To understand what ultraprocessed foods are, it helps to understand how NOVA classifies foods. Those groups are as follows:
Group 1: Unprocessed or minimally processed foods.
Unprocessed, or “natural,” foods are obtained directly from plants or animals and do not undergo any alteration. Minimally processed foods are natural foods that have been cleaned, had inedible or unwanted parts removed, or have been ground, dried, fermented, pasteurized, frozen, or gone through other processes that subtract part of the food. No oil, fat, sugar, salt, or other substances have been added to foods in this category.
Examples include fresh or pasteurized fruit or vegetable juices with no added sugar or other substances; eggs; dried fruits; lentils, chickpeas, and beans; nuts; fresh and dried herbs and spices; fresh or pasteurized milk and yogurt without sugar; fresh or frozen meat, poultry, and seafood.
Group 2: Processed culinary ingredients
These are products extracted from natural foods using processes including pressing, grinding, crushing, pulverizing, and refining. They are used in homes and restaurants to season and cook food.
Examples include oils made from seeds, nuts, and fruits (olive oil, corn oil, sunflower oil); white, brown, and other types of sugar and molasses from cane or beets; honey; maple syrup; butter; lard; and refined or coarse salt.
(The use of processed culinary ingredients does not make meals nutritionally unbalanced as long as they are used in moderation in food preparation for natural or minimally processed foods.)
Group 3: Processed foods
These are foods from Group 1 that are made outside the home with salt, sugar, oil, or substances from Group 2 added to preserve them or make them more palatable. These items are derived directly from food and are recognized versions of the original food. Most processed foods have two or three ingredients.
Examples include freshly made cheeses; bacon and beef jerky; salted or sugared nuts or seeds; canned or bottled legumes or vegetables; unpackaged, freshly made breads; tomato extract, pastes, or concentrates (with salt and/or sugar); and fruits in sugar syrup.
Group 4: Ultraprocessed foods
These are industrial formulations made mostly or completely from substances (oil, fat, sugar, starch, and protein) extracted from food or derived from hydrogenated fats or modified starches. They can also be synthesized in laboratories with flavor enhancers, colors, and additives to make them highly palatable. These typically have five or more (usually many more) ingredients.
Examples include sweetened and flavored yogurts; breakfast cereals and bars; cola, energy, and sports drinks; pastries, cakes, cookies, and cake mixes; instant soups; ice cream and frozen desserts; packaged breads, hamburger, and hot dog buns; and pre-prepared pizzas, pasta, hamburgers, sausages, chicken nuggets, and fish sticks.
Group 1 foods are a small proportion of or even absent from ultraprocessed products.
The authors of the BMJ study note that the NOVA classification system for UPFs could be improved as it is complex, and some items may be misclassified.
