American Heart Association Ultra-Processed Food Guidelines
In 2024, the AHA became the first major U.S. medical organization to formally distinguish between types of ultra-processed foods. Their three-tier classification acknowledges that not all UPFs carry the same health risks.
Information current as of February 2026
This page reflects the AHA presidential advisory published in 2024. Check the American Heart Association website for the latest updates.
The AHA Presidential Advisory on Ultra-Processed Foods
In 2024, the American Heart Association published a presidential advisory that represented a significant shift in how a major U.S. medical organization approaches ultra-processed foods. Rather than treating all ultra-processed foods as a single category to avoid, the AHA introduced a three-tier classification system that evaluates UPFs based on their overall nutritional contribution to the diet.
This advisory was notable for several reasons. It acknowledged the growing body of epidemiological research linking ultra-processed food consumption to cardiovascular disease, obesity, and type 2 diabetes. But it also recognized a practical problem with the existing NOVA classification system: by grouping all ultra-processed foods together, NOVA treats a fortified whole-grain bread the same as a can of soda. The AHA argued that this lack of differentiation limits the usefulness of processing-based classifications for dietary guidance.
The advisory drew on data from large prospective cohort studies, randomized controlled trials, and meta-analyses to support its recommendations. It concluded that the relationship between ultra-processed food and health outcomes varies substantially depending on the type of ultra-processed food consumed.
3 Tiers
of ultra-processed food classification in the AHA system
First
major U.S. medical organization to differentiate between UPF types
2024
year the presidential advisory was published
The Three-Tier Classification System
The AHA advisory divides ultra-processed foods into three groups based on their nutritional profile and potential health impact. This tiered approach provides more actionable guidance than a binary ultra-processed/not classification.
Group A: UPFs That May Provide Nutritional Benefits
Group A includes ultra-processed foods that contribute meaningful nutrients to the diet despite containing industrial additives. The AHA recognizes that for many Americans, these products serve as important sources of fiber, vitamins, and minerals that would otherwise be lacking.
Examples:
- Fortified whole-grain breads and cereals
- Packaged whole-grain products with added preservatives
- Fortified plant-based milks
- Canned beans with added calcium disodium EDTA
- Whole-grain crackers with minimal additives
Group B: UPFs With Limited Nutritional Benefit
Group B captures products that fall in a middle ground. They are not nutritionally harmful in moderate amounts, but they do not contribute significantly to dietary quality. The AHA advises consuming these foods in moderation rather than as dietary staples.
Examples:
- Flavored yogurts with added sugars and thickeners
- Some granola and snack bars
- Sweetened breakfast cereals with fortification
- Packaged flavored oatmeal
- Refined-grain breads with dough conditioners
Group C: UPFs to Limit
Group C includes ultra-processed foods that the AHA recommends actively limiting. These products are characterized by high levels of added sugars, sodium, or saturated fat combined with minimal nutritional value. The health effects of these foods are most strongly supported by epidemiological evidence.
Examples:
- Sugar-sweetened beverages (soda, energy drinks)
- Candy and confectionery
- Processed meats (hot dogs, deli meats, sausages)
- Heavily frosted or cream-filled baked goods
- Artificially flavored snack chips and puffs
Comparison: AHA Tiers vs. NOVA Groups vs. Processing Score
The following table compares how three different classification systems evaluate ultra-processed foods. Understanding these differences helps consumers and researchers interpret food processing data from multiple frameworks. Our Processing Score methodology shares the AHA's philosophy that processing level should be evaluated on a spectrum rather than as a binary designation.
| Characteristic | AHA Three-Tier System | NOVA Classification | Our Processing Score |
|---|---|---|---|
| Number of Categories | 3 tiers within UPF (Groups A, B, C) | 4 groups for all foods (UPF is Group 4) | 4 levels (Minimal, Processed, Highly, Ultra) |
| Scope | Only ultra-processed foods | All foods and beverages | All foods and beverages |
| Considers Nutrition | Yes -- tiers based on nutritional contribution | No -- based solely on processing methods | Partially -- separate Nutrition Score (0-10) |
| How Fortified Cereal Is Classified | Group A (may provide nutritional benefits) | Group 4 (ultra-processed, same as soda) | Varies by ingredients (typically Level 2-3) |
| How Soda Is Classified | Group C (recommend limiting) | Group 4 (ultra-processed, same as cereal) | Level 4, high Processing Score (10+) |
| Developed By | American Heart Association (USA) | University of Sao Paulo (Brazil) | Ultra Processed Food List |
| Primary Use | Clinical dietary guidance | Epidemiological research and public policy | Consumer product comparison |
| Granularity | Moderate (3 broad groups) | Low (binary within food types) | High (continuous numeric score) |
Key Takeaway
The AHA system and our Processing Score share a common principle: the degree and type of processing matters more than whether a food is technically ultra-processed. A whole-grain bread with an emulsifier is fundamentally different from a sugar-sweetened beverage, even though both qualify as ultra-processed under NOVA. Our two-score system separates processing level from nutritional quality, providing a similar level of nuance.
How the AHA Approach Compares to NOVA
The NOVA classification system has been the dominant framework for ultra-processed food research since it was developed by Brazilian researchers in the early 2010s. NOVA divides all foods into four groups: unprocessed or minimally processed, processed culinary ingredients, processed foods, and ultra-processed foods. The system has been adopted by governments and health organizations worldwide.
The AHA advisory does not reject NOVA. It builds on it. The advisory accepts the fundamental premise that industrial processing can alter foods in ways that affect health outcomes. But it argues that NOVA's treatment of all ultra-processed foods as a single category creates a practical problem: it discourages consumption of foods that could actually improve diet quality for populations with limited access to whole foods.
This distinction has significant implications for dietary guidance. Under a strict interpretation of NOVA, a dietitian advising a patient to avoid ultra-processed foods would have to recommend against fortified whole-grain bread, which provides fiber and micronutrients many Americans need. The AHA three-tier system allows clinicians to make more targeted recommendations: limit Group C foods while recognizing that some Group A foods may be reasonable or even beneficial choices, particularly for populations where access to fresh whole foods is constrained by cost or availability.
Where NOVA Excels
- Clear, simple framework for population-level research
- Widely adopted and validated in epidemiological studies
- Easy for consumers to understand conceptually
- Supported by substantial peer-reviewed evidence base
Where the AHA Adds Value
- Acknowledges nutritional heterogeneity within UPFs
- More practical for individual dietary counseling
- Avoids discouraging consumption of nutrient-dense UPFs
- Better suited for nuanced food policy development
Practical Implications for Consumers
The AHA three-tier system offers consumers a more nuanced framework for evaluating the ultra-processed foods in their diet. Rather than trying to eliminate all UPFs, which is impractical for most households, the AHA guidance suggests prioritizing which products to reduce and which may be acceptable or even beneficial. This aligns with our approach to reducing ultra-processed food intake through practical, gradual changes.
1. Focus on Reducing Group C First
The strongest evidence for health harm is concentrated in Group C foods: sugar-sweetened beverages, processed meats, candy, and similar products. If you are looking to make the highest-impact dietary changes, reducing these products should be the priority. Our ingredients-to-avoid guide identifies specific additives commonly found in Group C products.
2. Do Not Fear Group A Foods
Fortified whole-grain breads, plant-based milks, and similar Group A products can be part of a healthy diet. The AHA guidance suggests these foods should not be avoided solely because they are technically ultra-processed. This is especially relevant for families on a budget, where fortified products may be the most affordable source of key nutrients.
3. Evaluate Group B Foods in Context
Group B products like flavored yogurts and granola bars are not inherently harmful, but they should not displace whole foods in your diet. Use them as occasional convenience items rather than daily staples. Check food labels for added sugar content and ingredient quality.
4. Use Multiple Frameworks Together
No single classification system captures the full picture of food quality. Combining the AHA tiers with our Processing Score and Nutrition Score gives you the most complete view of any product. A food that scores well on processing level but poorly on nutrition -- or vice versa -- is worth examining more closely before making it a regular part of your diet.
What This Means for Food Labeling and Policy
The AHA presidential advisory carries significant weight in U.S. health policy discussions. As the first major American medical organization to formally propose differentiating between types of ultra-processed foods, the AHA has influenced the terms of the policy debate.
The advisory's tiered approach directly addresses a key criticism of NOVA-based regulation: that a blanket ultra-processed label would stigmatize affordable, nutrient-dense foods alongside genuinely harmful products. Policymakers working on federal food definitions, including those responding to the MAHA commission's recommendations, can now point to the AHA framework as evidence that a more granular approach is scientifically supported.
At the state level, legislators crafting ultra-processed food legislation may incorporate tiered systems inspired by the AHA model. A state school meal policy, for instance, could restrict Group C products while allowing Group A foods that meet nutritional standards. This middle-ground approach may prove more politically viable and practically achievable than outright bans on all ultra-processed products.
Looking Forward
Whether the AHA three-tier system is eventually adopted in regulatory frameworks, its publication marks a turning point. The conversation about ultra-processed food has moved beyond "all UPF is bad" toward a more nuanced understanding that different ultra-processed products carry different levels of risk. This shift benefits consumers, clinicians, and policymakers alike by supporting more targeted, evidence-based decision-making.
Frequently Asked Questions
How does the AHA classification differ from the NOVA system?
The NOVA system classifies all ultra-processed foods into a single group (Group 4) regardless of nutritional quality. The AHA three-tier system subdivides ultra-processed foods into Groups A, B, and C based on whether they provide nutritional benefits, have limited nutritional value, or should be limited due to high sugar, sodium, or saturated fat content. This makes the AHA approach more nuanced and practical for dietary guidance.
Does the AHA say all ultra-processed foods are unhealthy?
No. The AHA presidential advisory explicitly acknowledges that some ultra-processed foods can contribute positively to diet quality. Group A ultra-processed foods, such as fortified whole-grain breads and certain fortified cereals, may provide fiber, vitamins, and minerals that many Americans lack. The advisory recommends evaluating ultra-processed foods individually rather than avoiding the entire category.
What are examples of Group C ultra-processed foods?
Group C includes ultra-processed foods that the AHA recommends limiting. Examples include sugar-sweetened beverages such as soda and energy drinks, candy and confectionery, processed meats like hot dogs and deli meats, and heavily sweetened or artificially flavored snack foods. These products are characterized by high levels of added sugars, sodium, or saturated fat with minimal nutritional benefit.
Is the AHA classification used in government policy or food labeling?
As of early 2026, the AHA three-tier classification is a scientific advisory, not a regulatory standard. It has not been adopted by the FDA or USDA for labeling or food program purposes. However, its publication by a major medical organization adds scientific weight to the argument that processing-based classifications should be more granular than the binary ultra-processed/not-ultra-processed framework currently used in most research.
How does the AHA classification relate to the Processing Score on this site?
Our Processing Score uses a similar philosophy to the AHA approach: not all processed foods are equal. The Processing Score assigns a numeric value (1 to 32+) based on specific ingredients and processing indicators, which maps to four levels from Minimally Processed to Ultra-Processed. Products in AHA Group A tend to score lower (better) on our scale than Group C products, because our scoring penalizes artificial additives, high-fructose corn syrup, and hydrogenated oils that are more prevalent in Group C foods.
Continue Learning
Health Effects of UPF →
Review the research linking ultra-processed food consumption to chronic disease, obesity, and cardiovascular outcomes
NOVA Food Classification →
Understand the four-group NOVA system that the AHA advisory builds upon and how it classifies all foods
MAHA Report on UPF →
How the federal MAHA commission is approaching ultra-processed food policy and the FDA/USDA response
Disclaimer: All tools and data visualizations are provided for educational and informational purposes only. They are not intended as health, medical, or dietary advice. Product formulations change frequently — always check the actual label for current ingredients and nutrition facts before making purchasing decisions. Consult healthcare professionals for personalized dietary guidance.