Ultra-Processed, Health Stars & NOVA—How to Choose Food Without the Confusion

One of the key things I’ve taught families over the years as a paediatric dietitian is how to read food labels, so you can shop with confidence knowing exactly what you’re putting in your trolley each week. It’s easy to feel overwhelmed trying to make the right choice at the supermarket — what do those labels mean? Are health stars helpful? Should I be worried about additives?

Let’s break it down and simplify things.

Step 1: Is it a whole food?

Before you even flip over the pack to look at the label, ask yourself: Is this a whole food? Think fruit, veg, wholegrains, meat, eggs, legumes, nuts and seeds. If the answer is yes — great! You probably don’t need to worry about a label at all (and many whole foods won’t have one).

But let’s get real — most of what we eat has undergone some form of processing. Bread, pasta, yoghurt, milk – all staples in a healthy diet – are processed to some degree. That’s where the NOVA classification system comes in handy.

Understanding the NOVA food classification system

This system categorises foods by their level of processing:

• Group 1: Unprocessed or minimally processed — basic prep only (e.g. washing, cutting)

• Group 2: Processed culinary ingredients — things used in cooking like salt, sugar, oils

• Group 3: Processed foods — made by combining Groups 1 & 2 (e.g. cheese, tinned beans, bread)

• Group 4: Ultra-processed foods (UPFs) — contain additives you wouldn’t have in your kitchen (e.g. packaged snacks, soft drinks, instant noodles)

Research has shown that diets high in ultra-processed foods are associated with higher risks of heart disease, cancer and other health conditions. While the NOVA system doesn’t tell us how nutritious a food is, it does help us understand the degree of processing — and this can be a useful tool when thinking about long-term health.

But the NOVA system doesn’t look at nutrient content — just processing. That’s an important distinction, and where reading the nutrition panel comes in. The NOVA food classification system isn't something you’ll see printed on food packaging — it's a tool used by researchers to identify dietary patterns and study their impact on health. It’s still helpful to understand it, though, and to recognise that most foods we eat are processed to some degree — that’s not necessarily a bad thing. What we really want to minimise are the ultra-processed foods.

Some of the reasons why ultra-processed foods may be problematic are still being explored. There’s been a lot of discussion around emulsifiers, for example — additives that help ingredients like oil and water mix together. Emulsifiers are commonly used in things like plant milks, mayonnaise, ice cream, and some breads. Early animal studies suggested they might disrupt the gut microbiome or the mucus lining in the gut, raising concerns particularly for people with conditions like Crohn’s disease.

However, recent human trials (including those done right here in Australia) haven’t found strong links between emulsifiers and inflammatory bowel disease. More research is needed, but for now, the focus remains on reducing UPFs overall rather than avoiding individual ingredients across the board.

So what about food labels — what should you actually look for?

Let’s talk about the Health Star Rating (HSR) system. Introduced in 2014, the HSR gives a score between 0.5 and 5 stars based on a food’s nutritional profile. It deducts points for things like energy, saturated fat, sugar and sodium, and adds points back for fibre, protein and the proportion of fruit, veg, legumes and nuts.

It’s a helpful tool at a glance — but it has its flaws. For example, it doesn’t penalise foods that use concentrated fruit juice as a sweetener, even though that’s still added sugar. Also, because it’s voluntary, food companies can choose whether or not to include it — and unsurprisingly, they often only display it on products that score well.

The HSR also doesn’t account for the degree of processing or the presence of additives like preservatives or colours.

So here’s my advice: read the ingredient list and the nutrition panel yourself and know what to look for.

Here’s what to look for:

Ingredients list:

• Ingredients are listed from most to least by weight.

• Look for whole food ingredients you recognise.

• A shorter ingredients list is often a good sign.

• Be cautious with products that list sugar (or its many other names — glucose, fructose, corn syrup, honey, etc.) in the top few ingredients.

Nutrition Information Panel:

• Fat: <10g per 100g

• Saturated fat: < 3g/100g

• Fibre: >3g per serve

• Salt (sodium): <400mg per serve

• Sugar: <15g per 100g (higher is okay in products containing dried fruit or dairy)

It’s also worth noting that not all additives are created equal. Some have been added to food to improve public health outcomes — for example, folate in bread to reduce neural tube defects, or thiamine to prevent Wernicke-Korsakoff syndrome (an irreversible neurological syndrome caused by thiamine deficiency). Added fibres like inulin found in chicory root may also have positive effects on gut health.

So if you’re stuck choosing between two snacks — one with more fibre but an additive or two, and one with less salt but lower fibre — it’s okay to weigh up the pros and cons. Personally, I usually prioritise higher fibre and lower salt when I can.

That said, there are a few additives we do have solid evidence to avoid — like nitrates and nitrites, which are linked to an increased risk of bowel cancer. And some food colourings may trigger hyperactivity in sensitive children. You can read more here.

The big picture?

Focus on mostly whole foods. Cook from scratch when you can. Choose whole food snacks (like fruit, veggie sticks, boiled eggs or smoothies) most of the time. And when you do buy packaged food — which we all do! — learn to read the ingredient list and nutrition information panel yourself and not necessarily reply on foods that have a health star rating - aim for options with ingredients you recognise, minimal added sugar and salt, and a decent amount of fibre.

It doesn’t need to be perfect — just balanced.