These days, it feels like everyone is talking about ultra-processed foods. The federal government is trying to come up with a better way to define and regulate them, and studies are constantly pointing to their health harms.1

“People have been told so many times now that processed foods are bad,” to the point that they can start to seem “evil,” said Angela Zivkovic, PhD, a professor in the University of California, Davis’ department of nutrition.

New research suggests it’s not that simple. Your overall diet quality seems to matter more than whether you eat processed foods, said Xiaowen Wang, PhD, a postdoctoral research fellow at the Harvard T.H. Chan School of Public Health who led the new study.

“People should look beyond the label ‘ultra-processed’ and consider the food’s nutrient content and its role in their overall dietary pattern,” Wang told HEALTH.

What’s an Ultra-Processed Food, Anyway?

“Processed” and “unhealthy” aren’t synonyms, even though they’re sometimes used that way. Previous studies have shown that not all ultra-processed foods are created equal, and that it’s possible to form a healthy diet from ultra-processed foods with better nutritional profiles.23

The federal government is actively working on a new, uniform definition for ultra-processed foods. But for now, the most commonly used categorization system goes like this:4

• Group 1, unprocessed or minimally processed: Naturally occurring foods without additives
• Group 2, culinary ingredients: Foods from group 1 that have been processed for use in cooking, such as salt, vegetable oils, sugar, and butter
• Group 3, processed: Group 1 foods that include group 2 additives meant to improve taste or shelf life, such as canned goods and cured meats
• Group 4, ultra-processed: Industrially created foods that include ingredients you wouldn’t find in a home kitchen, such as frozen meals, packaged desserts, flavored yogurts, and plant-based meat substitutes

A frozen pizza and a frozen veggie burger likely have very different nutrient profiles. Do they really have the same effect on your health, just because they both fall into the ultra-processed category? That’s where Wang’s study comes in.

What the New Study Found

For the new research—which was presented at a July nutrition conference but has not yet been published in a peer-reviewed journal—Wang’s team drew on data from three studies that followed more than 200,000 U.S. adults for decades. About half of the participants died or developed heart disease or type 2 diabetes during the monitoring period.

The researchers analyzed the overall quality and processing level of participants’ diets. For comparison’s sake, they focused on plant-based foods rather than those that came from animals. Then, they sorted participants into four categories:

• Healthy and ultra-processed (for example, lots of whole-grain cereals and plant-based dairy substitutes)
• Healthy and minimally processed (oatmeal, fresh fruits and vegetables, home-cooked meals)
• Unhealthy and ultra-processed (fast food, packaged snacks, sodas)
• Unhealthy and minimally processed (white rice, potatoes, homemade desserts)

Overall diet quality, they found, was a better predictor of health problems than processing level.

People in both of the “healthy” groups were at lower risk of death and chronic disease, while people in both of the “unhealthy” groups were at higher risk. People who followed a healthy but processed diet were at 14% lower risk of heart disease, 33% lower risk of type 2 diabetes, and 11% lower risk of death; in the healthy but less-processed group, those numbers were 18%, 34%, and 7%.

“A healthy plant-based diet rich in whole grains, fruits, vegetables, legumes, nuts, and healthy plant oils was associated with lower risks of heart disease, type 2 diabetes, and premature death, even when some of those foods were classified as ultra-processed,” Wang said.

So, Should You Avoid Ultra-Processed Foods?

Studies like this one can only find patterns, not prove cause and effect. It’s also hard to comment on specifics about the data before the full study has been published, said Zivkovic, who was not involved in the new research.

But the study’s main finding, which builds upon other research on this topic, is important, she said. “There’s more to this story than just the processing,” Zivkovic said.

That’s certainly not to say all—or even most—ultra-processed foods are good for you. “The vast, vast majority of foods that would be considered unhealthy are ultra-processed,” said Maya Vadiveloo, PhD, RD, an associate professor of nutrition at the University of Rhode Island who was not involved in the new research.

The point is that processing level, alone, only tells you so much.

Wang said she doesn’t automatically avoid foods because they’re ultra-processed—nor does she assume a food is healthy just because it’s not heavily processed. The idea is to eat lots of nutrient-rich foods that provide protein, fiber, vitamins, and minerals, without eating too much salt, added sugar, and saturated fat.

“You want to be focusing on the overall pattern,” Vadiveloo said, “more so than whether this one food came from a package or not.”