Highly processed foods: not all of them are bad for your health

Highly processed foods are generally considered unhealthy. But the potential risks for diabetes and CVDs depend heavily on specific product types.

Key Findings at a Glance

In the studies analyzed, meat, sugary drinks (including “diet” products), fats, sauces, and spreads fared particularly poorly. They may increase the risk of diabetes, cardiovascular disease, and overall mortality.
In contrast, several studies show that bread, cereals, cookies, and whole-grain products are associated with more favorable cardiometabolic outcomes.

About the Study

In large-scale dietary studies, highly processed foods are often linked to a higher risk of type 2 diabetes, cardiovascular disease, and other chronic conditions. However, according to the NOVA criteria, a wide variety of products are classified as “highly processed”—ranging from soda to packaged whole-grain bread. This makes it difficult to draw a blanket conclusion. A research group investigated whether different groups of highly processed products are indeed equally associated with adverse health outcomes or whether a more nuanced approach is warranted.

The review included 14 publications that examined subgroups of highly processed foods separately (e.g., sweetened beverages, bread, meat). The study investigated the extent to which these individual product categories are associated with diabetes, cardiovascular disease, and mortality.

Mixed Results

The studies consistently showed that the following groups of highly processed foods were associated with type 2 diabetes, high blood pressure, and increased mortality:

Meat (e.g., sausage, ham, processed meat),
sweet beverages—both those containing sugar and those sweetened with artificial sweeteners,
fats (e.g., margarine), spreads, and sauces.

Highly processed bread, cereals, cookies, and some whole-grain products, on the other hand, fared significantly better—they were even associated with beneficial cardiometabolic effects.

When it comes to sweets and desserts, however, the overall picture is less consistent. The reason: depending on the study, this category included a wide variety of products—from cakes to chocolate, ice cream, or milk-based desserts. Depending on which sweets were consumed, the results varied.

What Makes Some Products More Problematic

The fact that foods are associated with different cardiometabolic effects can be explained, among other things, by the following mechanisms:

Processed meat, for example, is often high in salt, saturated fats, and additives such as nitrites and nitrates. This can contribute to high blood pressure, hyperlipidemia, and inflammatory processes. Added to this is a high heme iron content, which can promote oxidative stress and insulin resistance. Some components (e.g., L-carnitine and choline) are also converted by gut flora into metabolic byproducts that have been linked to atherosclerosis, severe cardiovascular events, and death.
With sugary drinks, the problem is often simply the quantity: you quickly consume a lot of calories without subsequently eating less. This makes it easier to develop a calorie surplus in everyday life. With artificially sweetened drinks, the mechanism of action is less clear. Effects on gut flora and insulin sensitivity are being discussed. It is also conceivable that they are simply a sign of an overall unhealthy diet.
The fact that bread, cereals, and whole-grain products are less problematic may be due to their fiber content. Fiber keeps you full longer, aids in weight control, slows the rise in blood sugar after eating, and supports insulin sensitivity. Whole-grain products also provide micronutrients, antioxidants, and magnesium, which reduce oxidative stress and may have a beneficial effect on blood pressure. Another aspect is that dietary fiber is fermented in the gut. The short-chain fatty acids produced in this process support sugar and fat metabolism and can counteract inflammatory reactions as well as endothelial dysfunction.

Conclusion

The key message of the review is that not everything classified as “highly processed” according to the NOVA classification is automatically unhealthy. Foods repeatedly associated with adverse cardiometabolic outcomes and an increased risk of mortality include processed meat, sugary drinks, and high-fat sauces and spreads.

Bread, cereals, cookies, and whole-grain products require a more nuanced assessment. Whole-grain products, in particular, can help people adopt a diet that is more plant-based and higher in fiber overall. Thus, despite their high degree of processing, they can be beneficial to health.

Source

Kahleova H, Himmelfarb J, Barnard ND. Not all ultra-processed foods are created equal: a review. BMJ Nutrition, Prevention & Health. 2026;:e001358. https://doi.org/10.1136/bmjnph-2025-001358