What counts as a processed food?

A healthy lifestyle intended to prevent disease often includes, as is frequently stated, limiting the consumption of processed foods, particularly highly processed foods.

But when is a food considered processed? Hardly anyone pulls a carrot straight out of the ground and bites into it. In most cases the carrot gets at least a quick wash or a rinse to remove the soil before it ends up on our plates. Is that cleaning already a form of processing, or where does processing begin?

The NOVA classification offers a fairly easy-to-understand guide. It sorts foods into four groups based on how processed they are:

Group 1

includes foods that are natural, unprocessed, or only minimally processed. That means after harvest or slaughter they were merely cleaned, chilled, frozen, heated, or fermented. Processing in this group is limited to making the product edible or safe to store while keeping it essentially in its natural state. Our washed carrot would fall into this group.

As a rule, no additives from Group 2 are used to extend shelf life. However, there are rare exceptions, such as stabilizers added to pasteurized milk or antioxidants added to vacuum-packed vegetables.

Alongside fresh fruit and vegetables, Group 1 also includes seeds and roots, as well as milk, eggs (even if heated), plain yogurt without added sugar or similar, and meat.

Group 2

covers processed ingredients mainly used to prepare food. They are made directly from the Group 1 products by pressing, refining, milling, or drying. Additives such as anti-caking agents, iodine, or antioxidants may be present here.

Products in this group are usually not eaten on their own but are used in food preparation. Group 2 includes items like unrefined oils, sugar, salt, honey, butter, lard, and plant starches such as corn or potato starch.

Group 3

then includes typical, relatively simply processed foods like bread, cheese, or canned goods. Basically, these are Group 1 foods to which food additives from Group 2 have been added. Preserving, fermenting, cooking, or baking extends their shelf life, which is one of the main purposes of processing products in this group. Another reason is to change or improve their texture, appearance, smell, or taste.

An easy-to-understand example is bread: Flour is mixed with water and salt and, with the help of leavening agents such as yeast or sourdough, forms a dough that needs to "rise," meaning that it undergoes a certain amount of fermentation. Baking then gives it a firmer texture and a longer shelf life. The finished product, bread, has therefore been changed in appearance, smell, taste, and texture.

Other examples in this group are canned fruits, vegetables, and fish, salted or sugared nuts, cured and smoked meats, and cheese. Alcoholic drinks like wine and beer can also be placed in this group.

Group 4

belongs to the category of so-called highly processed or ultra-processed foods, which usually contain five or more ingredients, and often many more. The abbreviation UPF is also commonly used for this group; it stands for "ultra-processed food".

These are products that contain only extracts of Group 1 foods and hardly any whole foods from this group. Sometimes the latter are entirely absent. Instead, the foods classified here typically contain Group 2 ingredients that have been heavily processed, such as hydrogenated fats, inexpensive sugars or sugar substitutes, as well as flavor enhancers, etc.

They also use substances not normally used in food preparation to mimic sensory properties or mask undesirable ones.

There is an almost endless list of substances that can be added, such as flavors, colorings, fillers, emulsifiers, etc., to make the final product tasty, ready-to-eat, shelf-stable, colorful, attractive, and much more. The base ingredients are often inexpensive, and their flavor is heavily altered by the manufacturing process.

The final product is offered in appealing packaging and often pushed with sophisticated marketing.

Group 4 includes a wide range of items, from pre-baked rolls to "diet" products, energy drinks, ready meals, fruit drinks, "health" products, flavored or artificially sweetened yogurt, infant formula, sweets, and frozen dessert rolls. If you count alcohol as food, distilled spirits like whiskey or vodka and colorful alcopops fit here as well.

Why does this matter?

Several studies have shown harmful health effects from consuming ultra-processed foods. Higher mortality and increased rates of disease have been observed in participants whose diets mainly consisted of ready-made meals and highly processed products. This includes a worse cardiometabolic risk profile, that is, a higher risk of developing cardiovascular disease, as well as higher overall mortality, increased cancer risk, more changes in cerebral blood vessels, including strokes, and also depression.

A Brazilian study even identified high consumption of ultra-processed foods as an independent risk factor for premature death. The researchers demonstrated a linear increase in mortality with rising intake of ultra-processed foods.

Many health-related dietary guidelines therefore recommend avoiding highly processed foods, because they tend to be high in calories, contain unhealthy fats, a lot of salt and/or sugar, and have few vitamins and fibers.

On top of that, the health effects of the many possible additives are often unknown or poorly understood. Reports of potential health risks from these substances repeatedly appear in the media. Quite often, they concern additives that were previously considered harmless.

Like other additives, sugar substitutes are repeatedly criticized. Erythritol was linked in a 2023 study to increased platelet aggregation, meaning a greater tendency for blood clotting. Earlier studies have also been rather critical of this sugar substitute.

In another 2023 study, researchers found that the sweetener sucralose might affect certain immune cells.

In summary, higher UPF consumption was associated, albeit in a limited number of studies, with a poorer cardiometabolic risk profile and a higher risk of cardiovascular disease, cerebrovascular disease, depression, and all-cause mortality.

Sources

This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day. Our content is based on carefully researched, evidence-based data and is continuously updated (as of 12/2025).

Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.