What counts as ultra-processed food? It depends who you ask

If you’ve not heard of ultra-processed food (UPF), it’s time to crawl out from under that rock. But if you’ve heard of UPF and still aren’t sure which foods count, you’re not alone.

Despite all the buzz, few people truly understand what UPF is, why it matters, or who decides what qualifies. That’s because there is no single, agreed-upon definition. What is highly processed to one person, may not be to another.

Confused? Let’s break down the definitions.

The first and best-known definition of UPF: NovaFor many, there is only one definition of UPF: that of Carlos Monteiro.

The Brazilian researcher developed his Nova classification system in 2009 in response to observations that Brazilians were moving away from traditional foods like rice and beans, to more ultra-processed foods such as soft drinks and snacks. At the same time, obesity levels were rising.

Believing there’s a link between the two, Monteiro categorised foods not in terms of their nutritional profile, but based on the extent of their processing. Monteiro’s definition was the first to be developed and remains the best-known definition of UPF.

How does Nova classify UPF? Nova puts all food into one of four groups: unprocessed or minimally processed foods; processed culinary ingredients; processed foods; and ultra-processed foods.

What is an ultra-processed food? According to Monteiro and his Nova definition, an ultra-processed food is made from ingredients extracted from foods, such as oils, fats, sugar, starch and proteins, or else made from processed food fractions, like modified starch or hydrogenated fats. These products are usually convenient, require little to no cooking, frequently include additives, and tend to be high in sugar, fat and salt. Monteiro believes they’re designed to be highly palatable, which can lead to overeating and greater calorie intake.

Any pushback against this definition? Yes, lots. The biggest criticism is that Nova tars all UPF with the same brush, while research suggests not all UPF is the same. Some are most definitely unhealthy, but not all. One of the best-known studies on this found that while lots of UPF can be linked to poor health outcomes, packaged bread and breakfast cereals (both UPF) were not.

The debate gets more complex when we consider the benefits of food fortification (which increases the processing of foods) and additives that keep food safe and prolong shelf life.

Big pharma enters the UPF definition contest It’s big news when big pharma gets involved in the food debate, and that’s exactly what’s happened via Europe’s largest pharmaceutical company. If you’ve noticed Denmark-headquartered Novo Nordisk in the news recently, it’s because it’s making billions from its GLP-1 weight loss drugs Ozempic and Wegovy.

Through its charity arm, Novo Nordisk Foundation, the pharma giant is now backing a two-year project to develop the next generation of processed food classification systems. The project is being led by professor Susanne Bügel from the University of Copenhagen, who by the end of next year hopes to have developed a new definition.

Bügel wants to take the nutritional content and food matrix of highly-processed foods into account.

Also read → Outcry as Novo Nordisk Foundation eyes UPF classificationAlthough the professor finds fault in the Nova system, she wants to make sure it’s included in her work. “An important aim of this project is to bring together and include both those who invented the original Nova classification and those who have been critical.”

How does the Novo Nordisk Foundation-funded project classify UPF? Watch this space.

‘Healthy’ vs ‘unhealthy’ UPF: GoCoCoAs the University of Copenhagen’s professor Susanne Bügel suggests, developing a classification system for processed foods doesn’t always mean starting from scratch. Just as Bügel wants to bring Nova developers into the picture, others are turning to existing methodologies.

Spanish start-up GoCoCo is a case in point. The barcode-scanning app wants to draw the distinction between ‘healthy’ and ‘unhealthy’ UPF for consumers, and is leaning on the UN World Health Organization (WHO) and Nova to get there.

GoCoCo uses its own scoring methodology, but is informed by the WHO Nutrient Profile Model and the Nova food classification system. The WHO Nutrient Profile Model classifies food into 18 categories, setting specific limits for each category. These include total and added sugars, total and saturated fats, calories, sodium, and the addition of sweeteners.

To determine whether a processed food is ‘healthy’ or ‘unhealthy’, it receives a score based on a combination of the WHO Nutrient Profile Model and Nova systems. One point is then deducted from that score if the product would receive a ‘warning’ according to the Warning System, used in countries like Chile and Argentina. For example, if a food product contains more than 400mg of salt per 100g, it would carry a ‘high in sodium’ warning label.

How does GoCoCo classify UPF? When consumers scan a food or drink product’s barcode with the GoCoCo app, the item receives a score between 1-10, colour coded from dark red for 1, through to orange, yellow, light green, and dark green for 10. Dark green processed products are considered the most ‘healthy’, whereas dark red is the most ‘unhealthy’, according to the app.

What is an ultra-processed food? An example of an ‘unhealthy’ processed food product would be a Cadbury Creme Egg. According to GoCoCo, the confectionery is ultra-processed, fails WHO standards, and is high in saturated fat, sugar, and calories.

Any pushback against this definition? None that we know of.

Zoe: Processed foods on a scale from ‘no risk’ to ‘high risk’UK health app Zoe has now well and truly entered the UPF debate with the launch of its own ‘risk scale’ for processed food and drink. If you haven’t heard of Zoe, it’s a personalised nutrition start-up co-founded by professor Tim Spector – who is very public in his support for whole foods, and disdain for UPF.

Personalised nutrition aside, Zoe has also co-launched probiotic gut shot drinks into retail, and sells a food supplement direct-to-consumer.

Zoe presented its new Food Risk Scale in the UK House of Lords earlier this year, suggesting it’s more nuanced than Nova: “Not all UPFs are equally detrimental to health.” The system splits up foods based on energy intake and the combination of ‘natural’ and ‘manmade’ “hyperpalatability” ingredients.

How does Zoe classify UPF? Zoe places food into one of four risk categories. These are: no risk, low risk, moderate risk and high risk.

What is an ultra-processed food? According to Zoe, a ‘high risk’ product is something like sliced white bread, margarine, milk chocolate and chicken nuggets. On the other end of the scale, a ‘no risk’ product would be unsalted butter and dark chocolate.

Any pushback against this definition? It’s fair to say food and beverage manufacturers are not fans. The UK’s Food & Drink Federation (FDF) condemned Zoe’s new scale, arguing it would confuse consumers as it “contradicts government’s healthy eating advice”. The trade body takes issue with the scale’s treatment of food additives. “All additives that are used by food manufacturers are approved by the Food Standards Agency, who have robust processes in place to ensure that these are safe for us to eat and drink,” said a spokesperson at the time. “It is irresponsible to state these ingredients are a high risk to health.”

Beyond UPF to ‘super ultra-processed food’By now, you’re familiar with the term ultra-processed food. A concept you may not be familiar with, however, is ‘super ultra-processed food’.

That’s a new classification of processed food developed by Richard Black, adjunct professor at the Tufts University School of Nutrition Science and Policy, who is helping sell the system via the barcode-scanning app WISEcode.

Also read → What is ‘super ultra-processed’ food?Black and colleagues follow four steps to classify processed food products. Firstly, they count the number of processed ingredients, then evaluate each one based on amount of processing and known health risks. After that, they factor in how much of the food’s energy comes from added sugar, and finally, they flag foods that contain banned or high-risk additives.

How does WISEcode classify UPF? Depending on a food’s score, it will be classified as either minimal, moderate, ultra, or super-ultra processed.

What is an ultra-processed food? I’d rather know what a ‘super ultra-processed food’ is! According to WISEcode, it’s a food or drink product made in a factory containing multiple ingredients, including additives almost never found in the kitchen. A super-UPF has a long shelf life and is developed for convenience.

Any pushback against this definition? None that we know of.

What other processed food definitions have we missed?As new definitions and categories for food processing come to light, we’ll be tracking them here.

Know of a processed food classification system not listed above? Get in touch!