Background

Food processing is essential for food safety, quality, accessibility, affordability and sustainability, yet increasing consumption of some ultra-processed foods (UPFs) has intensified debate about their potential contribution to chronic disease. Although systems such as NOVA have advanced epidemiological research, processing-based categories provide limited mechanistic resolution of how food structure, formulation and processing influence human physiology.

Scope and approach

This review critically evaluated food-processing classification systems and integrates advances in food matrix science, food engineering, mechanistic and precision nutrition, artificial intelligence (AI), and sustainable food systems. Literature from PubMed, Scopus and Web of Science (2019–2026), supplemented by targeted searches, was synthesized to examine relationships among food structure, formulation, processing, oral and gastrointestinal physiology, nutrient bioaccessibility, gut microbiota, eating behaviour and metabolic responses.

Key findings and conclusions

Evidence indicates that biological responses to processed foods cannot be explained by processing intensity alone but emerge from interactions among matrix architecture, formulation, processing conditions and host biology. Food structure influences mastication, eating rate, digestion, nutrient release, gut-hormone signalling and postprandial metabolism, providing a mechanistic interface between food design and human physiology. These insights support Precision Food Design (PFD), a framework for moving beyond processed-versus-minimally processed classifications towards deliberate engineering of foods with defined nutritional, metabolic, sensory and environmental functions. PFD integrates matrix engineering, precision formulation, AI-enabled prediction and sustainability while accounting for consumer acceptance, affordability and scalability. Future priorities include standardized matrix characterization, controlled human intervention studies, mechanistic phenotyping, validated predictive modelling, life-cycle assessment and evidence-based regulatory frameworks. PFD thus reframes processing as a controllable design variable for developing foods optimized for biological, nutritional, sensory and environmental performance.