Sports Foods Are Ultra-Processed: New Review Weighs Athlete Health Against Performance

Athletes have long reached for engineered nutrition, from the carbohydrate drinks that emerged in the 1960s to today’s bars, gels and protein-fortified snacks. But a new narrative review published in Sports Medicine – Open suggests that the very products designed to fuel performance sit squarely within the category of ultra-processed foods, a class increasingly linked to adverse health outcomes in the general population. The review, led by Sara F. Forbes of Australian Catholic University and Adelaide University, together with Louise M. Burke, Evangeline Mantzioris and Adrienne K. Forsyth, is the first to systematically pull together what is known about how and why athletes consume ultra-processed foods and sports foods, and what that means for both human and planetary health.

The authors frame their work against a backdrop of mounting concern. A 2024 umbrella review in the BMJ concluded that greater dietary exposure to ultra-processed foods is associated with a higher risk of adverse health outcomes across the lifespan, with the evidence for cardiometabolic and mental health effects rated convincing or highly suggestive. A subsequent systematic review of 104 prospective studies found that 92 demonstrated an association between an ultra-processed dietary pattern and increased risk of chronic disease in adults. Ultra-processed foods have also been implicated in significant diet-related environmental impacts, and limiting them has been identified as a strategy to advance both human health and environmental sustainability. For athletes, who often consume large quantities of formulated products, these findings raise uncomfortable questions.

Central to the review is the question of classification. The dominant framework, the NOVA system developed by Monteiro and colleagues, sorts foods into four groups based on the nature, extent and purpose of processing: unprocessed and minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. Sports foods, by virtue of their formulation with protein isolates, maltodextrins, emulsifiers, flavour enhancers and other ingredients rarely found in domestic kitchens, typically fall into the ultra-processed category. Yet NOVA judges foods solely on their degree of processing and additives, not on their nutritional value, performance utility or environmental footprint, a limitation the authors argue is particularly problematic for athletes whose needs differ sharply from those of the general population.

The classification system is not without controversy. The review catalogues numerous categorisation anomalies: plain yoghurt is minimally processed, some fruit yoghurts are merely processed, and flavoured yoghurt is ultra-processed, while homemade fries and certain packaged corn chips can share the same category. Even food and nutrition experts disagree when classifying products using NOVA, and manufacturer reformulations can shift a product between categories over time. Alternative systems such as Siga, which offers finer gradations from unprocessed foods to ultra-processed products with multiple markers of ultra-processing, address some criticisms but have their own gaps. A new formulation and processing food index developed by an international task force may eventually refine the picture, but for now athletes and practitioners must navigate imperfect and sometimes contradictory tools.

On the question of awareness, the review found a striking research void: no published studies have examined athletes’ knowledge or understanding of ultra-processed foods. Evidence from the general population suggests familiarity with the term does not translate into accurate recognition. In a UK study, only 13 percent of participants correctly categorised all ultra-processed foods shown, and confidence in identifying them far outstripped actual ability. Even among dietitians, more than half were unfamiliar with NOVA, and fewer than a quarter correctly classified many grain foods. Given that sports dietitians are well placed to influence athlete food choices, these knowledge gaps matter, the authors argue, because practitioners cannot guide athletes on products they themselves struggle to classify.

What the review did find is a consistent picture of why athletes choose these products. Convenience and performance dominate. Among 1,145 athletes surveyed in Ireland, sensory appeal, food and health awareness and performance were the leading determinants of food choice, while sustainability considerations ranked in the lowest quartile. Ultra-endurance athletes prioritised products that avoid gastrointestinal discomfort, provide energy and can be easily carried and consumed. Australian athletes and exercisers reported improved performance, endurance and recovery as key reasons for using sports foods, with cost and taste the main deterrents. German endurance athletes noted that while everyday foods were generally preferred, sports foods were sometimes more convenient or time-saving during training. Interviews with English Premier League players revealed that upbringing, club culture, coaches, teammates and media all shape dietary practices.

Consumption data, though sparse, suggest frequent use. In an Australian survey, nearly all athletes and exercisers reported consuming sports foods within the previous 12 months, and roughly 70 percent of German-speaking triathletes, cyclists and runners used a combination of commercial sports nutrition products and everyday foods. Studies of European endurance runners, Romanian soccer players and Spanish cyclists and triathletes all documented regular intake of processed and ultra-processed items, though the authors caution that inconsistent classification methods, small samples and questionnaires that capture only narrow food categories make comparisons difficult. Notably, no study has yet quantified ultra-processed food intake as a percentage of total energy intake in athletes, the metric most relevant for assessing health risk.

The review also challenges a cherished assumption of sports nutrition: that a food-first approach automatically reduces ultra-processed intake. When the authors classified the everyday food swaps suggested in Australian Institute of Sport resources using NOVA, they found that each sports food category included replacement items spanning multiple processing categories, including some that are themselves ultra-processed. An Australian analysis of the packaged food supply found that 40 percent of core foods were ultra-processed, meaning that swapping a sports gel for honey or a bar for a muesli bar may not meaningfully change processing exposure. Meanwhile, a systematic review found little or no difference in endurance performance between carbohydrate supplements and ordinary foods such as bananas, raisins or potatoes, and a Spanish case study showed that an ultra-endurance event could be fuelled entirely with sustainable, minimally processed foods, though the practicality of doing so outside controlled settings remains untested.

On health and environmental impacts, the evidence in athletes is thin. Only one study has examined high ultra-processed food consumption and fitness measures in athletes, finding no differences in anthropometrics or cardiovascular fitness among elite basketball players but altered gut microbiota, with confounding from suboptimal carbohydrate and high fat intakes. No studies have linked sports food consumption to health outcomes in athletes or the general population. Yet athletes may carry a larger environmental food footprint than the general population because of higher total energy and protein needs, and data from Turkish elite athletes showed higher greenhouse gas emissions and water footprints strongly tied to red meat and animal protein consumption. The authors call for research into the prevalence and patterns of sports food and ultra-processed food use, their effects on athlete health and performance, and how dietitians can help athletes optimise nutrition strategies that support performance, personal health and planetary health alike.

Subject of Research: Ultra-processed food and sports food use, awareness and impacts among athletes

Article Title: Ultra-processed Foods and Athletes: Current Insights on Classification, Use, Awareness, and Impact—A Narrative Review

Article References: Ultra-processed Foods and Athletes: Current Insights on Classification, Use, Awareness, and Impact—A Narrative Review. (n.d.). https://doi.org/10.1186/s40798-026-01098-7

Image Credits: AI Generated

DOI: 10.1186/s40798-026-01098-7

Keywords: ultra-processed foods, sports foods, athletes, sports nutrition, NOVA classification, planetary health, food-first approach, athlete health, sustainability, dietitians, performance nutrition, food processing