By Joan Salge Blake, EdD, MS, RDN, LDN, FAND
Many researchers have been using the NOVA food classification system to categorize foods based on their level of processing. NOVA is not an acronym, but rather the name for the system developed by the Center for Epidemiological Studies in Health and Nutrition, School of Public Health at the University of São Paulo in Brazil. The NOVA system has four groups of processed foods, with group 1 being the least processed and group 4 being the most processed. Here’s a breakdown of the four groups and some food examples:
| Groups | Examples |
| Group 1 Unprocessed or Minimally Processed Foods: Naturally occurring foods with no added salt, sugar, oils, or fats. | Milk, meat, eggs, fish, poultry, plain unsweetened yogurt, beans, fresh, frozen, or dried fruits and vegetables, oats, grits, pasta, rice. |
| Group 2 Processed Culinary Ingredients: Food products from Group 1 that have been processed by pressing, refining, grinding and/or milling; they are used in home and restaurant kitchens to prepare, season and cook Group 1 foods. | Vegetable oils, butter, vinegar. Salt, sugar and molasses from cane or beet, honey extracted from combs and syrup from maple trees. |
| Group 3 Processed Foods: Food products made by adding sugar, oil and/or salt to create simple products from Group 1 foods with increased shelf life or enhanced taste. | Canned vegetables, fruits, and beans; some salted or sugared nuts and seeds; salted, cured, or smoked meats; canned fish; fruits in syrup; cheese and freshly made bread. |
| Group 4 Ultra-Processed Foods: Industrially created food products created with the addition of multiple ingredients that may include some Group 2 ingredients as well as additives to enhance the taste and/or convenience of the product, such as hydrolyzed proteins, soy protein isolate, maltodextrin, high fructose corn syrup, stabilizers, flavor enhancers, non-sugar sweeteners, and processing aids such as stabilizers and bulking and anti-bulking agents. | Commercially produced breads, rolls, cakes, cookies, donuts, breakfast cereals, soy burgers, flavored yogurts, ready-to-heat meals, such as frozen pizzas, soft drinks, and candy. |
All foods go through processing before they are consumed. When a person washes and cooks dried chickpeas to be edible, this is considered minimal processing and the chickpeas are classified as a group 1 food. Ready-to-eat canned chickpeas that you can drain and add to meals are considered a processed food in group 3. When you buy a commercially made hummus, which is made with chickpeas but has guar gum added as a stabilizer, this product would be considered a group 4 ultra-processed food. That means this hummus is in the same category as commercially produced sweetened beverages, chips and many sweet treats.
Some prospective, population-based research studies suggest that eating patterns high in ultra-processed foods are associated with increased incidences of chronic diseases such as obesity, heart disease and Type 2 diabetes. However, due to the nature of these studies, when compared to randomized control trials, it cannot be concluded that ultra-processed foods cause these diseases but rather are associated with them.
Some group 4 foods, such as hummus made with or without a stabilizer — and especially if consumed with baby carrots or other vegetables — are nutritionally superior to a calorie-dense, but nutrient-poor snack of donuts, candy or chips. According to the 2020-2025 Dietary Guidelines for Americans, consuming a diet rich in added sugars or saturated fat may displace healthier foods such as fruits, whole grains and dairy which, as part of a well-balanced eating pattern, are associated with reducing chronic diseases.
Nutrition professionals should question the simplicity of the NOVA system as a tool to denote healthful foods based only on processing and not also considering the nutritional quality of the foods.
A recent study published in Diabetes Care, which analyzed three large prospective cohort studies, found that while an overall diet containing a higher level of ultra-processed foods increased the risk of Type 2 diabetes, there were some subgroups of ultra-processed foods — namely breakfast cereals, whole-grain breads, yogurt and dairy-based foods — that lowered this risk. This finding raises the question of whether a food categorized as ultra-processed under the NOVA system might be miscalculated and could be included as a regular part of healthful eating pattern.
To answer this question, researchers in an USDA-funded study published in The Journal of Nutrition planned a seven-day, 2,000-calorie daily diet that was based on the recommendations in the Dietary Guidelines but with more than 80% of the foods coming from NOVA’s ultra-processed food category. The results showed that this planned diet achieved a Healthy Eating Index (HEI) score of 86 out of 100 points. The HEI measures the diet quality and evaluates to what extent Americans are following the Dietary Guidelines. For reference, the current HEI for Americans is 59 on average, meaning many Americans are consuming a diet below what is considered desirable.
Nutrition professionals should critically assess if using the NOVA system to categorize foods provides a health benefit to the consumer. Other valuable resources include MyPlate and the Nutrition Facts Panel to assess the nutrition composition of packaged foods. With food prices remaining high, it is important for nutrition professionals to communicate science-based information to patients or clients and the public on how to incorporate all types of healthful, affordable foods including canned, frozen and packaged foods — even those that may be categorized as ultra-processed by the NOVA system — into their eating pattern.
References:
- Monteiro CA. Nutrition and health. The issue is not food, nor nutrients, so much as processing. Public Health Nutrition. 2009;12(5):729-731.
- Monteiro CA, Levy RB, Claro RM, Castro IR, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica. 2010; 26(11):2039-49.
- Monteiro C. The big issue is ultra-processing. World Nutrition. 2010; 1(6):237-269.
- Monteiro CA, Cannon G, Levy RB, Moubarac J-C, Jaime P, Martins AP, Canella D,
Louzada ML, Parra D; with Ricardo C, Calixto G, Machado P, Martins C, Martinez E, Baraldi L, Garzillo J, Sattamini I. NOVA. The star shines bright. Position Paper 2. World Nutrition. 2016; 7(1-3):28-38. - Srour B, Fezeu LK, Kesse-Guyot E, et al. Ultra-processed food intake and risk of cardiovascular disease: Prospective cohort study (NutriNet-Santé). BMJ. 2019; 1451.
- Chen Z, Khandpur N, Desjardins C, et al. Ultra-processed food consumption and risk of type 2 diabetes: Three large prospective U.S. cohort studies. Diabetes Care. 2023;46(7):1335-1344.
- Beslay M, Srour B, Méjean C, Ultra-processed food intake in association with BMI Change and risk of overweight and obesity: A prospective analysis of the French NutriNet-Santé cohort. PLOS Medicine. 2020;17(8).
- U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition.
- Chen Z, et al. Ultra-processed food consumption and risk of type 2 diabetes: Three large prospective U.S. cohort studies. Diabetes Care. 2023
- Hess, J, Comeau, M, Casperson, S, Slavin, J, Johnson, G, Messina, M, Raatz, S, Scheett, A, Bodensteiner, Palmer, D. Dietary guidelines meet nova: Developing a menu for a healthy dietary pattern using ultra-processed foods. The Journal of Nutrition. 2023;153(8), 2472–2481.
- Healthy eating index (HEI). Food and Nutrition Service U.S. Department of Agriculture.
Join the Academy
Members of the Academy of Nutrition and Dietetics receive exciting benefits including complimentary continuing professional education opportunities, discounts on events and products in eatrightSTORE.org, invitations to exclusive members-only events and more!