I should note that I was referring to American supermarkets, not necessarily ones that you find in Europe. I will quote directly from the World Nutrition article you cite in the original post “The fourth NOVA group is of ultra-processed food and drink products. These are industrial formulations typically with five or more and usually many ingredients.” These foods indeed dominate the middle aisles of the American supermarket. This World Nutrition article codifies Michael Pollan’s Rule # 6 in Food Rules: An Eater’s Manifesto to “Avoid food products that contain more than five ingredients.” Although this has become a mantra for critics of processed food and has been repeated many times, it is not grounded in science. Many of these convenience foods are directly what Jonathan Katz was describing in his guest blog appearance on my site on Processed Food, Disability and Autonomy. With respect to American home-made sandwiches, if the bread was purchased in a supermarket it is likely mass produced with more than five ingredients and thus ultra-processed. Likewise any deli meat and spread like mustard, mayo or margarine is also likely ultra-processed.

As far as processed meats that you mention in your original post, it would appear that cured ham and bacon would be processed and not ultra-processed as they “contain additives used to preserve original properties or to resist microbial contamination.” That description clearly applies to nitrates and nitrites whether added directly or surreptitiously as celery powder or celery salt. Virtually all sausages including bologna and pepperoni would also be considered ultra-processed as they are “reconstituted meat products.” I also find it curious that sugar added by the food industry makes a food ultra-processed but highly refined white sugar, honey or maple syrup are culinary ingredients and thus not ultra-processed. Likewise, butter and lard when used by the home cook are acceptable culinary ingredients, but, if added to a commercial product they turn it into an ultra-processed food.

The problem I have with the World Nutrition classification of ultra-processed foods is that they lump all the high sugar/high fat/high salt foods with convenience foods that have more than five ingredients. Then studies are conducted matching health outcomes to consumption of ultra-processed food. The health outcomes are not good, so the conclusion of a recent study in prestigious journal is that both junk foods and convenience foods are hazardous to our health because they are both classified as ultra-processed (1). I suspect that if you removed convenience foods from the category and lumped fruit consumption with junk food that fruit consumption would be deemed unhealthy.

(1)Schnabel, L., Kesse-Guyot, E., Alles, B., Touvier, M., Srour, B., Hercberg, S., Buscail, C., and Julia, C. 2019. Association between ultraprocessed food consumption and risk of mortality among middle-aged adults in France. JAMA Internal Medicine 173 [JAMA Internal Med doi:10.100/jamainternmed.2018.7289]