A new meta-analysis of 51 prospective cohort studies involving more than 8 million people found that higher consumption of ultra-processed foods was associated with multiple chronic health risks, adding to evidence about the potential health effects of diets high in UPFs.
Published in Family Medicine and Community Health, the study analyzed research from the Americas, Europe, Asia and Oceania, including studies published as recently as April 2026. It is among the most comprehensive analyses to date of the potential health risks associated with UPF consumption, according to the authors. The findings come amid ongoing debate among researchers, regulators and industry groups over how ultra-processed foods should be defined.
The authors referred to the NOVA classification system’s definition of UPFs. The framework defines UPFs as “ready-to-eat or heat-and-serve products that undergo extensive industrial processing … often containing multiple additives,” such as candy and packaged snacks. These foods are “typically energy-dense and high in sugar and salt but low in dietary fiber, protein, vitamins and minerals, contributing to their convenience, palatability and long shelf life,” according to the authors.
The authors argue that global UPF consumption has increased over the last several decades. In the US, UPFs made up 57% of energy consumption in 2018 before declining to 53% between 2021 and 2023, according to the meta study.
Over the last three decades, UPF consumption increased in other countries. In Spain, UPF consumption increased from 11% to 31.7%. In Mexico and Brazil, UPF intake jumped from 10% to 23%. In China, UPF consumption rose from 3.5% to 10.4%, according to the meta studies.
Questions remain about safe UPF consumption levels
The authors say they are uncertain how much UPFs are safe to eat or whether there is a tipping point where health risks increase. To investigate this, they analyzed evidence on how much UPF consumption relates to a wide range of health outcomes and measured whether higher consumption is linked to higher risk, with the aim of helping shape dietary guidelines and medical advice.
A majority of the pooled meta-analysis studies associate higher UPF consumption with cardiovascular events, cancer events, digestive diseases, obesity and overweight conditions, all-cause mortality and depression and anxiety. However, eight studies involving 118,946 participants found that higher UPF intake was “not significantly associated” with a higher risk of hypertension.
The analysis also found that each additional 100 g/day of UPF intake was associated with higher risks of cardiovascular events, cancer, all-cause mortality and metabolic syndrome/diabetes.
From these findings the authors note that although people who consume higher amounts of ultra-processed foods often develop several chronic health problems, reducing these foods and choosing more natural alternatives may help prevent disease and improve overall health.
NOVA’s limits continue to fuel debate
While NOVA’s framework groups together foods based on processing levels, critics point out that it does not determine a finished product’s nutritional content. Further, NOVA’s system may misidentify fortified foods as ultra-processed – a caveat the study’s authors acknowledged.
“It is necessary to recognize that the NOVA Classification emphasizes the degree and purpose of food processing rather than nutritional composition,” the authors wrote.
As research evolves, UPF definitions remain in flux
The meta-analysis findings come as the industry navigates multiple conflicting definitions of ultra-processed foods.
While the US Department of Health and Human Services (HHS) confirmed in August that a federal UPF definition is in the works, some states are moving forward with legislation.
Earlier this month, California lawmakers unanimously approved AB 2244, which creates a government-backed certification for non-UPF foods. The bill broadly defines UPFs as foods containing one or more ingredients that deliver a “specific technical effect,” such as stabilizers and thickeners, among many others. The bill excludes certain ingredients like spices and natural seasonings or flavorings and non-nutritive sweeteners.
The bill, if signed by Gov Gavin Newsom by the end of September, will create a standard “Non-Ultraprocessed Certified” label which food manufacturers can voluntarily add on qualifying products.
Non-UPF Verified challenges state certification framework
At the same time, some organizations raised concerns over AB 2244’s exclusion of processing methods for certifiers reviewing non-UPF products.
Non-profit organization Non-UPF Verified called on Gov Newsom to veto the bill because it does not include processing methods as part of the certification. By excluding manufacturing processing, California’s non-UPF seal could be misleading for consumers not only in the state, but for other states that may copy the framework, Non-UPF said.
“Any non-UPF certification must examine the processing methods used to make both the ingredients and the finished product. If California certifies a product as non-ultraprocessed without reviewing how it was made, the certification will miss the very thing the claim is supposed to address: how the food was actually processed,” Megan Westgate, founder and CEO, Non-UPF Project Verified and Non-GMO Project, said.
Non-UPF Verified’s concern comes as the organization continues to expand its own certification program, which uses a different methodology that incorporates processing methods alongside ingredients.
Independent certifiers emphasize processing methods alongside ingredients
Last year, Non-UPF Verified developed an independent UPF definition based on ingredients and processing methods. The Non-UPF Verified certification program, which launched in January, grew to 304 qualifying food products across 23 brands.
According to the program’s processing standards, products must be at least 70% minimally or moderately processed and up to 30% can be conditionally processed, such as protein powders, by weight.
“For years, shoppers have been taught to scan ingredient lists for substances they may want to avoid. But we have not been taught about the many processing methods behind seemingly simple ingredients in packaged foods. Two products can list the same ingredient even when that ingredient has undergone very different processes. Those processes can alter the food matrix and affect how the body digests and responds to the food,” Westgate said.
Similarly, consumer-forward mobile app Wisecode, which developed a Non-UPF Shield label for qualifying products in 2024, considers processing levels (minimal, moderate, ultra or super) as part of its UPF criteria.
