Trends in Food Science & Technology 94 (2019) 98–104

Contents lists available at ScienceDirect

Trends in Food Science & Technology

journal homepage: www.elsevier.com/locate/tifs

Are all ‘ultra-processed’ foods nutritional demons? A commentary and T

nutritional profiling analysis.
E. Derbyshire
Nutritional Insight, Epsom, Surrey, KT17 2AA, UK

A R T I C LE I N FO A B S T R A C T

Keywords: Background: There has been a growing body of literature published on ultra-processed foods (UPF). This has
Ultra-processed foods (UPFs) been driven by an ambiguous definition that can be easily applied to observational work. Nutritionally, UPF
Classification systems have been given the umbrella label of being “energy-dense, high in unhealthy types of fat, free sugars and salt, and
Nutritional profiling poor sources of protein, dietary fibre and micronutrients” (Monteiro et al., 2018). Unfortunately, such overarching
Protein
statements are imprecise and not necessarily reflective of all modern food products.
Fibre
Scope and approach: This commentary evaluates the NOVA classification system and includes an analysis of 50
Fortification
foods falling under its definition of being ‘ultra-processed’ yet classified as ‘healthy’ according to the UK Nutrient
Profiling Model. Nutritional profiles were also compared against European Regulation (EC) No 1924/2006
Nutrition Claims.
Key findings and conclusions: No statistically significant correlations were found between the number of in-
gredients and energy, saturated fat, total sugar, sodium, AOAC fibre and protein. The majority of UPFs identified
were low in saturated fat (84 percent), low in sugar (80 percent) and a source of fibre (60 percent). Thirty eight
percent were low salt and 30 percent a source of protein.
Based on the findings of this commentary it is suggested that rigorous nutritional analyses should be con-
ducted alongside ‘processing loads’. Overarching and tautological definitions could lead to the public avoiding
all UPFs and have unintended consequences such as fibre and micronutrient shortfalls.

1. Introduction
Interest in ultra-processed foods (UPF) has been mounting with di-
chotomy between viewpoints becoming increasingly evident. Most re-
cently it has been concluded that food processing has reached a
‘crossroads’ – historically it has been important from a preservation,
palatability, stability and convenience perspective (Knorr & Watzke,
2019) yet a stronger emphasis on health and classifications systems
now grading ‘levels’ of food processing appear to be placing processed
foods under closer inspection.
In particular the NOVA system classifies foods into four distinct
categories: Group 1 – Unprocessed or minimally processed; Group 2 –
Processed culinary ingredients; Group 3 – Processed foods and Group 4
– Ultra-processed foods (Monteiro, 2016). UPF (and drinks) forming
Group 4 are defined as: “Industrial formulations typically with five or more
and usually many ingredients.“ (Monteiro, 2016) (full definition;
Table 1). Such a system, however, does not consider the nutritional
profile of foods nor does it account for methods used in the culinary
preparation of food (Monteiro, 2016). NOVA authors also conclude
that: “All together, they (UPF) are energy-dense, high in unhealthy types of
fat, refined starches, free sugars and salt, and poor sources of protein,
dietary fibre and micronutrients” (Monteiro et al., 2018).
This classification is rapidly being embedded within observational
research, partly due to its ease of application. However, concerns about
the application of such definitions are now being raised. For example,
there are no specified cut –offs for food components e.g. energy, fat,
sugar and salt (per gram or portion) making conclusions about the
nutritional profile of UPFs rather cumbersome (Gibney, Forde, Mullally,
& Gibney, 2017). It has also been pointed out that consumer confusions
about UPF and the avoidance of foods deemed to fall within this cate-
gory such as cereals and wholegrain/enriched breads could even have
inadvertent consequences and reduce folate, calcium and fibre intakes
(Jones, 2018).
Food Standards Australia and New Zealand have recently high-
lighted the need to develop nutrient profiling knowledge to enable the
application of more reliable and rigorous health claims (Pivk Kupirovic
et al., 2019). The French have recently developed the simplified nu-
trition labelling system (SENS) algorithm which has been adapted from
the SAIN, LIM system (Tharrey, Maillot, Azais-Braesco, & Darmon,
2017). In the UK an updated Nutritional Profiling Model has recently

E-mail address: emma@nutritional-insight.co.uk.

https://doi.org/10.1016/j.tifs.2019.08.023
Received 14 March 2019; Received in revised form 1 August 2019; Accepted 29 August 2019
Available online 05 September 2019
0924-2244/ Crown Copyright © 2019 Published by Elsevier Ltd. All rights reserved.
E. Derbyshire
Table 1
NOVA definition of Group 4 ultra-processed products.
Group 4 – Ultra-processed food and drink products
The fourth NOVA group is of ultra-processed food and drink products. These are
industrial formulations typically with five or more and usually many ingredients.
Ingredients often include: sugar, oils, fats, salt, anti-oxidants, stabilisers, and
preservatives. Ingredients only found in ultra-processed products include
substances not commonly used in culinary preparations, and additives whose
purpose is to imitate sensory qualities of group 1 foods or of culinary
preparations of these foods, or to disguise undesirable sensory qualities of the
final product. Group 1 foods are a small proportion of or are even absent from
ultra-processed products.
Substances only found in ultra-processed products include some directly
extracted from foods, such as casein, lactose, whey, and gluten, and some derived
from further processing of food constituents, such as hydrogenated or
interesterified oils, hydrolysed proteins, soy protein isolate, maltodextrin, invert
sugar and high fructose corn syrup. Classes of additive only found in ultra-
processed products include dyes and other colours, colour stabilisers, flavours,
flavour enhancers, non-sugar sweeteners, and processing aids such as
carbonating, firming, bulking and anti-bulking, de-foaming, anti-caking and
glazing agents, emulsifiers, sequestrants and humectants.
Several industrial processes with no domestic equivalents are used in the
manufacture of ultra-processed products, such as extrusion and moulding, and
pre-processing for frying.
Purpose: The main purpose of industrial ultra-processing is to create products that are
ready to eat, to drink or to heat, liable to replace both unprocessed or minimally
processed foods that are naturally ready to consume, such as fruits and nuts, milk
and water, and freshly prepared drinks, dishes, desserts and meals. Common
attributes of ultra-processed products are hyper-palatability, sophisticated and
attractive packaging, multi-media and other aggressive marketing to children
and adolescents, health claims, high profitability, and branding and ownership
by transnational corporations.
Examples: Carbonated drinks; sweet or savoury packaged snacks; ice-cream,
chocolate, candies (confectionery); mass-produced packaged breads and buns;
margarines and spreads; cookies (biscuits), pastries, cakes, and cake mixes;
breakfast ‘cereals’, ‘cereal’ and ‘energy’ bars; ‘energy’ drinks; milk drinks, ‘fruit’
yoghurts and ‘fruit’ drinks; cocoa drinks; meat and chicken extracts and ‘instant’
sauces; infant formulas, follow-on milks, other baby products; ‘health’ and
‘slimming’ products such as powdered or ‘fortified’ meal and dish substitutes; and
many ready to heat products including pre-prepared pies and pasta and pizza
dishes; poultry and fish ‘nuggets’ and ‘sticks’, sausages, burgers, hot dogs, and
other reconstituted meat products, and powdered and packaged ‘instant’ soups,
noodles and desserts.
When products made solely of group 1 or group 3 foods also contain cosmetic or
sensory intensifying additives, such as plain yoghurt with added artificial
sweeteners, and breads with added emulsifiers, they are classified here in group
4. When alcoholic drinks are identified as foods, those produced by fermentation
of group 1 foods followed by distillation of the resulting alcohol, such as whisky,
gin, rum, vodka, are classified in group 4.
undergone consultation (PHE, 2018b). These publications highlight the
need to better address the nutritional profile of foods including UPFs.
As a result of such conjecture, the present commentary evaluates
and discusses the nutritional profile of fifty UPF that were graded as
being ‘healthy’ according to the UK Nutritional Profiling Model and
aligned with current food trends.
2. Approaches
2.1. UPF identification
Products were identified though an online supermarket search
(Tesco.com; Groceries search). A search list was created within the
supermarket database using terms that were reflective of current
dietary guidelines and environmentally-driven consumer trends
(Gulland, 2017; PHE, 2016; SACN, 2015; Willett et al., 2019). Subse-
quently, the following were used as a basis for search terms: ‘reduced
sugar’, ‘reduced salt’, ‘cereals low sugar’, ‘wholegrain’, ‘plant-based’,
‘meat alternatives’, ‘probiotic’. A comma and new line was added be-
tween each item. This produced a total of 127 items which were
screened (reduced sugar, n = 5; reduced salt, n = 21; low sugar cereals,
n = 40, whole-grain, n = 40; meal alternatives, n = 21). When
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Trends in Food Science & Technology 94 (2019) 98–104
screening labels the use of fortificants or other functional components
was also recorded.
A total of 77 foods were excluded as they: 1) did not meet the de-
finition of being UPF according to the NOVA criteria [7] or 2) obtained
an overall nutrient profile score of 4 points or more [13] when the
Nutrient Profile Model was applied as explained below. Suggestions
that were created based on our searches were also screened. This gave
the final 50 foods for analysis. When using the 2018 scoring system 12
of the identified foods became ‘unhealthy’ which were then excluded.
3. Nutrient profiling
In the UK the Department of Health has established a set of guide-
lines to assist food manufacturers, retailers and advertisers with the
calculation of nutrient profiling scores. The model allocates points
based on the nutritional profile of a food or drink (per 100 g) and
provides a scoring system. Points are given for ‘A’ group nutrients
which include: energy, saturated fat, total sugar and sodium along with
‘C’ group nutrients which include: fruit, vegetables and nut content,
fibre and protein. The ‘C’ score is then subtracted from the ‘A’ score to
provide a final overall nutrient profile score. From this score, foods with
4 points or more and drinks scoring 1 points or more are classed as ‘less
healthy’ (DOH, 2011). Subsequently, products with scores less than 4
were taken as being ‘healthy’ in the present publication.
The UK Nutrient Profiling Model underwent consultation in 2018
(PHE, 2018b). This was undertaken to better reflect and account for
updated UK dietary recommendations, particularly those for free sugars
and dietary fibre (PHE, 2018b). Rather than develop a new model the
original model was adapted to: 1) adjust the energy criterion to align
with food labelling regulation intakes of 8,400kJ (2,000kcal), 2) adjust
saturated fat and sugar cut-offs and recalculate as a proportion of food/
total dietary energy, 3) replace total sugar with 5 percent of total
dietary energy for free sugars, 4) adjust the fibre criterion to account for
new guidelines and 5) replace the sodium criterion with salt (PHE,
2018b). This model uses similar food scoring systems to its previous
2011 versions with foods scoring 4 points or more and drinks scoring 1
points or more being classed as ‘less healthy’ (PHE, 2018a). Given these
adjustments the 50 foods identified were also applied to this newly
proposed modelling system (PHE, 2018a).
The following data was extracted from food manufacturers’ labels:
1) Number of ingredients, 2) Energy kJ/100g, 3) Saturated fat g/100g,
4) Total sugar g/100g, 5) Free sugars g/100g, 6) 7) Sodium mg/100g,
8) Salt g/100g, 9) Percentage of fruit, vegetables and nuts per 100g, 10)
AOAC fibre g/100g, 11) Protein g/100g and 12) any fortificants or
functional ingredients was applied to the identified 50 foods using both
the 2011 and 2018 Nutritional Profiling Model systems and adjusted
cut-offs.
4. Nutrition claims
The European Regulation (EC) No 1924/2006 Nutrition Claims
were also applied and used to classify the nutritional profile of the
products identified (EFSA, 2006). A summary of these are shown in
Table 2. The percentage of foods that were categorised as healthy under
the EFSA nutrition claims i.e. were: 1) low in energy, 2) low in fat, 3)
low in sugars, 4) low or very low in sodium/salt, 5) a source or high in
protein and 6) a source of high in fibre was then calculated for each
component.
Further analysis was conducted focusing on six and three core nu-
trient components in relation to claims. Spearman rank correlations
were used to establish whether there were any associations between the
number of ingredients, energy, saturated fat, total sugar, sodium, AOAC
fibre, protein and overall nutritional profile scores.
E. Derbyshire Trends in Food Science & Technology 94 (2019) 98–104

Table 2
EFSA Nutrition Claims applied to UPF identified.
Low Energy A claim that a food is low in energy, and any claim likely to have the same meaning for the consumer, may only be made where the product does not
contain more than 40 kcal (170 kJ)/100 g for solids or more than 20 kcal (80 kJ)/100 ml for liquids. For table-top sweeteners the limit of 4 kcal (17 kJ)/
portion, with equivalent sweetening properties to 6 g of sucrose (approximately 1 teaspoon of sucrose), applies.

Low in Fat A claim that a food is low in fat, and any claim likely to have the same meaning for the consumer, may only be made where the product contains no more
than 3 g of fat per 100 g for solids or 1.5 g of fat per 100 ml for liquids (1.8 g of fat per 100 ml for semi-skimmed milk).
Low Sugars A claim that a food is low in sugars, and any claim likely to have the same meaning for the consumer, may only be made where the product contains no
more than 5 g of sugars per 100 g for solids or 2,5 g of sugars per 100 ml for liquids.
Low Sodium/Salt A claim that a food is low in sodium/salt, and any claim likely to have the same meaning for the consumer, may only be made where the product contains
no more than 0,12 g of sodium, or the equivalent value for salt, per 100 g or per 100 ml. For waters, other than natural mineral waters falling within the
scope of Directive 80/777/EEC, this value should not exceed 2 mg of sodium per 100 ml.
Very Low Sodium/Salt A claim that a food is very low in sodium/salt, and any claim likely to have the same meaning for the consumer, may only be made where the product
contains no more than 0,04 g of sodium, or the equivalent value for salt, per 100 g or per 100 ml. This claim shall not be used for natural mineral waters
and other waters.
Source of fibre A claim that a food is a source of fibre, and any claim likely to have the same meaning for the consumer, may only be made where the product contains at
least 3 g of fibre per 100 g or at least 1,5 g of fibre per 100 kcal.
High fibre A claim that a food is high in fibre, and any claim likely to have the same meaning for the consumer, may only be made where the product contains at
least 6 g of fibre per 100 g or at least 3 g of fibre per 100 kcal.
Source of Protein A claim that a food is a source of protein, and any claim likely to have the same meaning for the consumer, may only be made where at least 12 percent of
the energy value of the food is provided by protein.
High Protein A claim that a food is high in protein, and any claim likely to have the same meaning for the consumer, may only be made where at least 20 percent of the
energy value of the food is provided by protein.

5. Findings and discussion
The fifty foods identified and number of ingredients are shown in
Fig. 1. The number of ingredients listed was, on average 13.6 but
ranged from 5 to 33. Forty percent of the UPFs contained ten in-
gredients or less. Just under half (44 percent) had 5 to 10 ingredients
listed. These findings demonstrate a large degree in variability in the
number ingredients used between products. Quite often some of the
ingredients used were herbs and spices, preservative or fortificants. This
yields the question about whether it is fair to judge products based on
‘ingredient numbers’ when some ingredients listed have a functional
role to play by improving safety, shelf-life and nutritional profile. It is
also unclear why a cut-off of 5 ingredients or more has been used for the
NOVA definition of UPFs (Monteiro, 2016).
Spearman Rank correlations between the number of ingredients and
individual nutritional components were also not statistically significant:
Energy kJ/100g (rho = 0.15, p = 0.30), Saturated fat g/100g
(rho = 0.10, p = 0.51), Total Sugar g/100g (rho = 0.15, p = 0.28),
Sodium mg/100g (rho = 0.20, p = 0.16), Dietary Fibre g/100g
(rho = 0.06, p = 0.68) nor Protein g/100g (rho = −0.004, p = 0.98).
Previously it has been reported that UPFs consumption has a ‘protein-
diluting effect’ – displacing protein from diets whilst driving up energy
intakes (Martinez Steele, Raubenheimer, Simpson, Baraldi, & Monteiro,
2018). The present commentary refutes this as 30 cent of the identified
UPFs were a ‘source’ of protein according to European Nutrition Claims.
Other work using mycoprotein (a component of Quorn™ - classified as
UPF by NOVA standards) has found its consumption to be associated
with reduced energy intake and insulin release in overweight subjects
suggesting that it has satiety and appetite regulatory properties (Bottin
et al., 2016).
Nutritional profile scores of the 50 ‘healthy’ UPF are shown in
Fig. 2. These ranged between −8 and 3. Lower values were generated
when products were lower in energy, fat and sugar and had a higher
fibre and protein profile. Higher sugar and salt profiles tended to in-
crease nutrient profile scores most frequently, particularly in the 2018
model. There were no statistically significant correlations between the
overall nutrient profile score and the number of ingredients listed
(rho = 0.10, p = 0.49) (Fig. 3a) using the 2011 Department of Health
model. The correlation between the nutrient profile score and the
number ingredients listed was increased using the 2018 cut-offs but the
association remained non significant (rho = 0.24, p = 0.09) (Fig. 3b).
Regarding nutrient claims using the 2011 Department of Health
model 84 percent of the identified UPFs were low in saturated fat, 80
percent were low in sugar, 60 percent were a source of fibre, 38 percent
were low salt, 32 percent high in fibre, 30 percent a source of protein,
18 percent very low sodium and 12 percent low energy (Fig. 4a). Under
the updated 2018 model 38 of the original 50 UPFs remained healthy
(nutrient profile score < 4) and these tended to be healthier for the
EFSA categories than the original 50 (Fig. 4b). So, overall, 38 of the 50
were still healthy under the 2018 model and these tended to be heal-
thier for the EFSA categories than the original 50.
When focusing on six of nutrient claims (low energy, low in satu-
rated fat, low sugar, low salt and a source of fibre and energy) and using
the 2011 model 4 percent of UPFs met EFSA nutrient claims for one
component, 20 percent met nutrition claims for two components and 50
percent met EFSA benchmarks for three components. 1 in 5 (20 per-
cent) aligned with four EFSA nutrient claims and 6 percent for five of
these. So all foods met EFSA nutrient claims for at least one component
and 76 percent of these UPFs had 3 or more healthy components and
aligned with EFSA benchmarks (Fig. 5). This indicates that there are a
number of areas in which certain UPFs can meet nutritional bench-
marks.
Of the 50 UPFs identified 28 percent provided fortificants or other
functional components. One in five (20 percent) were fortified with
riboflavin, vitamin B6 or calcium, 18 percent with vitamin D, 14 per-
cent add vitamin B12 added, 12 percent were fortified with thiamine,
niacin or iron, 10 percent were fortified with folic acid, 6 percent
provided vitamin E, 4 percent were fortified with iodine or pantothenic
acid and 2 percent had zinc or magnesium added. Omega-3 fatty acids
were added in 6 percent of UPFs and plant stanols in 4 percent of UPF
products.
It should be recognised that food fortification can be an important
delivery vehicle for certain nutrients. For example, in one randomised
controlled trial fortified breakfast cereal consumption over 12 weeks
was found to significantly improve the micronutrient intakes and status
of teenage girls, particularly in the case of vitamins B1, B2, B6, B12,
folate, iron (p < 0.001) and of vitamin D (p = 0.007) (Powers,
Stephens, Russell, & Hill, 2016). In another randomised controlled trial
bread fortified with vitamin D eaten by healthy adults (n = 90) was
effective at raising serum 25-hydroxyvitamin D levels to nearly ade-
quate levels (Nikooyeh et al., 2016). Given such findings it should be
questioned whether fortificants should be excluded when classifying
UPF using ingredients lists.
Subsequently, the present commentary and analysis provides evi-
dence contradicting the statement that: “All together, they (UPF) are
energy-dense, high in unhealthy types of fat, free sugars and salt, and poor

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E. Derbyshire Trends in Food Science & Technology 94 (2019) 98–104

Fig. 1. 50 UPFs identified and number of ingredients listed.

sources of protein, dietary fibre and micronutrients” (Monteiro et al., sodium, fibre or protein) nor nutrient profiling scores.
2018). In the present paper the number of ingredients did not correlate
against nutrition components (energy, saturated fat, total sugar,

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Fig. 2. Nutrient profile scores for identified UPFs.
6. Progressive trends
From a food processing perspective nutrition is expected to remain
an important issue in coming years, especially as inter-relationships
between food and health continue to strengthen (Fardet et al., 2015). It
should be considered that food systems are changing rapidly - this in-
cludes growing interest in plant-based approaches for economic, health
and environmental motives (Kevany KM et al., 2018).
Interestingly, 42 percent of the identified ‘UPFs’ were either plant-
based, meat or dairy alternatives. Twenty-eight percent were also for-
tified or contained functional components. Given changing markets and
movements away from traditional meat and dairy sources the exclusion
of some of these foods deemed to be ‘ultra-processed’ could restrict
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Trends in Food Science & Technology 94 (2019) 98–104
diets and even pose a risk nutritionally. Elsewhere concerns have al-
ready been addressed, particularly in relation to fortified foods such as
wholegrain bread, fortified enriched bread and cereals that could im-
pact on dietary fibre, folate and calcium intakes (Jones, 2018) if these
were to be further restricted by being demonised as being ‘ultra-pro-
cessed’.
As well as the nutritional profile of UPFs other defamatory remarks
have also been made. For example, it has been stated that: “Ultra-pro-
cessed products are also troublesome from social, cultural, economic, poli-
tical and environmental points of view” (Monteiro et al., 2018). Yet many
progressions are also being made. For example, innovative package
schemes are evolving such as eco-friendly sugar palm starch-based films
as an effective biopackaging material (Ilyas, Sapuan, Ishak, & Zainudin,
E. Derbyshire Trends in Food Science & Technology 94 (2019) 98–104

Fig. 4. a: Percentage meeting EC nutrition claims (pink bar).2011 model

n = 50 UPFs.
Fig. 4b: Percentage meeting EC nutrition claims (pink bar). 2018 model n = 38
UPFs. (For interpretation of the references to colour in this figure legend, the
reader is referred to the Web version of this article.)

Fig. 3. a: Spearman rank correlations (non-significant) between the numbers of.

ingredients listed and nutrient profile score using the 2011 model.
Fig. 3b: Spearman rank correlations (non-significant) between the numbers of
ingredients listed and nutrient profile score using the 2018 model.

2018; Sanyang, 2017). Microbial biodegradable polymers produced

from agro-food waste residues are another promising approach to re-
ducing food losses and plastic accumulation (Guillard et al., 2018).
Ongoing work is now needed to test a range of validated profiling
systems, such as the French SENS algorithm (Tharrey et al., 2017). We
also need to better understand the way that the different classification
frameworks define the degrees of food processing and the extent to
which these frameworks differ in their definitions (Crino, Barakat,
Trevena, & Neal, 2017). Finally, large assumptions are being made that
un/minimally processed foods i.e. those prepared at home and with Fig. 5. Percentage meeting EC nutrition claims. across a number of nutrition
components.
fewer ingredients are healthier. In reality this can depend of recipe
formulation, financial costs, time, culinary skills and knowledge
(Gibney et al., 2017). model of being ‘healthy’ and have a functional role to play in the diet,
Moving forward we now need to consider the nutritional profiles of such as providing protein, fibre and fortificants. Given this, the present
food alongside levels of processing. Without this overarching assump- publication recommends a number of future actions:
tions that UPFs are all “energy-dense, high in unhealthy types of fat, free
sugars and salt, and poor sources of protein, dietary fibre and micro- • Food classification systems should not judge processed foods un-
nutrients” (Monteiro et al., 2018) cannot be made. fairly and should encompass other core aspects such as nutritional
profiling into methodologies so that fair and robust judgements can
7. Conclusions be made.
• The human body does not respond to ‘processing’ but the nutrients
The present commentary and analysis has shown that UPFs are not in a food, hence, this signifies the importance of evaluating this too.
necessarily all ‘nutritional demons’. As with most things there are al- • Terms like “ultra-processed” can be misleading to consumers and do
ways exceptions and some UPFs can meet the UK nutritional profiling not accurately represent all products.

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• Processing when the right approaches are taken may be beneficial
from a food safety, preservation and nutritional stance. e.g. bread
fortified with folic acid, fortified cereals, meat alternatives, pro-
biotic food products or gluten-free food products.
• Overall, food manufacturers should produce products that have the
best profile possible from a food safety, nutrition and environmental
perspective.
Conflicts of Interest Statement
This review was supported by Marlow foods. The views expressed
are those of the author alone and Marlow Foods had no role in writing
the review. The author declares no competing interests.
Acknowledgements
Many thanks to Jackie Cooper, statistical consultant for her input
into the data analysis.
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