{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:02:17Z","timestamp":1790776937943,"version":"4.1.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med"],"DOI":"10.1186\/s12916-026-05217-9","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:01:42Z","timestamp":1790636502000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Response to: Debate in relation to \u201cUltra\u2011processed foods and human health: the main thesis and the evidence\u201d"],"prefix":"10.1186","volume":"24","author":[{"given":"Leandro F. M.","family":"Rezende","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Laura","family":"da Costa Louzada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euridice","family":"Martinez-Steele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Cannon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata B.","family":"Levy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia C.","family":"Jaime","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A.","family":"Monteiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"issue":"1","key":"5217_CR1","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1186\/s12916-026-05214-y","volume":"17","author":"M Singh","year":"2026","unstructured":"Ibsen DB, Frid\u00e9n M, Tomova, GD. Public health policy should be grounded in established evidence that acknowledges uncertainty: a response to The Lancet series on ultra-processed foods. BMC Med. 2026;24,522. https:\/\/doi.org\/10.1186\/s12916-026-05214-y","journal-title":"Stem Cell Res Ther"},{"key":"5217_CR2","doi-asserted-by":"publisher","first-page":"2667","DOI":"10.1016\/S0140-6736(25)01565-X","volume":"406","author":"CA Monteiro","year":"2025","unstructured":"Monteiro CA, Louzada ML, Steele-Martinez E, Cannon G, Andrade GC, Baker P, et al. Ultra-processed foods and human health: the main thesis and the evidence. Lancet. 2025;406:2667\u201384.","journal-title":"Lancet"},{"key":"5217_CR3","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1016\/S0140-6736(26)00292-8","volume":"407","author":"CA Monteiro","year":"2026","unstructured":"Monteiro CA, Rezende LFM, Baker P, Nestle M, Corval\u00e1n C, Popkin BM. Ultra-processed foods in research and policy - Authors\u2019 reply. Lancet. 2026;407:949\u201350.","journal-title":"Lancet"},{"key":"5217_CR4","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1017\/S1368980017000234","volume":"21","author":"CA Monteiro","year":"2018","unstructured":"Monteiro CA, Cannon G, Moubarac JC, Levy RB, Louzada MLC, Jaime PC. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr. 2018;21:5\u201317.","journal-title":"Public Health Nutr"},{"key":"5217_CR5","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1038\/s43016-022-00599-4","volume":"3","author":"G Scrinis","year":"2022","unstructured":"Scrinis G, Monteiro C. From ultra-processed foods to ultra-processed dietary patterns. Nat Food. 2022;3:671\u20133.","journal-title":"Nat Food"},{"key":"5217_CR6","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s10654-019-00488-4","volume":"34","author":"E Giovannucci","year":"2019","unstructured":"Giovannucci E. Nutritional epidemiology: forest, trees and leaves. Eur J Epidemiol. 2019;34:319\u201325.","journal-title":"Eur J Epidemiol"},{"key":"5217_CR7","doi-asserted-by":"publisher","first-page":"3390","DOI":"10.3390\/nu13103390","volume":"13","author":"D Martini","year":"2021","unstructured":"Martini D, Godos J, Bonaccio M, Vitaglione P, Grosso G. Ultra-Processed Foods and Nutritional Dietary Profile: A Meta-Analysis of Nationally Representative Samples. Nutrients. 2021;13:3390.","journal-title":"Nutrients"},{"key":"5217_CR8","doi-asserted-by":"publisher","first-page":"3586","DOI":"10.1038\/s41591-025-03858-6","volume":"31","author":"EM LaFata","year":"2025","unstructured":"LaFata EM, Moran AJ, Volkow ND, Gearhardt AN. Now is the time to recognize and respond to addiction to ultra-processed foods. Nat Med. 2025;31:3586\u20137.","journal-title":"Nat Med"},{"key":"5217_CR9","doi-asserted-by":"publisher","first-page":"3297","DOI":"10.1038\/s41591-025-03842-0","volume":"31","author":"SJ Dicken","year":"2025","unstructured":"Dicken SJ, Jassil FC, Brown A, Kalis M, Stanley C, Ranson C, et al. Ultraprocessed or minimally processed diets following healthy dietary guidelines on weight and cardiometabolic health: a randomized, crossover trial. Nat Med. 2025;31:3297\u2013308.","journal-title":"Nat Med"},{"key":"5217_CR10","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.cmet.2019.05.008","volume":"30","author":"KD Hall","year":"2029","unstructured":"Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2029;30:67\u201377.","journal-title":"Cell Metab"},{"key":"5217_CR11","doi-asserted-by":"publisher","first-page":"5431","DOI":"10.1111\/dom.15922","volume":"26","author":"S Hamano","year":"2024","unstructured":"Hamano S, Sawada M, Aihara M, Sakurai Y, Sekine R, Usami S, et al. Ultra-processed foods cause weight gain and increased energy intake associated with reduced chewing frequency: A randomized, open-label, crossover study. Diabetes Obes Metab. 2024;26:5431\u201343.","journal-title":"Diabetes Obes Metab"},{"key":"5217_CR12","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1016\/j.cmet.2025.08.004","volume":"37","author":"JM Preston","year":"2025","unstructured":"Preston JM, Iversen J, Hufnagel A, Hjort L, Taylor J, Sanchez C, et al. Effect of ultra-processed food consumption on male reproductive and metabolic health. Cell Metab. 2025;37:1950\u201360.","journal-title":"Cell Metab"},{"key":"5217_CR13","doi-asserted-by":"publisher","first-page":"e087538","DOI":"10.1136\/bmj-2025-087538","volume":"392","author":"LFM Rezende","year":"2026","unstructured":"Rezende LFM, Martinez-Steele E, da Costa Louzada ML, Levy RB, Monteiro CA. Misleading narrative of healthy ultraprocessed foods. BMJ. 2026;392:e087538.","journal-title":"BMJ"},{"key":"5217_CR14","doi-asserted-by":"publisher","first-page":"2703","DOI":"10.1016\/S0140-6736(25)01567-3","volume":"406","author":"P Baker","year":"2025","unstructured":"Baker P, Slater S, White M, Wood B, Contreras A, Corval\u00e1n C, et al. Towards unified global action on ultra-processed foods: understanding commercial determinants, countering corporate power, and mobilising a public health response. Lancet. 2025;406:2703\u201326.","journal-title":"Lancet"},{"key":"5217_CR15","doi-asserted-by":"publisher","first-page":"2685","DOI":"10.1016\/S0140-6736(25)01566-1","volume":"406","author":"G Scrinis","year":"2025","unstructured":"Scrinis G, Popkin BM, Corvalan C, Duran AC, Nestle M, Lawrence M, et al. Policies to halt and reverse the rise in ultra-processed food production, marketing, and consumption. Lancet. 2025;406:2685\u2013702.","journal-title":"Lancet"}],"container-title":["BMC Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-026-05217-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12916-026-05217-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-026-05217-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:50:11Z","timestamp":1790776211000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12916-026-05217-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5217"],"URL":"https:\/\/doi.org\/10.1186\/s12916-026-05217-9","relation":{},"ISSN":["1741-7015"],"issn-type":[{"value":"1741-7015","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors have read and approved the final manuscript for publication","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors of this essay are members of the University of S\u00e3o Paulo team that developed and refined the ultra-processed food (UPF) construct and the Nova system. They have no financial competing interests since their salaries and grants are funded by public or philanthropic institutions that have no ties to the food industry.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"525"}}