As the nation’s top healthcare leaders consider how to define ultraprocessed foods, a new survey of consumer views on processed foods sought to learn what American adults thought the terms meant and whether they believed all processed foods are unhealthy.

The recent survey by the Physicians Committee for Responsible Medicine (PRCM) found that among a representative sample of Americans of ages 18 to 92, consumers are equally divided about whether all processed foods are unhealthy. The remainder are unsure or don’t know, according to research published in JAMA Network Open in July.

There are currently no universally accepted definitions for processed and ultraprocessed foods. The Nova food classification system defines processed foods as products changed from their natural state with two of three ingredients while ultraprocessed foods are recognized as industrially processed products made with five or more ingredients. The definitions haven’t been updated in many years.

Processed products, in general, are known to be high in sugar, saturated fats, and additives such as artificial dyes that lead to chronic health conditions. They may also contain colorants, flavorings, sweeteners, emulsifiers, and thickening agents.

In the new study: 

• 28% cited meat products as the unhealthiest processed foods
• 14% said shelf-stable foods such as canned, packaged, and frozen items
• 13% said foods with artificial additives

When asked which foods increased type 2 diabetes risk:

• 51% said desserts
• 15% said carbohydrates, in general
• 7% said processed foods
• 1% said meat products

The study included nearly 2200 participants who completed an online survey in December.

Study authors were particularly alarmed that younger participants failed to identify meat as a processed food, considering its tendency to raise risks for diabetes, colorectal cancer, and cardiovascular disease. Study participants also didn’t seem to recognize that plant-based foods, even breakfast cereals considered ultraprocessed, can reduce risks for these conditions, according to lead study author Neal Barnard, MD.

He believes doctors can help their patients make better dietary choices if they explain: “When it comes to processed foods, low-fat plant-derived foods are typically healthy and animal-derived foods are typically unhealthy,” said Barnard, PCRM’s founding president and a professor at the George Washington University School of Medicine, Washington, DC.

The confusion consumers express about processed foods is part of the challenge the nation’s top healthcare leaders also face lately as they consider how to reduce America’s reliance on ultraprocessed foods, clinicians told Medscape Medical News.

The clinicians agree that processed food terms are misleading, but they differ in their views on whether some of those foods are beneficial. They say they also don’t receive much nutritional training and the lack of standard definitions for processed and ultraprocessed foods complicates how they counsel patients to improve their diets.

Regulatory Initiatives 

National attention has focused lately on regulating ultraprocessed foods. More than half of the daily calories Americans consume come from such foods, according to a recent report from the National Center for Health Statistics.

The White House targeted ultraprocessed foods in its initial Make America Healthy Again report earlier this year. The final report released on September 9, though, only mentions efforts to develop a formal definition for ultraprocessed foods.

A draft of the final recommendations, indicated the administration would promote the benefits of whole foods and seek a definition for ultraprocessed foods over stronger regulations.

In August, the American Heart Association released guidelines for the consumption of the foods and several states are considering legislation to regulate their use.

Meanwhile, the 2025 Dietary Guidelines Advisory Committee report released in December noted the lack of a clear definition of ultraprocessed foods but didn’t make any recommendations about them. The report emphasized increasing plant-based protein and cutting down on red and processed meats.

The American Medical Association encourages doctors to counsel their patients on reducing “unhealthful” ultraprocessed foods as part of a new policy its House of Delegates adopted in June. The policy promotes public awareness and education about the differences between “healthful and unhealthful ultraprocessed foods, as well as the benefits of minimally processed and unprocessed foods.” 

Are All Processed Foods Equal?

Many clinicians disagree that cereal and related ultraprocessed foods are healthy.

Cereals with added sugar can contribute to weight gain, diabetes, and overeating, said Dalia Perelman, a research dietitian at the Stanford Prevention Research Center, Stanford, California.

Perelman concedes that some plant-based ultraprocessed foods are often a better choice for patients than animal-based ones, but she’s concerned about additives and preservatives that change food composition and strip away nutrients, including in many cereals and breads.

While terms such as “ultraprocessed” can be confusing, Perelman believes they’re still useful for guiding patients toward less engineered, more natural forms.

She advises clinicians to help patients read labels for added sugars, saturated fat, sodium, and additives. “A good rule of thumb: If the list reads like a recipe full of ingredients you wouldn’t cook with at home, it’s likely ultraprocessed.”

“The goal is to encourage patients to choose less processed foods more often and build meals from fresh ingredients like vegetables, whole grains, legumes, nuts, and seeds. For those who eat meat, lean cuts are preferable, while processed meats like bacon and sausage should be limited.”

Lack of Doctor Training 

Stephen Devries, MD, a preventive cardiologist and executive director of the nonprofit Gaples Institute, Deerfield, Illinois, said most doctors don’t receive the nutrition education they need to counsel their patients about ultraprocessed foods.

Nutrition lessons in medical school tend to focus on biochemical pathways related to vitamin deficiencies, Devries explained.

“Medical education needs to focus more on how clinicians can integrate nutrition science into patient care. They should be able to explain what a whole grain is, and how whole grains have beneficial nutrients that are stripped away when grains are refined to make ultraprocessed foods.” 

Recognizing the need for more education in this area, a nutrition course offered by the Gaples Institute is now required in the curriculum in 10 medical schools, according to Devries, executive director of the educational nonprofit. The course is also used in graduate medical education and by practicing physicians.

Devries said he understands the confusion surrounding ultraprocessed foods, compounded by efforts to separate foods into good or bad, ultraprocessed or not.

“Some foods are clearly highly manufactured, loaded with added sugar and preservatives, and don’t resemble a whole food at all. I think people largely assume that they’re not healthy,” he said.

“A lot of packaged snack foods and desserts fall into that category. On the other hand, some foods, like 100% whole grain bread, can be labeled as ultraprocessed because of how they’re manufactured. These foods have a much better health profile and, in moderation, aren’t a problem.” 

Even products that start off as healthy whole foods, such as oatmeal or yogurt, can end up unhealthy with added sugars, flavorings and additives, Devries added.

He emphasized that the biggest health risks from ultraprocessed foods are from ultraprocessed meats such as hot dogs, sausage, and bacon, and sugar-sweetened beverages. As a start, Devries suggested counseling patients to focus on reducing or eliminating ultraprocessed meats and sugar-sweetened beverages. Doctors could also help patients compare products to find those with more fiber and less sugar.

“More broadly, I think it’s essential for physicians to convey the message to patients that taking the prescribed medication is essential, but medicine alone isn’t enough. Optimal health can only be achieved through a combination of attention to nutrition and lifestyle added to prescribed medication.” 

The Future for Ultraprocessed Foods

Christopher Gardner, PhD, director of nutrition studies at the Stanford Prevention Research Center, said the recent attention to ultraprocessing may eventually convince food manufacturers to “remove and replace many of those cosmetic ingredients” similar to past efforts to reduce trans fats from certain products. But it will take a while, he cautioned.

“We ended up putting it in the nutrition fact panel [to show] that trans fats were industrially processed and not good for us, but it took decades of research to get this one thing on the label,” Gardner said about the packaging change that took effect in 2006.

He also cited California’s 2023 law to prohibit the manufacture, distribution, and sale of food and beverages that contain brominated vegetable oil and other harmful additives that can be found in such products as candy, fruit juice, and cookies. The food additives had been banned in several countries decades earlier, said Gardner, who recently served on the 2025 Dietary Guidelines Advisory Committee.

“As to whether this new designation of UPF [ultraprocessed food] is additionally helpful [to patients and consumers], well, that’s kind of up in the air,” he said. “Most of the foods that have them are already pretty low in nutritional quality.”

It would also be impossible to study the huge number of ingredients individually in some of the products used to make them look, smell, and taste good and even be addictive to convince the food industry to remove them, Gardner said. “So it’s a little unrealistic to think that this new attention to ultraprocessed foods is going to be the solution health professionals have been looking and hoping for.”

Efforts to remove ultraprocessed foods from public school lunches, such as proposed in California, also means coming up with inexpensive alternatives. Even if food manufacturers reformulate their products with whole foods instead of cosmetic ingredients and high salt, sugar, and fat, the food will cost more and may become unaffordable to some of the many Americans who currently purchase a lot of ultraprocessed foods, he said.

Trying to completely remove all ultraprocessed foods will be difficult to implement without further research, but Gardner believes clinicians can advise their patients to reduce consumption of the many ultraprocessed foods that are also high in sugar, salt, and saturated fat.

Still, he said he’s interested to see if pressure from the public and government can help remove at least some of the ultraprocessed foods from the American diet.

Roni Robbins is a freelance journalist and former editor for Medscape Business of Medicine. She’s also a freelance health reporter for The Atlanta Journal-Constitution. Her writing has appeared in WebMD, HuffPost, Forbes, New York Daily News, BioPharma Dive, MNN, Adweek, Healthline, and others. She’s also the author of the multi-award-winning novel Hands of Gold: One Man’s Quest to Find the Silver Lining in Misfortune.