It’s no secret that eating foods that are high in unhealthy fats, salt and sugar may be harmful to our health. It can also increase the risk for some chronic conditions such as type 2 diabetes, cardiovascular disease and cancers. The latest research shows that regularly eating ultra-processed food could increase your risk of developing type 2 diabetes by 53% ^(1-4).

The Australian Dietary Guidelines recommend limiting intakes of foods containing saturated fat, added salt, and added sugars (e.g., chips, lollies, chocolate, pizza, soft drinks, and alcohol) to “only sometimes and in small amounts”. The most recent National Nutrition & Physical Activity Survey (2011-2012) found Australians consumed over a third (35%) of their total energy (kilojoules) intake from “sometimes” foods, most of which are ultra-processed.

For people living with diabetes, navigating this food environment can be especially challenging. The cost of living with diabetes is already high, and no one should be further burdened by the rising cost of good healthcare. The good news is that small, realistic changes to your eating habits can make a meaningful difference to your health without increasing your food budget, and there are simple ways to get started.

So, what exactly are ultra-processed foods, and how can we reduce our intake?

What are ultra-processed foods and how are they categorised?

Not all processed foods are harmful to health. Instead, they sit on a continuum from unprocessed/minimally processed to ultra-processed.

The art of processing foods is not new. Humans have been doing it for centuries. From cooking raw flesh over open fires to grinding wheat to make flour. Even bottling and preserving fruits and vegetables are forms of food processing.

The process of adding salt and sugar or heating and grinding foods helps extend shelf life. It also makes the food more nutritious and safer to eat. However, in recent times, food processing has taken on a new form. New technology has been created which combines foods with cheap, nutrient-poor ingredients such as additives, flavours, and colours. Such innovation results in highly edible, attractive, and convenient ultra-processed foods. The term “ultra-processed foods” (UPFs) was coined by researcher Dr Carlos Monteiro over a decade ago, when he developed the slightly controversial NOVA classification system¹. Four studies using the NOVA classification system showed that the risk of developing type 2 diabetes could increase by 53% if ultra-processed foods were regularly consumed^(1-4). The NOVA classification system groups foods into four categories based on the degree of processing. The four groups are outlined below:

#1 Unprocessed or minimally processed foods

This includes foods that have been frozen, washed, or pasteurised. Food examples include washed and bagged salads, frozen fruit, and plain milk

#2 Processed culinary ingredients

Such as pressing, grinding, or milling of foods. Examples of food include oils, seeds, nuts, and sugar.

#3 Processed foods

These are foods from either of the first two groups with the addition of salt, sugar, or fat. Food examples include canned fish, some types of bread, and cheeses.

#4 Ultra-processed foods

These foods have undergone extensive processing and include chemicals such as artificial sweeteners, colours, and flavours. They are usually ready-to-eat and don’t need much preparation, such as soft drinks, cakes, biscuits, ice creams, chips and frozen meals including pizzas, pasta dishes, sausage rolls, nuggets, and pies.

Why does processing matter?

One key difference is how processing affects the structure of food. For example, whole grains like oats or brown rice contain a protective outer layer (bran), which provides fibre and helps keep the glycaemic index (GI) lower. When grains are heavily milled or refined—as in instant porridge sachets or quick-cook white rice—this structure is broken down. This results in faster digestion, higher blood glucose spikes, and reduced satiety.

How does processed food affect diabetes?

High intakes of ultra-processed foods have been linked to several factors that may affect diabetes management. This includes consuming more energy (kilojoules or calories) and larger quantities of high-glycaemic index (GI) foods.

A recent review found that for every 10% increase in energy per day eaten from ultra-processed foods, there was a 15% increase in the risk of developing type 2 diabetes.

If you already have diabetes, excess energy intake can result in an increased waistline and higher insulin resistance. This may mean an increase in medications. It may also increase the risk of long-term diabetes-related complications.

Blood glucose levels

Many ultra-processed foods are low in fibre and high in added sugars. This means they are rapidly digested, raising blood glucose levels quickly. These types of foods have a high glycemic index (GI), which is known to spike blood glucose levels. In contrast, whole or minimally processed foods, particularly those rich in fibre and protein, are more filling (increase satiety) and help stabilise blood glucose levels.

Making healthier food choices doesn’t have to be overwhelming; even small, achievable changes can support better blood glucose management, and there are practical steps you can take today.

A balanced approach: what to eat more of

Rather than focusing only on cutting out ultra-processed foods, a more practical and positive approach is to add more whole, nutrient-dense foods to your diet.

Aim to include more:

• Vegetables and fruit
• Wholegrains (e.g. oats, brown rice, wholegrain bread)
• Legumes (beans, lentils, chickpeas)
• Dairy or alternatives
• Lean protein sources (meat, eggs, poultry, fish, tofu)

Foods that are higher in protein and fibre can help you feel fuller for longer, which may naturally reduce the need for convenience foods and frequent snacking.

Tips to reduce your consumption of ultra-processed foods

1. Reduce temptation and availability 

Out of sight, out of mind! Avoid stocking ultra-processed foods such as cakes, chips, or biscuits in your pantry. Try grocery shopping online, so you are less likely to be tempted by treats and impulse buys. If you go in-store to shop, keep to the outer edges of the supermarket as much as possible, where you will find more fresh foods. The inner aisles of the supermarket are where you will find ultra-processed foods. It is also a good idea to avoid shopping when hungry. This will reduce the temptation of buying treat foods that even appear at the checkout.

2. Be prepared and plan meals

Set aside 20 to 30 minutes on your weekend to plan your meals and shopping list for the week. Taking time to plan your meals will save you money and reduce the number of trips to the supermarket. It will also decrease the likelihood of reaching for ultra-processed ready meals when you get to that ‘5pm panic’.

If you’re stuck for meal ideas, look at the Healthy Meal Ideas fact sheet. It is full of breakfast, lunch, dinner, and snack options. If you’re stuck for recipe ideas, look at the great selection of recipes from Diabetes Australia.

3. Save time by doubling the recipe

This will cut down the number of times you have to prepare meals during the busy week. Healthy lasagnes, casseroles, and soups make easy, nutritious meals. They are also easy to double quantities and freeze leftovers for another meal.

4. Choose wholegrains where possible

Choose grainy products, such as bread and crackers, instead of wholemeal or white varieties. You can check the glycemic index of carbohydrate-containing foods using the GI search tool on the glycemicindex.com’s website, allowing you to find alternatives for your carb intake. 

5. Get savvy with food labels

Food manufacturers are not required to label their food as ultra-processed, but they must list the ingredients used to make that food. Look at the ingredients list to work out whether a product is ultra-processed. Ultra-processed foods usually have five or more ingredients, many of which are not found in a normal kitchen. Examples include monosodium glutamate, soy lecithin, or inverted syrup, just to name a few. Read understanding food labels for more information.

For more tips about eating well, be sure to check out our Healthy Living section.

Take the next step toward a healthier you

If you’re looking to reduce your intake of ultra-processed foods or want support in making healthier everyday choices, you don’t have to do it alone. Small changes make a meaningful difference, and having the right guidance can help you stay on track.

1800PREVENT (1800 773 8368) is your free, national type 2 diabetes prevention information service, connecting you with trusted support that’s right for you. We’ll help link you to online resources, prevention programs, health coaching, or other local services that can support your health journey. 

Take home messages

• There are four types of processed food categories according to the NOVA classification system. These include minimally/unprocessed, processed culinary, processed, and ultra-processed.
• Research has shown that regularly eating ultra-processed food could increase your risk of developing type 2 diabetes by 53%^(1-4).
• The art of food processing has been around for centuries. It extends shelf life and makes food safer and more nutritious.
• Australians are consuming too many ultra-processed foods in their diets.
• Reducing consumption of ultra-processed foods can lead to better blood glucose management and reduced risk of diabetes-related complications.
• Eat a diet comprised of mostly minimally processed, whole foods such as fresh fruit and vegetables, fresh meat, poultry, eggs, and seafood, and low-GI wholegrains.
• Consider ultra-processed foods as ‘sometimes’ foods, only to be eaten in small amounts, and in moderation.
• There are several helpful resources to help you reduce your ultra-processed food intake listed below.

Where can I get more information?

• Become a FREE member of Diabetes YOUnited. You will be provided with regular news and updates, evidence-based, practical information from health professionals, and support every step of the way.
• Healthy food choice fact sheet with a sample meal plan of healthy, minimally processed options
• Healthy meal ideas fact sheet
• Glycemic Index Food Database
• Understanding food labels fact sheet
• The NOVA Food Classification System handout
• Quality Carbohydrates and Health Report
• Low GI Diabetes Guide

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References

1. Levy RB, Rauber F, Chang K, Louzada M, Monteiro CA, Millett C, et al. Ultra-processed food consumption and type 2 diabetes incidence: A prospective cohort study. Clin Nutr. 2021;40(5):3608-14.
2. Llavero-Valero M, Escalada-San Martin J, Martinez-Gonzalez MA, Basterra-Gortari FJ, de la Fuente-Arrillaga C, Bes-Rastrollo M. Ultra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study. Clin Nutr. 2021;40(5):2817-24.
3. Srour B, Fezeu LK, Kesse-Guyot E, Alles B, Debras C, Druesne-Pecollo N, et al. Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Sante Prospective Cohort. JAMA Intern Med. 2020;180(2):283-91.
4. Delpino FM, Figueiredo LM, Bielemann RM, da Silva BGC, Dos Santos FS, Mintem GC, et al. Ultra-processed food and risk of type 2 diabetes: a systematic review and meta-analysis of longitudinal studies. Int J Epidemiol. 2022;51(4):1120-41.
5. Moradi S, Hojjati Kermani MA, Bagheri R, Mohammadi H, Jayedi A, Lane MM, et al. Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis. Nutrients. 2021;13(12).
6. Machado PP, Steele EM, Levy RB, Sui Z, Rangan A, Woods J, et al. Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study. BMJ Open. 2019;9(8):e029544.

Notes

¹While widely used in research, it’s worth noting that the NOVA system has some limitations, as it classifies foods based on processing rather than nutritional value alone. For this reason, it’s helpful to focus not just on processing, but also on nutrient density—that is, how much fibre, protein, vitamins, and minerals a food provides.

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By Rebecca McPhee, Accredited Practising Dietitian, and Libby Evans, MSc Human Nutrition

This article has been reviewed by Diabetes Australia Health Professional Advisory Council (HPAC)

This blog was originally published 3 September 2022.