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A Critical Review of the Science on "Highly" Processed Food Intake and Body Weight
Giorgia Rutigliani1, Joseph Balagatas2, Richard D Mattes1
1Department of Nutrition Science, Purdue University, West Lafayette, IN, United States.
Advances in Nutrition (Bethesda, Md.)
|June 16, 2026
Summary
Dietary guidance on highly- or ultra-processed foods and beverages (HPFB) is controversial. Current evidence does not adequately support a causal link between HPFB intake and obesity risk, questioning its public health benefit.
Area of Science:
- Nutrition Science
- Public Health Policy
- Dietary Guidelines
Background:
- Dietary guidance increasingly considers food processing, particularly highly- or ultra-processed foods and beverages (HPFB), for managing obesity.
- The evidence base linking HPFB to health outcomes is controversial due to undefined terms and inconsistent findings.
- Observational studies suggest HPFB intake is associated with greater obesity risk, but these associations are weak and inconsistent.
Purpose of the Study:
- To critically assess the evidence supporting a causal relationship between highly- or ultra-processed foods and beverages (HPFB) intake and obesity risk.
- To evaluate the scientific validity of current dietary guidance focused on HPFB.
- To determine if HPFB-based dietary guidance is in the public's best interest.
Main Methods:
- Review and critical assessment of observational studies and randomized controlled trials (RCTs) on HPFB intake and health outcomes.
- Analysis of metabolic ward feeding trials and community-based dietary interventions.
- Evaluation of the definition and predictive health risks associated with different HPFB definitions.
Main Results:
- Observational studies show weak and inconsistent associations between HPFB intake and obesity risk.
- Metabolic ward trials reported no significant changes in appetite or only transient shifts in food intake.
- Community-based trials demonstrated challenges in intervention adherence and yielded mixed results on weight changes, with no consistent support for a causal link between HPFB and obesity.
Conclusions:
- Current evidence from RCTs does not adequately support a causal relationship between highly- or ultra-processed foods and beverages (HPFB) intake and obesity risk.
- Potential adverse effects of eliminating HPFB, including increased food costs and reduced convenience, must be considered.
- Dietary guidance solely based on the HPFB concept is currently not in the public's best interest due to insufficient evidence and potential negative consequences.
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