💡 Key Takeaways
Table of Contents
The NOVA classification, which divides foods into four groups based on their degree of processing, has become the most cited reference when discussing "ultra-processed foods." It's useful, but not infallible: it groups sugary soft drinks and industrially produced whole wheat bread into the same category, two foods with very different nutritional profiles.
What the NOVA classification really measures
NOVA classifies foods into four groups based on their level of industrial processing: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. This last group is defined by the use of ingredients rarely found in a home kitchen—additives, protein isolates, concentrated syrups—and by industrial processes that alter the food's original matrix.
The criterion is about the process, not directly about the final product's nutritional composition. This distinction is at the root of much of the methodological criticism the system has received in recent years.
The case of whole grains: when the criterion fails
A review published in 2025 analyzes a specific problem: almost all dietary guidelines recommend increasing the consumption of whole grains, with moderate to high-quality evidence of their health benefits. At the same time, some of these same guidelines recommend "avoiding ultra-processed foods." The problem is that the NOVA classification labels up to 90% of common whole-grain foods—breads, whole-grain breakfast cereals, tortillas—as ultra-processed, which creates a contradictory message for those trying to follow both recommendations simultaneously (Jones, 2025, DOI: 10.3390/nu17132188).
The analysis does not invalidate the general concern about ultra-processed foods; it points out that applying the label mechanically, solely based on the level of processing, can displace foods from the diet—such as industrially produced whole wheat bread—with solid evidence in their favor, while allowing products with less favorable nutritional profiles that technically fit into "less processed" categories to pass through.
How much composition varies within the same category
A study with over 7,284 packaged products in the Uruguayan market applied a statistical grouping method based on nutritional composition and additive declaration, instead of starting from predefined NOVA categories. The result was nineteen groups with very different nutrient and additive profiles, showing substantial heterogeneity even within product categories traditionally considered equivalent. The declaration of additives, moreover, did not always coincide with the product's nutritional profile (Ares et al., 2025, DOI: 10.1016/j.foodres.2025.117417).
In practice, this means that two "ultra-processed" products according to NOVA can have radically different nutritional profiles—one with a lot of added sugar and little fiber, the other with a more balanced profile but processed similarly.
What consistently shows solid evidence about ultra-processed foods as a whole
Despite these classification limitations, an umbrella review that analyzed 45 meta-analyses, with nearly 10 million participants in total, found direct associations between greater exposure to ultra-processed foods and 32 out of 45 evaluated health outcomes. The evidence was deemed convincing for an increased risk of cardiovascular disease mortality (risk ratio 1.50) and type 2 diabetes in a dose-response relationship, as well as an increased risk of anxiety and common mental disorders. The evidence was rated as highly suggestive for all-cause mortality, heart disease mortality, depression, sleep disturbances, and obesity. The overall quality of the evidence, however, was mostly low or very low according to the GRADE system (Lane et al., 2024, DOI: 10.1136/bmj-2023-077310).
This is the complete nuance: the association between high consumption of ultra-processed foods as a whole and worse health outcomes is consistent and repeated in the literature, even if the NOVA label, applied product by product, doesn't always clearly distinguish borderline cases like industrial whole wheat bread.
How to identify an ultra-processed food beyond the label
| Sign to check | What it indicates |
|---|---|
| Ingredients you wouldn't recognize in a home kitchen | Protein isolates, concentrated syrups, artificial flavors |
| Nutritional profile on the packaging | Added sugars, sodium, and saturated fats above what is expected for that type of product |
| Presence of fiber and nutrients characteristic of the base food | Whole wheat bread retains fiber and nutrients despite being "processed"; a soft drink provides none |
| Product's role in the usual diet | Daily staple food versus occasional low-nutrient-density product |
What to do with this information daily
Reducing the consumption of sugary soft drinks, snacks with long lists of additives, and low-nutritional-quality prepared meals is supported by consistent evidence. Applying that same logic automatically to whole wheat bread or canned legumes without added sugars, just because they appear in the NOVA "ultra-processed" category, is not supported by the same evidence.