Consumer Attitudes and Food Labeling Open access Peer reviewed

Are All Ultra-Processed Foods Created Equal? Descriptive Analysis of Nutritional Composition, Nutritional Quality, Energy Density and Hyperpalatability in Relation to Non-Communicable Disease Risk

Melvin Bernardino, Julia T. Regalado, Silvia Gazzin, Claudio Tiribelli and 1 more

Foods | Jul 28, 2026

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It is suggested that UPFs are not nutritionally uniform and that assessment of UPF-related health relevance should consider food group, subgroup, nutrient profile, energy density, and hyperpalatability in addition to processing classification.

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Ultra-processed foods (UPFs) are increasingly consumed worldwide, and higher consumption has been linked to higher risk of non-communicable diseases (NCDs). This study examined the nutritional composition and quality, energy density, and hyperpalatability of UPFs available in the Italian food market according to their literature-derived NCD-risk categories. Products were classified into main food groups and subgroups and further categorized according to reported associations with NCD risk: positive, negative, or no reported association. Differences between the main food groups were analyzed in RStudio using non-parametric tests, with results summarized using medians and interquartile ranges. A total of 13,025 UPF products were included in the analysis. UPFs showed substantial variation in nutritional composition, nutritional quality, nutrients-of-concern levels, energy density, and hyperpalatability across the main food groups and literature-derived NCD-risk categories. Snacks represented the largest UPF group and showed the most consistently unfavorable profile, including high median energy, carbohydrate, saturated fat, and sugar contents, a high proportion of Nutri-Score D and E products, and the highest proportion of medium- and high-energy-density products. Overall, 64.3% of UPFs were classified as Nutri-Score D or E, indicating generally lower nutritional quality. However, unfavorable nutritional characteristics were not limited to UPF subgroups reportedly associated with increased NCD risk; some subgroups reportedly associated with lower or no reported NCD risk also contained products with poor nutritional quality, high energy density, or hyperpalatable profiles. These findings suggest that UPFs are not nutritionally uniform and that assessment of UPF-related health relevance should consider food group, subgroup, nutrient profile, energy density, and hyperpalatability in addition to processing classification.

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Researchers on this paper

Melvin Bernardino

first | University of Trieste | ORCID 0000-0002-3625-6775

Julia T. Regalado

middle | University of Trieste | ORCID 0009-0001-7323-0937

Silvia Gazzin

middle | Fondazione Italiana Fegato | ORCID 0000-0001-9403-3564

Claudio Tiribelli

middle | Fondazione Italiana Fegato | ORCID 0000-0001-6596-7595

Natalia Rosso

last | Fondazione Italiana Fegato | ORCID 0000-0002-4251-3547

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BibTeX

@article{Bernardino2026Ultra,
  title = {Are All Ultra-Processed Foods Created Equal? Descriptive Analysis of Nutritional Composition, Nutritional Quality, Energy Density and Hyperpalatability in Relation to Non-Communicable Disease Risk},
  author = {Melvin Bernardino and Julia T. Regalado and Silvia Gazzin and Claudio Tiribelli and Natalia Rosso},
  journal = {Foods},
  year = {2026},
  doi = {10.3390/foods15152651},
  url = {https://doi.org/10.3390/foods15152651}
}

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