The Nova definitions are used to define ultra-processed foods (Monteiro, et al., 2019).

UPFs might provide a clearer understanding around plant-based, whole-food diets (which may tend to be less processed) and the on-going debate between the different macronutrient contents.

Srour et al identified that 1 10% increase in dietary UPFs led to a 15% higher risk of developing Type 2 Diabetes (Srour, et al., 2020).

Levy et al have performed a prospective study involving over 21,000 participants in the UK and identify a hazard ratio of 1.44 between the lowest and highest quartiles of UPF consumption (Levy, et al., 2021).

1.1 million individuals were studied in a metanalysis in 2022 which confirm a positive association with a relative risk increase of 12% between zero consumption and moderate consumption of UPFs (Delpino, et al., 2022).

Dietary approaches based on these studies overall tend to take a ‘non-processed’ approach to foods, reducing meat and eating foods that have a lower glycaemic index will lead to significant improved outcomes in Hba1c and also in down-stream impacts of cardiovascular disease, with potentially further reaching impacts including in long-term cancer risk.

Low-carbohydrate as an approach is potentially contentious as is going plant-based for individual and communities’ lifestyles and culture, however a combined approach appears to be most effective.

UPFs provide another dimension in helping to understand why different studies identify different responses in macronutrient constituents. UPFs are likely to have to foods with a higher GI (Fadet, 2016), and may drive excess energy food intake (Hall, Ayuketah, Brychta, & al, 2019).

Srour et al (2020) noted the reduce dietary quality as UPF consumptions increased intake of sodium, sugar, fat, reduced fibre, reduced fruit and veg, increased processed meat and sugar and/or sweetened beverages.