Ultra-processed Foods and Athletes: Current Insights on Classification, Use, Awareness, and Impact-A Narrative Review
Sports medicine - open · 2026
We barely know why athletes eat ultra-processed foods, this review maps the gap rather than filling it.
The paper
Narrative review of athlete sports food/ultra-processed food use, drawing on four small primary studies plus broader literature and sporting body sources.
What they found
No pooled effect sizes are reported since this is a narrative review; the authors describe frequent ultra-processed food consumption across four small studies, but note classification inconsistencies limit interpretation, and that no studies have asked athletes why they consume these foods or examined athlete knowledge/awareness of ultra-processed food classification or planetary health impact.
Study design
Narrative review (not systematic), no n applicable to the review itself; it synthesises findings from four small observational studies of athlete dietary intake alongside grey literature (sporting body websites) and general population UPF literature.
Methodology
Searches were run across Google Scholar, Scopus, Web of Science and peak body websites but no PRISMA-style protocol, pre-registration, dual screening, or risk-of-bias/GRADE assessment is described, so this is squarely a narrative synthesis open to selection and citation bias in what evidence gets included and emphasised. The underlying primary evidence it draws on is itself thin: only four small studies on athlete UPF consumption frequency, with inconsistent classification systems (NOVA vs other schemes) undermining comparability, and the authors are transparent that entire domains (consumer awareness, reasons for consumption, planetary health) have zero athlete-specific studies. Funding/COI for a review with senior author Louise Burke, a prominent sports nutrition figure, is not stated in the abstract and would need checking in the full text.
The appraisal
There is no clinical or statistical effect to appraise here, this is a scoping-style narrative review mapping an evidence gap rather than testing a hypothesis, so it cannot support any causal or comparative claim about UPF and athlete health or performance. The search strategy (Google Scholar, Scopus, Web of Science, sporting body websites) isn't dated or bounded by explicit inclusion criteria, and there's no PRISMA-ScR reporting, so selection bias in what got included can't be ruled out. Its value is in identifying where research is missing (motivations for UPF use, awareness/knowledge, planetary health links), not in providing actionable findings.
The gap
There are no primary data on why athletes choose ultra-processed foods, no validated classification approach specific to sports foods, and no athlete-specific studies on planetary health awareness, meaning any clinical guidance on UPF intake in athletes is currently extrapolated from general population data.
Landmark context
This builds on the NOVA classification framework (Monteiro et al.) that underpins general population ultra-processed food research, and extends it into the sports nutrition space where it sits awkwardly because many recommended 'sports foods' (protein powders, gels, bars) are ultra-processed by NOVA criteria despite being evidence-based performance tools, a tension this review explicitly flags rather than resolves.
What to do Monday
This does not change Monday's practice. It's a reminder that many 'sports foods' caught up in blanket UPF-avoidance messaging (protein bars, gels, RTD shakes) are formulated to solve a real convenience or performance problem, and this review found no athlete data yet on why they're actually chosen or how much use tips into a problem. Keep individualising: use sports foods purposefully around training and competition rather than as general diet fillers, keep food-first as the default, and don't hand out UPF-restriction targets, there isn't athlete-specific evidence to base a number on yet.
In practice
Applies to any athlete leaning on protein bars, gels, RTD shakes or protein-fortified foods, most visibly post-op or high-load athletes struggling to hit protein or carbohydrate targets through whole food alone, and endurance or team-sport athletes fuelling around sessions. In the clinic, don't let generic 'ultra-processed is bad' messaging push a rehabbing athlete off a protein shake that's actually solving a real appetite or access problem during recovery, that's a food-first ideal colliding with a practical constraint, not evidence of harm. On the performance floor, gels and bars around training remain legitimate tools chosen for convenience and predictable carb/protein delivery, keep using them for that purpose rather than as default diet filler, and default to whole foods where they equally serve the goal. The caveat either side of the net: there's no athlete-specific data yet on thresholds, motivations or long-term pattern effects, so this is individualised judgement, not a protocol you can standardise across a squad.
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