Do we know what damage ultra-processed foods are doing to our health?
It’s no surprise that eating excess ultra-processed foods (UPFs) is linked with heart disease and obesity. Ultra-processed foods are loaded with less desirable ingredients, including saturated and trans-fat, excess sodium, and sugar. As the intake of these foods and beverages increases, chronic health issues do, too, particularly in low-income groups.
New American Heart Association Science Advisory reviews evidence about UPFs and their effects on negative health outcomes. It provides guidance on research, policy, and regulatory reform to improve nutritional intake and health.
The challenge is discovering which foods are the most detrimental and finding ways to help people hone in on better eating habits.
Ultra-processed foods are most often seen in US Dietary patterns and include a combo platter of high-calorie, high-sugar, high-fat, or high-sodium foods or beverages. Sugar-sweetened drinks, refined grains, candy, commercial baked goods, and ultra-processed meats top the list.
Other UPFs may include healthier options, such as whole grains, low-fat and low-sugar dairy products, and some plant-based products. These have positive nutritional value, but may overlap with less healthy options, leading to confusion among health care professionals and the public.
"The relationship between UPFs and health is complex and multifaceted," said Maya K. Vadiveloo, Ph.D., R.D., FAHA, volunteer chair of the writing group for this Science Advisory. "We know that eating foods with too much saturated fat, added sugars and salt is unhealthy. What we don't know is if certain ingredients or processing techniques make a food unhealthy above and beyond their poor nutritional composition. And if certain additives and processing steps used to make healthier food like commercial whole grain breads have any health impact."
Traditional dietary patterns were upended with the quick rise in UPF intake since the 1990s, possibly resulting in adverse health outcomes. Roughly 70% of US grocery products contain at least one ultra-processed ingredient. A recent CDC report found that 55% of calories consumed by people ages 1 and up in the US were UPFs.
This calorie range grew to nearly 62% in youth ages 1 through 18 and in young adults aged 19 and up, 53% of calories came from UPFs. In lower-income families, UPF calories were nearly 55% versus 50.4% in higher-income groups. 1
The problem with UPFs is that they’re cheap, convenient, and aggressively marketed, especially to youth and underserved communities. They often displace more nutritious choices. The intake of these foods lowers the overall diet quality of those in the US and is not aligned with dietary guidance from the American Heart Association.
This new Science Advisory reinforces current dietary guidelines from the American Heart Association to:
Reduce the intake of most UPFs, especially those high in saturated fat, added sugars, and sodium, and those that contribute to excessive calories; and
Replace UPF consumption with healthier options like vegetables, fruits, whole grains, beans, nuts, seeds, and lean proteins.
How are UPFs classified?
Most UPFS contain multiple ingredients, including some to improve shelf life, flavor, texture, and appearance. These ingredients are typically used in industrial food production, but not in home cooking. As our diets contain more processed foods, various systems can be used to classify processed foods. Science Advisory focuses on the Nova framework for food classification.
The most widely used system for classifying processed food is the Nova system. It’s based on the nature, extent, and rationale of the food's industrial processing. The Nova categorization doesn’t take into account the nutritional quality of foods. Some types of industrial food processing are helpful for preservation, safety, or to reduce cost. These include extending shelf life, limiting bacterial growth, limiting chemical toxins, preserving function, nutritional, and taste qualities. They may also reduce food waste and loss.
Ways to understand UPTs are held up by varying definitions, limitations in dietary evaluation tools, and food composition databases. They often don’t include detailed information on additives or processing methods. US manufacturers are not currently required to disclose their processing techniques or levels of cosmetic additives. This adds to the variability in risk estimates and consumer confusion.
The writing group fears that relying on the degree of processing as a pathway for food healthfulness could encourage the food industry to reduce or remove the markers of ultraprocessing from foods that contain more saturated fat, added sugar, and sodium, then promote them as “better-for-you options”.
Health Impact of UPFs
The advisory cited a meta-analysis of prospective studies which found a dose-response association between UPF consumption and cardiovascular events, including heart attack, transient ischemic attack and stroke, Type 2 diabetes, obesity, and all-cause mortality.
High intake of UPF versus low was linked to a 25%-58% higher risk of cardiometabolic consequences and a 21%-66% higher risk of death. Further research is necessary to understand the appropriate thresholds for regular intake of UPFs – what’s considered safe and the incremental risks of eating more UPFs.
Research has also discovered that there are likely additional mechanisms that impact eating behaviors and weight gain in some people, and that UPFs may promote obesity.
UPFs often include ingredient combinations and additives that aren’t found in whole foods, which improve the palatability and reduce cost. They may impact reward-related brain activity. As an example, artificial flavors may imitate sweetness without sugar. This interruption in flavor-nutrient relationships often precedes irregular eating habits and may lead to weight gain.
Opportunities for research and policy
The need for nutrient-dense, affordable food is a priority. Key research and policy changes to improve public health and reduce non-communicable diseases related to UPF intake include:
Offer steps for individuals, food manufacturers and retailers to help move eating patterns away from UPFs high in saturated fat, added sugars and sodium toward eating patterns high in vegetables, fruits, nuts, seeds, legumes, whole grains, nontropical liquid plant oils, fish and seafood, low-fat-low-sugar dairy, and, if desired, lean meat and poultry.
Enforce multipronged policy and systems-change strategies such as front-of-package labels, to help cut intake of HFSS products.
Increase funding for research to evaluate important questions about UPFs: How does the ultraprocessing itself make a UPF unhealthy vs. the fact that UPFs tend to contain unhealthy ingredients? Several UPFs overlap with HFSS foods that are already targeted for cardiometabolic risk reduction. Effective reduction strategies require a better understanding of the root causes of UPFs' link to poor health.
Improve current efforts to improve food additive science, including streamlined and efficient regulation and evaluation of food additives.
Vadiveloo notes, "More research is needed to understand the mechanisms of how UPFs impact health. In the meantime, the Association continues to urge people to cut back on the most harmful UPFs that are high in saturated fats, added sugars and sodium, and excessive calories and instead follow a diet rich in vegetables, fruits, nuts, seeds and whole grains, low-fat-low-sugar dairy, and lean proteins like fish, seafood or poultry -- for better short- and long-term health. “ 2
To learn more about the NOVA classification of processed foods, check here: Ultra-processed foods: how functional is the NOVA system? - PMC
Practitioners can help consumers reduce UPFs by:
1. Offering label-reading classes to better inform consumers.
2. Providing grocery store tours and highlighting UPFs and healthy choices
3. Doing cooking demonstrations for high-risk populations using whole foods
4. Getting involved with local schools to encourage changes in school breakfast and lunch
5. Advising teachers to avoid using UPFs (or any food) as rewards for learning.
6. Encouraging water consumption over sweetened beverages.
7. Discouraging UPFs at school functions or sporting events
8. Encourage reduction of ultra-processed red meat
9. Discourage fried snacks and commercially prepared desserts
10. Propose a healthy eating challenge to encourage consistent intake of fruits, vegetables, whole grains, beans, lean protein sources, and low-fat dairy products.
Lisa Andrews, MEd, RD
Journal References:
Ultra-processed Food Consumption in Youth and Adults: United States, August 2021-August 2023. National Center for Health Statistics. National Health and Nutrition Examination Survey. Data Brief No. 536. August 2025. U.S. Centers for Disease Control and Prevention https://www.cdc.gov/nchs/products/index.htm.
Maya K. Vadiveloo, Christopher D. Gardner, Sara N. Bleich, Neha Khandpur, Alice H. Lichtenstein, Jennifer J. Otten, Casey M. Rebholz, Chelsea R. Singleton, Miriam B. Vos, Selina Wang. Ultra-processed Foods and Their Association With Cardiometabolic Health: Evidence, Gaps, and Opportunities: A Science Advisory From the American Heart Association. Circulation, 2025; DOI: 10.1161/CIR.0000000000001365
