Processed foods are hiding in plain sight, and they could become a major public health problem.

Since 1990, the U.S. Department of Agriculture and the Department of Health and Human Services have collaborated every five years to publish a new edition of the Dietary Guidelines for Americans. The guidelines are intended to provide the general public with evidence-based dietary recommendations to promote health and reduce the risk of chronic disease. Over the decades, the advice provided in this manual has steadily changed with advances in modern nutritional understanding.

Take the food pyramid, for example: When first introduced into the guidelines in 1992, the original pyramid was based on foods high in whole grains like bread, pasta, cereals and rice, recommending 6-11 servings per day, then progressed from vegetables and fruit to dairy and protein, and finally to fats, oils and sweets.

In 2005, the guidelines transitioned to MyPyramid, tweaking the original icon. Instead of horizontal levels, vertical colored bands were used to represent different food groups, such as blue for dairy and orange for grains. The left side of the pyramid was replaced with stairs climbing by a simple stick figure. This change was intended to encourage exercise and promote the concept of a more personalized nutrition plan, but critics complained that the rendering was too complicated and unintuitive regarding the recommended proportions of food groups, and eventually MyPlate was introduced in 2011.

This was eventually replaced by the current guidelines, which promote the idea of ​​healthy “eating patterns” throughout different stages of life.

Throughout the evolution of the Dietary Guidelines, much of the advice offered has been based primarily on nutrients – that is, what types of foods or food groups should be prioritized to achieve a balanced diet. But with growing evidence of the harms of ultra-processed foods, it’s very likely that the Dietary Guidelines, due to be published in 2025, will also include recommendations on how much processed food Americans should eat.

This is a big problem because numerous studies have shown that processed foods are hiding in plain sight for most Americans, and it could become a major public health issue.

“Unprocessed or minimally processed foods are whole foods with their vitamins and nutrients intact,” writes dietitian Katherine D. McManus of Harvard Health Publishing. “The foods are in their natural (or nearly natural) state. These foods may have been minimally processed, such as removing inedible parts, drying, grinding, roasting, boiling, freezing, or pasteurization, to make them safe for storage. Examples of unprocessed or minimally processed foods include carrots, apples, raw chicken, melon, and raw unsalted nuts.”

She continues, “Processing changes foods from their natural state. Processed foods are basically made by adding salt, oil, sugar or other substances. Examples include canned fish and vegetables, fruit in syrup and freshly baked bread. Most processed foods contain two or three ingredients.”

Some foods are highly processed, or ultra-processed, which, in McManus’ words, means “made primarily from substances extracted from foods, such as fats, starches, added sugars, and hydrogenated fats.” They may also contain artificial colors, preservatives, and stabilizers to alter their shelf life, color, and texture. Much of what most Americans think of as junk food — packaged cakes, potato chips, and soft drinks — is ultra-processed, but so are many items people might otherwise consider healthy, including granola, veggie straws, fruit snacks, and even the nutrition-focused boxed macaroni and cheese that flood supermarkets these days.

In fact, although the exact percentages vary, studies have shown that about 60-70% of foods available in a typical American supermarket fall into the ultra-processed food category. However, most shoppers could not identify those products. According to a survey conducted by the International Food Information Council (IFIC) in September 2022, about 76% of Americans are not familiar with foods that are considered ultra-processed. More specifically, 66% of people said they have never heard of the term “ultra-processed food,” and 10% said they were unsure.

In an interview with Health, Bonnie Liebman, nutrition director at the Center for Science in the Public Interest (CSPI), said the results weren’t surprising because the concept of ultra-processed foods is still relatively new. “Most Americans don’t know exactly which foods qualify as ultra-processed, because researchers have only recently begun to look into whether highly processed foods might be harmful,” Liebman said.

But in the two years since, more and more studies have been published linking ultra-processed food consumption to a variety of health problems. As The Washington Post reported earlier this year, new research “[s] Researchers have warned that diets high in ultra-processed foods could be harmful to many body systems after linking them to more than 30 health conditions, including heart disease, diabetes and anxiety.

This gap between our knowledge of what ultra-processed foods are and their potential health effects is alarming, and it may be one of the reasons why the upcoming Dietary Guidelines may explicitly address the level of food processing for the first time. According to the 2025 Dietary Guidelines Advisory Committee, the committee is examining the health and nutrition evidence using three scientific approaches: data analysis, dietary pattern modeling, and systematic reviews. As part of step 1, HHS and USDA developed a proposed list of scientific questions to inform the committee’s work, and one of the first questions is: “What is the relationship between the consumption of dietary patterns that include different amounts of ultra-processed foods and growth, body composition, and risk of obesity?”

While the committee is deliberating, lobbying by the food industry has already begun, The Washington Post reports.

“At least six food industry and lobbying groups have written to the Department of Health and Human Services urging caution in issuing government recommendations on ultra-processed foods,” The Washington Post’s Anahad O’Connor wrote in November. “They argue that industrial processing makes foods safe, convenient and affordable, and that there is no accepted scientific definition of what exactly ultra-processed foods are.”

But many nutrition experts say there is enough evidence about the effects of ultra-processed foods to warrant recommendations in dietary guidelines.

“I think there’s enough evidence to recommend reducing the calories from ultra-processed foods,” Marion Nestle, professor emeritus of nutrition, food studies, and public health at New York University, told The Washington Post. “I’m not saying you shouldn’t eat them at all — that wouldn’t make sense — but ultra-processed foods are in the category of ‘don’t eat too much of them.'”