Ultra-processed foods and cardiometabolic risk: from evidence to policy

Ultra-processed foods (UPFs) account for a substantial share of daily energy in the US, UK, Canada, Australia, and across Europe, with health impacts that extend beyond nutrient content 1 , 2 . Although the term ‘UPF’ lacks universal definition, NOVA classification system is most widely used, distinguishing UPFs by their processing and use of additives 3 . UPFs are industrial formulations composed of fractionated ingredients (e.g. refined starches, hydrogenated oils, protein isolates, high-fructose corn syrup) combined with cosmetic additives (e.g. emulsifiers, flavours, colours, preservatives, sweeteners) and subjected to industrial processes such as extrusion and pre-frying 3 . These techniques enhance palatability, convenience, affordability, and shelf life, exemplified by products like breakfast cereals, sugar-sweetened beverages (SSBs), packaged bakery items, mass-produced bread, instant noodles, and ready-made meals 3 . While processing has improved preservation and access, growing evidence suggests that the degree and purpose of processing may independently disrupt appetite regulation, gut microbiota, and metabolic signalling contributing to elevated elevate cardiometabolic risk 2 , 4 , 5 . As global UPF sales continue to rise, understanding these implications is critical for effective nutrition policy 2 , 3 .