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thenOVAclassificationdevelopedinbrazilin 2010is themostwidelyusedsystemforclassifyingandestimatingtheintakeofUPFsinepidemiologicalstudiesthissystemconsidersthechemicalbiologicalandphysicalprocesses to which the foodundergoesbeforeconsumptionresultinginatotaloffourfoodgroups(48)thisclassificationwillbetheoneusedinthisreviewaswellastheoneusedintheanalyzedstudiesthefirstgroupinthenOVAclassificationincludesunprocessedorminimallyprocessedfoodsthatistosay,plant(fruitsseedsleavesstemsroots)oranimal-derived(offaleggsmilkmuscle)foodpresentedafterharvestcollectionorslaughter.thisgroupalsoincludeswater,fungiandalgaeMinimallyprocessedfoodreferstofoodalteredsoasnottoaddorintroduceanysubstancesuchasremovalofinedibleorunwantedpartsorotherprocessingsuchasdryingcrushinggrindingfractioningfilteringroastingboiling fermentationpasteurizationrefrigerationorchilling(478)secondgroupreferstoprocessedculinaryingredientswhichenglobesindustrialproductsextractedandpurified from foodingredientsorotheringredientsobtained fromnature thisincludesingredientssuchasoilsbutter,sugarandsaltas theyareextractedeither from the firstgroupof foodor fromnature throughpressingrefininggrindingmillinganddryingprocesses thepurposeof suchprocessesistobecombinedwithfoodsfromgroup1andtheyarenotmeanttobeconsumedbythemselves(478)thirdgroupincludesprocessedfoodsinwhichgroup1foodsaremodifiedbytheadditionofgroup2substancessuchasoil sugar, saltor sugar to whole foodsinorder toincrease theirdurabilityor tomodify their flavorandattractiveness theseareusuallyadditionsoftwoorthreeingredientsandareknownasmodifiedversionsofthefirstcategoryoffoodstheyareedibleontheirownorincombination withother foodsExamplesof thisgrouparebottledvegetablescannedfishorcheeses(478)Finally,group4referstoUPFsPreparedmainlyorentirelyfromfood-derivedsubstancesthisgroupincludesprocessessuchashydrogenationhydrolysis;extrusionmoldingreshaping;pretreatmentbyfryingandbakingsugarsoilsfatsandsaltarecommonlyusedin this foodgroupas wellasotheradditivesextractedfromfoodssuchascaseinlactosewheyandglutenItalsoincludeshydrogenatedorinteresterifiedoilshydrolyzedproteins soyaproteinisolatemaltodextrininvertsugarandhigh-fructosecornsyrupExamplesof thisgroupare softdrinks sweetsbreadedmeatsbreakfastcerealsbiscuitsfruitjuicesandfruitnectardrinksenergeticdrinksand sweetened yoghurts thisgroup willbe theone studiedinthisreview(478)1INTRODUCTIONbeingresponsibleof179milliondeathseachyear,andrepresenting 31%ofallglobaldeathscardiovasculardisease(cVD)istheleadingcauseofmortalityworldwide(1)themostcommoncVDsare strokeandheartattackaccounting for85%of thedeaths(12)regardingthepreventionanddevelopmentofcVDdiethasacrucialroleandisconsidered tobeamodifiableriskandpreventivefactor(3)cardiometabolicriskisdescribedasthesetofmetabolicanomaliesincludinghypertensiondyslipidemiaanddysglycemiawhichincreasecVDriskinadose-responsemanner.Insulinresistanceexcessvisceraladiposetissueandectopicfataccumulationsarelinkedtotheseabnormalitiesconditioningthecomponentsofmetabolicsyndrome(Mets)(4)Metsincreases theriskofdevelopingcVDby17(4) thissyndromeisdefinedasaclusterofmetabolicabnormalitieswhichincludeatleastthreeofthefollowingcVDriskfactorshighbloodpressurehighfastingplasmaglucoselevelslowHDLcholesterollevelshypertriglyceridemiaandabdominalobesity(4)On theotherhandultra-processed foods(UPFs)areproducts thathavebeenaround fordecadesbut whoseproductionhasincreasedovertheyearsduetonewprocessingtechnologyinthefoodindustry(5) Asaresult thisincreasehasalsoled to themassiveworldwideconsumptionofthistypeoffoodforinstancehavinga+207%consumptionofUPFsinspainfrom1990to2010(4)However, thereisalsoagrowing trend towardseatinghealthy,organicand sustainable foodHaving seen theharmfuleffectsthatadietbasedonindustrial foodscanhavepeoplehaverecentlybeguntoshowinterestinhavingahealthierlifestyle(6)InthewakeofthismassiveUPFsconsumptionseveralmovementshaveemergedagainst themincludingspanishnutritionistcarlosríossrealFoodingmovementrealFoodingisasocialmovementcreatedaroundsocialnetworksItslifestyleconsistsofeliminatingUPFsfromthedietandreplacingthemwithrealfoodhencethenamethe termultra-processed food(UPF)emergedin 2009whichdefined thedegreeofindustrialprocessingandincludedcertainingredientspresenceorabsenceinfood(4)However,ultraprocessedfooddoesnothaveaclear,conciseanduniversaldefinition the termhasbeendefinedalargenumberof timesandalldifferslightly fromeachother,butdefinitionsagree thatprocessedfoodisthetransformationofnaturalorrawproductsintoingredientsorfoodthroughoneormorephysicalchemicalormicrobiologicalprocesses(4)theaimofthesetransformationsistoimproveoneormoreaspectsof theproduct suchasitsavailability,shelflifeappearancesafetyornutritionalquality(7)340ANALESRANFwwwanalesranfcomConsumodealimentosultraprocesados yenfermedadcardiovascularunarevisión sistemáticaAmeliaMartidelMoral ySofiaAimiArrúeIshiyamAnRealAcadFarmVol87Nº3(2021)·pp337-348