Doughnuts can be irresistible for some individuals, leading to unhealthy eating habits. One consumer admitted, “I can’t even be in the same vicinity as… any type of doughnuts because I will finish a dozen all by myself. I’m a type 2 diabetic, so that could kill me… but for some reason, I just can’t stop eating them.” This illustrates the struggle many face in avoiding certain unhealthy foods.
According to Bobby Mukkamala, MD, President of the American Medical Association (AMA), the prevalent consumption of ultraprocessed foods in the American diet raises significant health concerns. Dr. Mukkamala recently collaborated with nutrition experts during an AMA webinar, focusing on the origins of these foods and the challenges patients encounter in resisting overconsumption.
In 2025, the AMA House of Delegates directed the organization to enhance public understanding of the health risks associated with ultraprocessed foods. The recently published Dietary Guidelines for Americans, 2025–2030 advises consumers to steer clear of highly processed, ready-to-eat products. Nonetheless, this still poses a perplexing issue for health experts.
So, what exactly defines ultraprocessed foods? Is all processing harmful? “What do we know about these products and how they affect health?” inquired Dr. Mukkamala, an otolaryngologist also certified in lifestyle medicine.
The on-demand webinar titled “Understanding Processed Foods” is accessible at the AMA Ed Hub™. The AMA has awarded this combined live and enduring session with a maximum of 1 AMA PRA Category 1 Credit™. This was the second of four webinars in the AMA Ed Hub series on “Healthy Diet and Dietary Patterns,” all hosted by Dr. Mukkamala. The final session, “Reducing Risk of Chronic Disease Through Diet,” is scheduled for June 23 at 2 p.m. CDT. Learn more and register now.
Why Broad Classifications Don’t Work
Despite rising concerns regarding ultraprocessed foods in both research and public health spheres, David Ludwig, MD, PhD believes that this classification may be too broad and vague to effectively guide nutritional advice.
Dr. Ludwig points out that the term “ultraprocessed foods” lacks a clear definition, even to the Food and Drug Administration. An esteemed pediatric endocrinologist and researcher at Boston Children’s Hospital, he is also a professor at Harvard Medical School and Harvard School of Public Health.
Although many observational studies indicate a correlation between ultraprocessed foods and a variety of adverse health outcomes—such as obesity, diabetes, cardiovascular disease, cancer, and cognitive decline—the overall quality of this evidence is considered low to very low, according to Dr. Ludwig, who cites issues like confounding factors and inconsistencies.
Furthermore, Dr. Ludwig critiques Brazil’s Nova classification system, which categorizes foods as minimally processed or whole, culinary ingredients, combinations of these, or ultraprocessed. This system isn’t based on health effects but rather whether certain ingredients or additives are typically used in home cooking, potentially resulting in what he calls “nonsensical distinctions.” For instance, it might allow homemade sugary cornflakes while discouraging some high-fiber packaged cereals.
Dr. Ludwig advocates for a more detailed assessment of how various types of food processing impact health, specifically emphasizing the refining of carbohydrates and certain additives. The recent dietary guidelines may be contentious, but he acknowledges one aspect they got right: “They don’t use the term ultraprocessed. They use highly processed specifically as it relates to carbohydrates,” he said.
Consumers Should Prioritize Certain Foods
Moving beyond mere definitions, other speakers from the webinar offered insights on making informed choices about food.
Dr. Neal Barnard, an adjunct professor of medicine at George Washington University and president of the Physicians Committee for Responsible Medicine, advised against indiscriminately avoiding everything labeled as ultraprocessed. Instead, he emphasized the importance of prioritizing whole plant foods and avoiding processed meats and sugar-sweetened beverages.
Talking about sugar, Dr. Barnard clarified, “It’s not always a bad thing. It’s your body’s favorite fuel,” pointing out that small amounts added to foods differ from sugar found in beverages. His main concern lies with sodas and similar drinks, where large quantities of sugar can be consumed rapidly, contributing to weight gain and diabetes risk. He also noted that high-fat diets can quickly impair insulin sensitivity, while excess sodium increases hypertension and stroke risks.
Processed meats were singled out by Dr. Barnard as particularly alarming, labeling them as significant contributors to health risks such as cancer, diabetes, and cardiovascular disease.
For better choices, consumers are encouraged to scrutinize the total fat and saturated fat content on food labels, he advised.
How Foods Are Processed Makes a Difference
Dr. Barnard also challenged the notion that all packaged or processed foods are detrimental. Based on cohort studies, he mentioned that some foods labeled ultraprocessed—like specific breakfast cereals, yogurt, and plant-based meat alternatives—have been associated with neutral or even positive health outcomes, while processed meats and sugary drinks consistently show adverse effects.
He cited soy milk as an example, arguing that some plant-based alternatives can enhance low-density lipoprotein (LDL) cholesterol, blood pressure, and inflammation compared with animal-based products.
Dr. Ludwig also pointed out that not all processing yields the same health implications. “Processing of carbohydrates is consistently unhealthy,” he noted, emphasizing concerns related to refined grains and quickly digested carbohydrates. However, processing fats and proteins often appears to have far less impact, as seen with items like olive oil, peanut butter, and tofu, which may have similar metabolic effects as their less processed counterparts.
When Processing Leads to Addiction
However, some ultraprocessed foods can lead to addictive eating behaviors, highlighted Dr. Ashley Gearhardt, a psychology professor specializing in clinical science at the University of Michigan.
Dr. Gearhardt explained that these products engage the brain’s reward systems similarly to addictive substances. She noted that “high glycemic load” foods are strong predictors of consumption patterns that resemble addiction, with fat amplifying the reward when paired with refined carbohydrates.
This differs from minimally processed foods, as industrial processing can “destroy the food matrix,” speed up absorption, reduce satiety signals, and facilitate “flavor engineering” designed to maximize enjoyment. “They are pulling every single lever at their disposal,” she remarked, describing an industry focused on intensifying cravings and consumption.
Furthermore, aspects like sensory engineering, product formulation, and widespread availability contribute to making some ultraprocessed foods hard to resist. Dr. Gearhardt compared these strategies to those used by the tobacco industry, asserting that such foods are not designed for moderate consumption. Instead, they create cue-triggered cravings linked to memorable branding elements or catchy jingles, leading to compulsive overeating despite negative effects.
To aid those struggling with such cravings, Dr. Gearhardt co-developed the Yale Food Addiction Scale, a tool that can identify individuals who may need additional support in managing their eating behaviors.
“We need systematic solutions that identify the corporate engineering of harm that has essentially figured out how to hack our limbic system for overwhelming corporate gain,” she concluded.
