Are Ultra-Processed Foods Bad for You? What the 2026 Evidence Shows

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Home › Nutrition › Ultra-Processed Foods
Medically Reviewed by: Dr. Frank Yap, MD | Written by: OneDayMD Editorial Team | Originally published August 2024 | Last updated: November 9, 2026 | Purpose: education, not individual medical advice

Quick Answer

Diets high in ultra-processed foods (UPFs, NOVA group 4) are consistently associated with higher risks of type 2 diabetes, cardiovascular disease, depression and early death. Most evidence is observational, but short randomized trials show UPF-heavy diets can raise calorie intake and weight, which makes a causal link plausible. The risk is not equal across products: sugary drinks, processed meats and sweet snacks look worst, while fortified cereals, plant milks and wholegrain breads are less clear. A practical goal is to cook more from whole ingredients and cut the worst categories, not to eliminate every packaged food. As of November 2026 the US still has no final federal definition of “ultra-processed.”

What changed in this update (November 2026)

  • Added the November 2025 Lancet Series on ultra-processed foods and the August 2025 UPDATE randomized trial (Nature Medicine).
  • Added 2026 US policy status: the Dietary Guidelines for Americans 2025–2030 and the pending FDA/USDA definition.
  • Corrected the cognitive-decline finding (the threshold was about 20% of daily calories, not “three-quarters of the diet”) and the teen-study description (a recall survey presented at a conference, not a two-month experiment).
  • Re-labelled the 2023 cancer study correctly (eClinicalMedicine, a Lancet-family journal; UK Biobank; published January 2023), and restructured the page with evidence tiers.
  • Removed social-media screenshots and a newspaper opinion link as sources; replaced them with primary studies.

1. What counts as ultra-processed?

The term comes from the NOVA classification, developed by researchers at the University of São Paulo (NOVA paper). NOVA sorts foods by the purpose and extent of industrial processing, not by nutrients:

  1. Group 1, unprocessed or minimally processed: fruit, vegetables, milk, fish, beans, eggs, nuts.
  2. Group 2, processed culinary ingredients: salt, sugar, oils, butter.
  3. Group 3, processed foods: foods from groups 1 and 2 combined, such as canned vegetables, cheese, simple bread, jams.
  4. Group 4, ultra-processed: industrial formulations made largely from extracted substances and additives (emulsifiers, sweeteners, flavors, colors), with little or no whole food. Soft drinks, packaged snacks, instant noodles, reconstituted meats and many ready meals are typical.

Contrary to a common shortcut, NOVA does not define UPF by a count of ingredients. A 
long ingredient list is a useful clue, not the rule.

How common are they? UPFs supply more than half of dietary energy in the US, UK and similar high-income countries, and a smaller but growing share in middle-income countries such as Brazil and Mexico (review; Lancet Series, 2025). One widely cited analysis put the share of US packaged foods and beverages classified as ultra-processed near 70% (Nutrients). Intake is high across income and education levels (Curr Dev Nutr).

2. Evidence at a glance

Evidence tiers use CEBM-style levels adapted for harm questions. “1*” means a systematic or umbrella review whose inputs are observational, so it should be read as strong for consistency but limited for causation. Tier 2 includes randomized trials and prospective cohorts; tier 3 is survey or abstract-level evidence.

Study Design and population Main finding Key caveat Tier
Monteiro et al., Lancet Series, Nov 2025 Three-paper series by 43 experts; systematic review of 104 long-term studies 92 of 104 studies reported higher risk of at least one chronic disease; significant associations for 12 conditions, including type 2 diabetes, obesity and depression Mostly observational; authors acknowledge limits; Bloomberg Philanthropies funded; industry says policy proposals exceed the evidence 1*
Lane et al., BMJ 2024 Umbrella review: 45 pooled analyses, 9,888,373 participants Direct associations with 32 health parameters (mortality, cardiometabolic, mental, respiratory, gastrointestinal) An umbrella review summarizes observational studies; it does not upgrade them to causal evidence. Strength varies by outcome 1*
Dicken et al., Nat Med 2025 (UPDATE) Randomized crossover feeding trial; 55 UK adults with overweight/obesity; 8 weeks per diet; both diets met the UK Eatwell Guide Weight change −2.06% (minimally processed) vs −1.05% (UPF); fewer cravings on the minimally processed diet Short; both diets caused weight loss; LDL fell more on the UPF diet; triglycerides were lower on the minimally processed diet 2 (RCT)
Rico-Campà et al., BMJ 2019 SUN prospective cohort; 19,899 Spanish university graduates, mean age 37.6; median follow-up 10.4 years More than 4 servings/day: 62% higher all-cause mortality; each extra daily serving: +18% Self-reported diet; residual confounding possible; authors state it cannot prove causation 2 (cohort)
Fang et al., BMJ 2024 Two US cohorts (nurses and health professionals); up to 34 years Higher total mortality with higher UPF intake, driven mainly by ready-to-eat meat/poultry/seafood products, sweetened beverages, dairy desserts and UPF breakfast foods Health professionals may not represent the general public; not every UPF subgroup was associated with risk 2 (cohort)
Srour et al., BMJ 2019 NutriNet-Santé cohort; 105,159 French adults, mean age 42.7 Each 10-point rise in UPF share: cardiovascular disease +12%, coronary heart disease +13%, cerebrovascular disease +11% Volunteer cohort; observational 2 (cohort)
Chang et al., eClinicalMedicine 2023 UK Biobank; 197,426 adults aged 40–69; median follow-up 9.8 years Per 10-point rise: overall cancer +2%, ovarian cancer +19%; cancer mortality +6%, breast cancer mortality +16%, ovarian cancer mortality +30% Ovarian finding rests on about 291 cases and needs replication; diet from 24-hour recalls 2 (cohort)
Gonçalves et al., JAMA Neurol 2022 ELSA-Brasil cohort; 10,775 adults aged 35–74; median follow-up 8 years Intake above about 20% of daily calories vs below: 28% faster global cognitive decline and 25% faster executive-function decline Association was reported to be absent in people with high overall diet quality 2 (cohort)
Balhara, AHA Hypertension Sessions 2022 Recall survey of 315 Florida teens (13–19) from 12 high schools Changes in candy, pastry and frozen-dessert intake tracked with changes in other UPFs (+31%, +12%, +11%) Conference abstract; self-reported recall of 2019 vs 2022 intake; hypothesis-generating only 3

3. Association vs. causation: what trials show

Observational studies can show that people who eat more UPFs have worse outcomes, but they cannot fully separate the food from the rest of a lifestyle. UPF-heavy eaters tend to exercise less, smoke more and eat fewer vegetables. The 2019 BMJ authors themselves stressed that their study cannot establish causality (BMJ press office). The 2025 Lancet Series makes the same acknowledgment while arguing that the signal is strong enough to justify policy action.

Controlled feeding trials fill part of the gap. In a 2019 inpatient trial by Kevin Hall and colleagues, adults on a UPF diet ate about 500 more calories per day and gained weight compared with a matched minimally processed diet. The 2025 UPDATE trial extended this to a home setting with diets that both followed national guidance: weight loss was roughly double on the minimally processed diet (−2.06% vs −1.05% over eight weeks), and participants reported better craving control (UCL summary).

The nuance. The UPF diet in UPDATE was a “healthy” one (higher in fruit, vegetables and fiber, lower in salt, sugar and saturated fat than participants’ usual diets), and it still produced weight loss. Outside experts noted that LDL cholesterol fell more on it and that other heart markers barely differed, which suggests processing matters less for some outcomes once overall diet quality is high. The honest summary is that nutrient quality and processing both appear to matter, and trials lasting months to years are still missing.

4. Cancer, heart disease, brain and gut

Cancer

In UK Biobank data, each 10-percentage-point increase in the share of diet from UPFs was associated with a 2% higher overall cancer risk and a 19% higher ovarian cancer risk, plus higher cancer mortality (6% overall, 16% breast, 30% ovarian). Cancer Research UK pointed out that the ovarian result came from relatively few cases and needs replication. The earlier version of this article called the study “the most comprehensive assessment to date”; that claim has been removed because it is not verifiable and the field has moved on.

Heart disease and mortality

The French and American cohorts above point the same way: higher UPF share, higher cardiovascular and total mortality. In Fang et al., the association was concentrated in specific categories (processed meat-based ready meals, sweetened drinks, dairy desserts, UPF breakfast foods), which is more actionable than “all UPFs are bad.”

Cognition

In ELSA-Brasil, people eating more than about 20% of calories from UPFs had faster decline in global cognition (28%) and executive function (25%) than people below that level, over a median of 8 years. The earlier version of this article said the highest group ate “three-quarters of their diet” as UPFs; that was incorrect. The authors also found no association in people with a high diet-quality score. Cognitive decline findings remain observational.

Gut health and additives

Additives, especially emulsifiers, are an active mechanism hypothesis. A 2024 French cohort of more than 100,000 adults linked higher emulsifier exposure to type 2 diabetes (Lancet Diabetes Endocrinol), and a cohort of more than 90,000 adults suggested a possible link with some cancers (PubMed). In a small human study, a common thickener disrupted gut microbes in healthy volunteers (Gastroenterology). A trial abstract in Crohn’s disease reported that people on a restricted-emulsifier diet were about three times more likely to have reduced symptoms (Gut abstract), and a randomized trial found lower gut-microbe diversity after three weeks of a UPF-heavy diet (Lane et al.). These are early signals, mostly small or abstract-level. Researchers quoted by the BBC stress that no one yet knows which additives or combinations matter, and that no public guidance on avoiding emulsifiers exists (BBC Future, Feb 2026).

5. Teens and “gateway” foods

A 2022 study presented at the American Heart Association Hypertension Scientific Sessions surveyed 315 South Florida teens about their intake of 12 ultra-processed products. Teens who increased candy, packaged pastries or frozen desserts were also more likely to increase their intake of other UPFs (+31%, +12% and +11%). It was a recall survey comparing 2019 and 2022, not an experiment, and it was a conference presentation, so treat it as a hypothesis. The lead researcher was a high-school and Broward College student; the earlier version of this article misnamed her institution. The practical idea, that cutting sweets and pastries may pull down overall UPF intake, is reasonable but unproven (AHA release).

6. US policy in 2026

  • Dietary Guidelines for Americans 2025–2030 (released January 7, 2026) tell Americans to limit highly processed foods, added sugars and artificial additives. They use “highly processed” rather than “ultra-processed,” and the supporting scientific report calls its definition provisional (National Law Review). See our full guideline review.
  • Federal definition: FDA and USDA issued a request for information in July 2025. On August 10, 2026, HHS and USDA said a proposed definition had gone to the White House Office of Management and Budget for final review, submitted as a white paper rather than a regulation (CNBC; FoodNavigator). As of early November 2026 it had not been finalized, and industry groups continue to oppose it (Food Safety Magazine).
  • State action: California’s AB 1264 (2025) created the first statutory UPF definition for school food programs.

Critics of regulating by processing level argue that it could penalize nutritious foods such as fortified cereals or plant milks and stigmatize useful food-safety processing. Supporters argue the evidence is already sufficient for action. Both positions are on the record, and the final definition will decide how much each concern matters.

7. Practical guide: spot it, swap it

Spot it. UPFs are usually packaged, ready-to-eat or ready-to-heat, with additives you would not find in a home kitchen (emulsifiers, flavors, colors, non-sugar sweeteners, modified starches, protein isolates). Some “healthy-looking” products are also UPFs: flavored yogurts, many granola bars, breakfast cereals, fruit drinks, low-fat dressings and some plant-based spreads.

Higher concern (strongest signals) Less clear or context-dependent Easy swaps
Sugar-sweetened and artificially sweetened drinks; processed and reconstituted meats; dairy desserts; sweet packaged snacks and pastries; instant noodles; many frozen ready meals Fortified breakfast cereals; wholegrain packaged breads; unsweetened plant milks; protein powders; infant formula Water, tea or coffee for soda; plain yogurt with fruit for flavored yogurt; oats cooked at home for sweet cereals; roasted nuts for chips; simple home-cooked meals in batches

A realistic approach. Experts quoted in the BBC and Reuters coverage broadly agree that avoiding every additive is unrealistic. A workable rule is to cook from scratch when you can, read ingredient lists, and replace the highest-concern items first. Adding foods (vegetables, legumes, fruit, nuts) often works better than a long list of bans.

Safety note. If you are pregnant, feeding an infant, managing diabetes, kidney disease or Crohn’s disease, or taking medication, ask your clinician before making large diet changes.

8. Where to buy whole foods

These directories help you find farms, markets and producers near you. The listing is carried over from earlier versions of this article; availability varies by region.

Raw dairy caution: Some of these directories list raw-milk sources. Unpasteurized milk can carry Listeria, E. coli and Salmonella, and public-health agencies advise against it, especially for pregnant women, children, older adults and anyone with a weakened immune system. Buying whole foods does not require raw dairy.

9. AI personalization guide

Assistants can help you apply this article to your own kitchen, but they cannot see your medical history. Copy a prompt, add your details, and check any health-specific answer with your clinician.

Assistant Suggested prompt Best used for
Claude “Here is my 3-day food log. Using NOVA, mark each item group 1–4 and suggest the 3 swaps that remove the most ultra-processed calories without raising my grocery bill.” Careful label reading and swap planning
ChatGPT “Build a 7-day dinner plan for [household size] with under 30 minutes of cooking and no group 4 foods except [items I choose].” Meal plans and shopping lists
Gemini “Read this ingredient list from a photo and tell me whether it is NOVA group 3 or 4, and why.” Photo-based label checks
Perplexity “What is the latest status of the US federal ultra-processed food definition? Cite sources from the last 30 days.” Fast-changing policy and new studies

10. Frequently asked questions

Do ultra-processed foods cause disease?
Large cohort studies and reviews consistently link high UPF intake with higher risks of type 2 diabetes, cardiovascular disease, depression and early death, but most are observational and cannot prove causation. Short randomized trials show that UPF-heavy diets can increase calorie intake and weight, which supports a causal pathway through overeating.

Are all ultra-processed foods equally harmful?
No. The strongest associations involve sugary drinks, processed meats, ready meals, dairy desserts and sweet snacks. Fortified cereals, plant milks, wholegrain breads and infant formula are also classified as ultra-processed under NOVA but are nutritionally very different, and the evidence for them is weaker.

Is infant formula an ultra-processed food?
Under NOVA, yes. It is a regulated, nutritionally complete product, and this classification is not a reason to avoid it. Parents with feeding questions should ask their pediatrician. (A 2026 analysis found nearly 75% of US baby foods are ultra-processed; see Nutrients 2026.)

Is soy milk an ultra-processed food?
Commercial soy milk is usually classified as ultra-processed under NOVA, but food scientists note that its processing is needed for safety and nutrition and that it differs from candy or soda. Unsweetened, fortified versions are generally considered a reasonable choice.

Is whey protein an ultra-processed food?
Protein powders such as whey isolate are generally classified as ultra-processed under NOVA because they are industrial food substances. Evidence about their specific health effects is limited, and context matters.

Is canned food ultra-processed?
Not necessarily. Plain canned vegetables, beans and fish with few added ingredients are usually NOVA group 3 (processed), not group 4 (ultra-processed).

Does the US have an official definition of ultra-processed food?
Not yet. As of November 2026, a proposed FDA/USDA definition submitted to the White House Office of Management and Budget in August 2026 as a white paper had not been published as a final definition.

Affiliate disclosure: OneDayMD participates in affiliate programs, including The Wellness Company (referral code ONEDAYMD) and Amazon Associates. This article contains no affiliate links or sponsored product placements; if that changes, the links will be marked.

Medical disclaimer: This article is for education and does not replace advice from a qualified healthcare professional. Observational findings describe associations, not proof of cause and effect.

References and related reading

  1. Monteiro CA, et al. Ultra-processed foods and human health: the main thesis and the evidence. Lancet. Published online November 18, 2025. doi:10.1016/S0140-6736(25)01565-X
  2. Dicken SJ, et al. Ultraprocessed or minimally processed diets following healthy dietary guidelines on weight and cardiometabolic health: a randomized, crossover trial. Nat Med. 2025. doi:10.1038/s41591-025-03842-0
  3. Lane MM, et al. Ultra-processed food exposure and adverse health outcomes: umbrella review. BMJ. 2024. BMJ
  4. Fang Z, et al. Association of ultra-processed food consumption with all cause and cause specific mortality. BMJ. 2024. BMJ
  5. Rico-Campà M, et al. Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ. 2019;365:l1949. BMJ
  6. Srour B, et al. Ultra-processed food intake and risk of cardiovascular disease. BMJ. 2019;365:l1451. BMJ
  7. Srour B, et al. Ultraprocessed food consumption and risk of type 2 diabetes in NutriNet-Santé. JAMA Intern Med. 2020;180(2):283. doi:10.1001/jamainternmed.2019.5942
  8. Chang K, et al. Ultra-processed food consumption, cancer risk and cancer mortality. eClinicalMedicine. 2023;56:101840. Full text
  9. Gonçalves NG, et al. Association between consumption of ultraprocessed foods and cognitive decline. JAMA Neurol. Published online December 5, 2022. JAMA Neurology
  10. Balhara M. Gateway food model for adolescent eating behavior. AHA Hypertension Scientific Sessions, September 2022. AHA release
  11. BBC Future. How ultra-processed foods influence our gut microbiome. February 2026. BBC
  12. HHS/USDA announcement and coverage of the proposed federal UPF definition, August 2026. CNBC
  13. Related on OneDayMD: New US Dietary Guidelines | Nutrition, Vitamins & Supplements Guide | How Linoleic Acid Wrecks Your Health | Best Diet During Cancer Treatment

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