Eat Real Food? Nutrition Advice · Episode 7 of 9 · 22 min
The War on Processing — Ultra-Processed Food
A Brazilian epidemiologist noticed obesity rising fastest among poorer Brazilians and began classifying foods by how industrially they were made, creating the NOVA system and the category ultra-processed food. A large body of research links it to many harms, and a 2019 NIH trial found about 500 extra calories a day. Whether processing itself is to blame remains unsettled.
Who's who
- Carlos Augusto MonteiroUniversity of São Paulo epidemiologist and architect of the NOVA classification
- Kevin HallNIH physiologist who ran the 2019 inpatient ultra-processed feeding trial
Where it happens
- São Paulo, Brazil+1 more episodeWhere Monteiro developed the ultra-processed food concept
- Brazil+3 more episodesFirst country with national dietary guidelines built around NOVA
Timeline
- Mid-1990sMonteiro sees obesity climbing among lower-income Brazilians
- 2010The NOVA classification is formally published
- 2014Brazil issues dietary guidelines advising people to avoid ultra-processed foods
- 2019Hall's NIH trial finds about 500 extra calories a day on an ultra-processed diet
- March 2024BMJ umbrella review links the foods to 30-plus outcomes but grades most evidence low quality
- November 2025The Lancet publishes a three-paper series on ultra-processed food
Still debated
Whether processing itself harms health, independent of sugar, salt and fat, is genuinely unsettled. Critics call NOVA's top category subjective and the observational evidence confounded by income, and scientists disagree whether the evidence justifies policy yet.
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