As ultra-processed foods comprise a considerable share of the US diet, consumers are increasingly aware of their associated health impacts. However, surveys underscore that consumers struggle to identify ultra-processed foods or to accurately determine which ones are linked to health risks, such as type 2 diabetes.
Although observational research links ultra-processed foods to health issues like obesity or non-communicable diseases, studies that distinguish between different types of foods underscore that not all have an equally adverse impact on health.
Research by the US Physicians Committee for Responsible Medicine finds that 39% of respondents to an online poll “incorrectly said all processed foods are unhealthy.”
The study also notes that participants inaccurately cited foods that increase type 2 diabetes risk — sugar (51% of respondents), desserts (19%), and carbohydrates in general (15%). However, only 17 of 2,174 respondents mentioned meat products, which research links to a higher risk.
“Foods considered ‘ultra-processed’ can reduce diabetes risk or increase it, depending on which ones they are,” says lead author Neal Barnard, MD, president of the Physicians Committee.
“Studies show it’s processed meat consumption that is associated with diabetes and cardiovascular disease, not plant-based ultra-processed foods, such as breakfast cereals, which are associated with reduced risk of these conditions.”
Consumer confusion
Ultra-processed food classifications are primarily set through the Nova system, developed in 2010, which distinguishes foods as unprocessed or minimally processed, processed culinary ingredients, processed foods, and ultra-processed foods. The latter group includes processed meats, plant-based meat alternatives, desserts, breakfast cereals, factory-produced whole wheat bread, and protein bars.
The AI-powered nutrition platform Lifesum surveyed 5,000 US adults, of whom 74% said ultra-processed foods harm their physical and mental health. However, 63% find it “more confusing to identify an ultra-processed food than to file their taxes,” and only 11% feel very confident spotting one on a label.
The Physicians Committee calls for a definition that reflects scientific evidence, as some foods are linked with a lower health risk.The survey reveals that 48% of respondents believe they’re addicted to ultra-processed foods and that 59% have tried and failed to cut back. Reported barriers to reducing consumption include cravings (46%), convenience (41%), and not knowing what to eat instead (33%).
Most respondents (76%) were “surprised” to learn that foods like oat milk, protein bars, and plant-based meats are often classified as ultra-processed foods.
Experts debate the validity and accuracy of the Nova system, as classifications are open to subjective interpretation. Nutrition Insight previously spoke with researchers calling to reclassify plant-based products, which are often categorized as ultra-processed under Nova. Instead of processing techniques, the scientists urge classifications to prioritize biochemical composition and nutritional values.
Updating definitions?
The US FDA has not formally developed its own definition of ultra-processed foods. However, the Physicians Committee expects it to soon release a Request for Information seeking stakeholder input.
“It is important that a federal definition of ultra-processed foods reflect scientific evidence and avoid aggravating public confusion,” says Barnard. “Science shows that ultra-processed foods differ greatly: Certain ones are associated with health problems, while others are associated with reduced risk.”
The American Medical Association has also adopted a new policy supporting public awareness and education about the differences between healthful and unhealthful ultra-processed foods. This policy also supports increased funding for the FDA to research these foods’ health impacts and strategies to mitigate their risks.
“The vague term ‘processed foods’ should be replaced by more specific terms describing foods’ known health effects,” urges Barnard. “Some plant-based foods that are considered processed, such as cereal and canned vegetables and fruit, are actually what US citizens need to fight chronic lifestyle diseases like diabetes and cardiovascular disease.”
Lifesum’s survey reveals that US adults want better labeling, with nearly one in three calling for regulation similar to tobacco.Last month, scientists proposed a new classification system to address criticism and consumer confusion. The alternative, developed by US-based WiseCode, takes a more nuanced approach to distinguish foods in the category that may contribute to a healthy diet, like fortified foods.
US consumers are also demanding reform. In Lifesum’s survey, 80% of respondents support mandatory ultra-processed food labeling, while 68% back health warnings.
Impact on health risk
Respondents to Lifesum’s survey suspect a link between their mental health and what they eat — 74% expect ultra-processed foods negatively impact mood, energy, focus, or burnout.
“This is more than a nutrition crisis — it’s a mental health and societal crisis,” says Signe Svanfeldt, lead nutritionist at Lifesum. “People know these foods are harming them, but they’re overwhelmed and misled by marketing. They need clarity, not shame.”
The Physicians Committee notes that responses to its survey were “highly subjective” and “largely unrelated” to previous research findings on processed foods’ health effects.
The organization notes that a 2023 survey found similar results. At the time, foods’ healthiness was strongly and inversely related to perceived processing levels. Moreover, most young participants in that research did not identify processed meat as a processed food.
Although the organization cautions against treating all ultra-processed foods equally, research on their adverse health impacts continues to expand. Recently, researchers linked ultra-processed food consumption to “preventable premature deaths.” However, experts reacting to the study say more research is needed to ascertain a causal link between these foods and diseases or mortality.