“It is a tale
Told by an idiot, full of sound and fury,
Signifying nothing.”
— William Shakespeare, Macbeth, Act V, Scene V
The new guidelines often, if not precisely, speak about “highly processed” foods (for a detailed discussion, see this recent column). This type of intentionally operationally vague language undermines the development of a focused solution whilst moving the goalposts.
If there is begrudging backpedaling on whether ultraprocessed foods (UPFs) might be a problem, there is also a parallel push to claim that it isn’t ultraprocessing per se, but which UPF we choose. If we consumers simply select the “better-for-you” options: high-protein bars, fiber-fortified cereals, vitamin-enriched beverages, or plant-based burgers, then we can enjoy the convenience of ultraprocessed foods (UPFs) without their downsides.
It is an argument full of sound and fury.
It is also, according to this week’s study spotlight, deeply disingenuous.
As with many ideas in nutrition, this narrative rests on an old and familiar foundation: Nutritionism. It is the belief that food can be reduced to nutrients, numbers, and functional attributes. It is the belief that health follows from optimizing those components. If a food contains enough protein, fiber, vitamins, or fewer “bad” nutrients, it must be healthy.
But living systems do not eat nutrients.
They eat food.
And they interpret that food as information.
This week’s Study Spotlight examines a powerful BMJ Analysis paper that dismantles the growing industry-sponsored policy push to classify some ultraprocessed foods as “healthy”. The paper argues that this framing obscures the real public-health priority: reducing ultraprocessed food consumption overall.
This BMJ Analysis, authored by Leandro Rezende, Euridice Martinez-Steele, Maria Laura da Costa Louzada, Renata Levy, and Carlos Monteiro, critically evaluates the scientific, policy, and industry narratives surrounding so-called “healthy” ultraprocessed foods.
The authors synthesize:
- Evidence from over 100 cohort studies, the vast majority of which link higher UPF intake to increased risk of obesity, type 2 diabetes, cardiovascular disease, cancer, mental health disorders, and increased early all-cause mortality.
- Results from randomized crossover feeding trials demonstrating the harms of UPFs independent of nutrient composition.
- Methodological critiques of studies that attempt to isolate “healthier” UPF subgroups rather than evaluating UPFs as a dietary pattern.
Key findings and arguments include:
- 92 of 104 cohort studies associate higher UPF intake with at least one adverse health outcome.
- Subgroup analyses that label certain UPFs as “healthy” rely on inappropriate comparators (e.g., packaged “whole-grain” bread vs. the rest of the diet, rather than vs. freshly baked bread).
- These analyses systematically conflate nutrient composition with processing effects, obscuring mechanisms related to food structure, additives, and matrix disruption
- Framing UPFs as “healthy” legitimizes industry reformulation narratives while weakening policies such as front-of-pack warning labels, marketing restrictions, and fiscal disincentives.
The authors argue that ultraprocessed foods must be evaluated as a category and pattern, not as isolated products with selectively improved nutrient profiles.
The Caveat:
This paper is not a rejection of nutritional science, nor does it deny the historical importance of nutrient-based interventions such as eliminating trans-fats or addressing micronutrient deficiencies. Rather, it highlights the limits of Nutritionism-type thinking in an era defined not by deficiency, but by chronic disease.
Ultraprocessed foods are not merely “bad versions” of whole foods. They are engineered systems, designed for hyperpalatability, shelf stability, convenience, and profit. They are not a natural evolution of food delivery. They are a fundamentally different construct from authentic foods. UPFs are built from reconstituted ingredients, industrial additives, flavor enhancers, emulsifiers, and texture modifiers. These features alter:
- The food matrix,
- Satiety signaling,
- Glycemic and hormonal responses,
- Gut barrier integrity and microbiome signaling,
- Learned eating behaviors and dietary displacement.
When studies attempt to rescue certain UPFs by labeling them “healthy,” they fragment a simple and evidence-based public-health message, one correctly emphasized in the most recent US Guidelines:
Eat real food. Avoid ultraprocessed food.
Worse, this persistent narrative to salvage the reputation of UPFs deepens health inequities. Premium “better-for-you” UPFs are marketed to wealthier consumers, while cheaper, nutrient-poor ultraprocessed products dominate low-income food environments. This shifts responsibility from structural food systems to individual “choice.”
As the authors note, this is not merely a scientific issue. It is a policy and communication failure that risks normalizing ultraprocessing itself.
This BMJ Analysis delivers a clear and long-overdue corrective:
The public-health question is not whether some ultraprocessed foods are less harmful than others, but whether the global shift toward ultraprocessed diets is driving chronic disease.
Labeling certain ultraprocessed foods as “healthy” does not solve the problem. It merely prolongs it. It reinforces Nutritionism, legitimizes industry narratives, confuses consumers, and distracts from the central goal of preserving and restoring diets based on fresh, minimally processed foods and cooked meals.
This current effort to legitimize UPFs as “healthy choices” distorts that signal. No amount of fortification or reformulation can restore the coherence of UPFs.
You cannot optimize your way out of misinformation.
The Study:
Rezende LFM, Martinez-Steele E, Louzada ML da C, Levy RB, Monteiro CA. (2026).
Misleading narrative of “healthy” ultraprocessed foods. BMJ. 392:e087538. doi:10.1136/bmj-2025-087538
Additional references:
Baker P, Slater S, White M, etal. Towards unified global action on ultra-processed foods:
understanding commercial determinants, countering corporate power, and mobilising a public
health response. Lancet 2025;406. doi: 10.1016/S0140-6736(25)01567-3
Monteiro CA, Cannon G, Levy RB, et al. Ultra-processed foods. Public Health Nutr. 2019;22
(5):936-941. doi:10.1017/S1368980018003762
Monteiro CA. Nutrition and health: the issue is not food, nor nutrients, so much as processing.
Public Health Nutr. 2009;12(5):729-731.doi:10.1017/S1368980009005291
