Can you build a 'healthy' diet out of ultra-processed foods?

• The USDA has devised an experimental, nutritionally complete, seven-day meal plan consisting almost entirely of ultra-processed foods.
• However, a range of ultra-processed foods have been extensively linked to chronic health issues.
• The diet scientists created also fell short in terms of meeting certain nutritional needs, such as vitamin D and E.
• The definition of what qualifies food as “ultra-processed” remains unresolved.

For the last 20 years, Americans have continually consumed more industrially manufactured foods, growing from 53.5% of their daily calories in 2001 and 2002 to 57% in 2017 to 2018. These foods are often referred to as “ultra-processed foods,” or “UPF.”

There is evidence that these foods are linked to chronic diseases, and — being formulated for flavor, cost, and an extended shelf life — may not provide adequate nutrition.

Scientists at the United States Department of Agriculture (USDA) involved in nutritional research were curious to know if a person could meet all the Dietary Guidelines for Americans (DGA) strictly from UPF. The researchers have released a study presenting a proof-of-concept seven-day menu.

The menu scored 86 out of 100 points on the Healthy Eating Index (HEI) with 91% of the calories in the diet obtained from UPF. It missed just two nutritional targets: It was high in sodium and low in whole grains.

By comparison, the average American diet scores just 59 on the HEI.

The menu is not an actual recommended meal plan, but is instead an experiment and a demonstration of the flexibility of DGA recommendations.

To construct their menu in a way that aligned with current nutritional recommendations, the researchers adapted the MyPyramid menu.

The press release announcing the study highlights that current dietary recommendations are more focused on nutritional content than the degree or type of processing involved, and that further research is necessary.

The study is published in Science Direct.

What are ‘ultra-processed’ foods?

One of the issues with assessing UPF, said study lead author Dr. Julie M. Hess, who works as a researcher for the USDA’s Grand Forks Human Nutrition Research Center, is defining what they are.

“Our study found that several nutrient-dense foods like whole wheat bread, nonfat milk, canned fruit, tofu, fruit juice, and canned fish could be considered ultra-processed,” she said.

The researchers collaborated with external “graders” who rated the foods under consideration based on their level of processing.

“Some of the foods that our graders considered ‘ultra-processed’ that did not end up on our menu were: almond butter, pork loin, smoked oysters, soy milk, cottage cheese, nonfat Greek yogurt, lactose-free milk, and apple juice,” said Dr. Hess.

Some of the foods that were included in the menu included black bean soup, oatmeal, a baked potato with chili, tofu stir fry, and a steak dinner.

“Some foods that our graders considered less processed that we did not include in our menu were: applesauce, canned peas, and canned mushrooms,” she added.

Also excluded from consideration were some foods that the researchers felt did not fit a DNA category, such as French fries, pickles, banana chips, sesame sticks, and a plant-based ‘meat’ burger.

Unexpected foods

Michelle Routhenstein, cardiology dietitian at EntirelyNourished.com, who was not involved in the study, said “It is also important to note that nutrient-dense foods like beans and legumes, for instance, can be considered ultra-processed due to the citric acid or additives added to preserve it. And while this is considered ultra-processed, they still confer health benefits that we need to evaluate in the big picture as well.”

”It will not be possible to determine whether ultra-processed foods are healthful or not until the scientific community identifies more clearly what the term ‘ultra-processed’ means.”
— Dr. Julie M. Hess

Why an ultra-processed foods meal plan was created

Knowing the 2025 DGA scientific committee would be discussing UPF, Dr. Hess’s team built the experimental menu according to the most commonly used system for identifying ultra-processed foods, the NOVA system.

“My research is centered on identifying and evaluating strategies to help Americans meet recommendations from the Dietary Guidelines for Americans, which means I follow closely the activities and conversation related to the development of dietary guidance in the U.S.,” recalled Dr. Hess.

Routhenstein expressed concern that creating the menu required nutritional expertise that most people do not have.

Routhenstein also questioned how realistic some menu items are. “For example, strawberry kefir may have xanthan gum, which is now considered ultra-processed. They are getting honey-roasted chickpeas, which have an additive in it which is now considered ultra-processed.”

“It is important that we meet individuals where they are, and depending on what may be accessible, this can be a valuable tool to learn,” she said.

However, “This is not a depiction of actually what is available to a person who relies on ultra-processed foods, that would not be available in a low-income neighborhood,” asserted Routhenstein.

Suspected hazards of ultra-processed foods

As vaguely defined as UPFs may be, there are ample concerns regarding the health effects of foods widely considered ultra-processed.

Dr. Marialaura Bonaccio of the IRCCS Istituto Neurologico Mediterraneo Neuromed in Italy, who was also not involved in the study, said “The well-documented adverse health effects of UPF are not exclusively related to the poor nutritional content of these foods, but are likely triggered by non-nutritional factors, such as food additives, contaminants from plastics, alteration to the food matrix, etc.”

Dr. Bonaccio cited her own research in which these concerns are discussed. Routhenstein noted that Dr. Bonaccio’s study increased UPF in one’s diet was associated with increases in all-cause mortality and cardiovascular disease.

There are studies finding that “UPF is independently associated with e.g., mortality cardiovascular disease, and certain cancers,” said Dr. Bonaccio.

Consideration of such health effects was beyond the scope of this study. However, Routhenstein cautioned, “ultra-processed foods, regardless if they are following a vegan, vegetarian diet, etc., cause an increase in cystatin c, an inflammatory biomarker that increases risk of heart disease, kidney disease, and stroke.”

“In light of this, a work exclusively focused on the nutritional quality of UPF, which of course could be also adequate in some cases, in my opinion, is completely misleading,” said Dr. Bonaccio.

Although Dr. Hess asserted “There is not a consistent or easy to apply definition of what an ‘ultra-processed’ food is,” both Dr. Bonaccio and Routhenstein recommended people consume fewer ultra-processed foods unless and until further research suggests otherwise.

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