food was associated with a 19% increase in risk of developing ovarian cancer, and a 30% increase in the risk of dying from it.

• Ultra-processed food is also linked to a higher risk of developing other diseases and conditions, such as type 2 diabetes, depression, obesity and tooth decay.

  For example, a meta-analysis published in 2022 looked at 18 studies involving more than one million participants. It concluded that a high intake of ultra-processed food increased the risk of type 2 diabetes by more than 30%. Even a moderate intake had an effect, with an estimated increase in risk of around 12%.

  A study from Harvard used data from more than 30,000 women enrolled in the Nurses’ Health Study. It found that participants who ate the most ultra-processed food—a massive nine or more servings per day, including snacks—were 50% more likely to develop depression than those who ate the least (four or fewer servings per day).

It is not really clear what exactly is the problem with ultra-processed food—that is, why it has these effects on our health. There are several possible theories:

1. Ultra-processed foods contain a lot of sugar, salt and ‘bad fats’. In other words, they contain things that we know are bad for our health—and it may simply be that they cause us to eat more of these substances.

2. Ultra-processed foods are designed to make us want to overeat and eat more quickly. These foods do not cause us to feel full in the same way that less processed foods do. They therefore tend to lead us to overeat, and that may be causing obesity, and then various linked problems such as type 2 diabetes or cancer.

3. There is something about the processing itself that is bad for you. This theory is supported by a study that fed two groups of people the same basic ‘building blocks’ of calories, sugar, fat, fibre and vitamins. However, one group ate unprocessed or minimally processed food, and the other group ate ultra-processed food. The group eating the ultra-processed food gained weight. The other group lost weight.

4. Ultra-processed food has a problematic effect on your gut microbiome. This is perhaps the newest theory, but one of the most compelling. Some of the additives, including emulsifiers, seem to disrupt your gut microbes, and may cause problems in signalling that you have eaten enough.

There is more about the microbes that live in your digestive system in our page on Understanding and Improving Your Gut Microbiome.

Whatever the precise cause, there seems to be little doubt that eating ultra-processed food is not good for health. The lesson is clear: we should all be trying to cut down on the amount of ultra-processed food that we eat.

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Avoiding Ultra-Processed Food

What key changes can you make to reduce your intake of ultra-processed food?

Chris Van Tulleken, author of the book Ultra-Processed People, suggests that the first change you make should be to stop drinking fizzy drinks. He also suggests avoiding sandwich shops, pubs and takeaways, because many of the coatings, batters and sauces there are likely to be ultra-processed.

If you want to eat snacks, Van Tulleken suggests plain salted crisps or nuts are likely to be less processed. Dried fruit or nuts are also good, as are fresh vegetables or fruit.

Ultimately, the best answer to avoiding ultra-processed foods is to prepare and cook your own food from unprocessed or minimally processed ingredients.

This isn’t always open to all of us—but we can probably all try to do it a little bit more. After all, the evidence shows that even a small reduction in the amount of ultra-processed food you eat can help to reduce your risk of cancer, heart disease and diabetes. It seems that every little helps, and that doing something is better than doing nothing.

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