Ultra-processed foods - what's all the fuss about?
Ultra-processed foods (UPF) are getting a lot of airtime at the moment, most of it negative. There are lots of studies now which link ultra-processed foods to negative health effects such as heart disease, weight gain, cancer and mortality.
This is pretty damning considering the UK has one of the highest consumption rates of ultra processed foods.
The average person in the UK consumes 63% of their calories through ultra-processed foods with 65% of children’s daily energy intake coming from these foods. There are differing opinions in the scientific world about whether it is the actual processing that causes the negative health effect or the fact the most UPF are higher in fat, salt and sugar.
Here we take look into what UPF are, how they are classified, the evidence behind them and what we should be doing about them in our diets.
How is processed food classified?
The term UPF was initially developed by the Brazilian nutrition researcher Carlos Monteiro, at the University of São Paulo, Brazil. In 2009, Monterio and his team went on to develop a classification system for defining foods by the level of processing.
This went from unprocessed or minimally processed, such as whole fruits and vegetables, to ultra-processed such as ready-meals, biscuits and burgers. They called this the NOVA classification system.
Whilst there are other classification systems available, this one is still the most widely used. Many research studies have used this classification as the basis of their research into the impact of processed foods on health.
Foods are placed into 4 groups:
Unprocessed or minimally processed foods
These include whole fruits and
vegetables, whole grains, meat and animal products that have been processed using techniques common in household kitchens, such as drying, crushing, grinding, steaming, boiling, roasting, chilling, and freezing.
Single ingredient: Fresh or dried fruit, rice and grains, legumes, leafy greens, starchy roots and tubers, fungi, herbs and spices, pasteurised plain yoghurt, fresh or pasteurised milk, tea, water
Multi-ingredient: Pasta, granola
(cereals, nuts and dried fruit with no
additives including sweeteners or salt
added by the manufacturer), cous cous.
Substances obtained directly from group 1 foods or from nature by industrial processes such as pressing, centrifuging, refining, extracting or mining. These are used to prepare, season and cook group 1 foods.
Pressed vegetable oils, butter, sugar and molasses obtained from cane or
beet; honey extracted from combs and
syrup from maple trees, salt, corn
starch Multi-ingredient: Salted butter,
Products made by adding group 2
ingredients to group 1 foods. Processes are used to increase shelf life or modify sensory qualities such as taste or form. For example, canning, bottling, and, in the case of breads and cheeses, using non-alcoholic fermentation.
Canned or bottled vegetables and
legumes in brine; salted or sugared nuts and seeds; salted, dried, cured, or smoked meats and fish; canned fish (with or without added preservatives); fresh bread; fruit in syrup (with or without added antioxidants); freshly made unpackaged breads and cheeses.
Formulations of ingredients made by a series of industrial processes, many requiring sophisticated equipment and technology.
They typically contain little or no whole foods, are ready-to-consume or heat up, and are fatty, salty or sugary and depleted in dietary fibre, and made using industrial additives and processes that wouldn’t be found in a household kitchen.
Fizzy drinks (sugary or sweetened); crisps and packaged snacks; chocolate, confectionery; ice-cream; mass-produced packaged breads and buns;
margarines and other spreads;
biscuits, pastries, cakes; breakfast ‘cereals’, ‘cereal’ and ‘energy’ bars; milk drinks, ‘fruit’ yoghurts and drinks; ‘instant’ sauces. Many pre-prepared ready to-heat products including pies and pasta and pizza dishes; poultry and fish ‘nuggets’ and ‘sticks’, sausages, burgers, hot dogs, and other reconstituted meat products; and powdered and packaged ‘instant’ soups, noodles and desserts. Infant formulas, follow-on milks, other baby products.
Taken from the Soil Association Taking the Biscuit Report…
So, what are Ultra-Processed Foods?
It’s group 4, the UPF that we’re interested in here. These tend to include ingredients which may not be used at home such as chemicals, colourings, sweeteners, and preservatives. What lots of people don’t realise is these are often included in common staples in our diet such as breakfast cereals and bread, that we may have perceived healthy.
For example most granary bread from the supermarket is classed as group 4 ultra-processed, as are baked beans.
What is the evidence?
When it comes to UPF, scientists and nutritional experts can’t agree on where the detrimental health effects arise from. Some believe it is not actually the ultra-processing that causes the increased health risk, but the fact that these foods generally tend to be high in fat, salt and sugar. And that they tend to be low in fibre, vitamins minerals.
But many believe, and observational studies have shown, that it may not be that simple. And that even after adjustments for fat, sugar and sodium intake, or adjustment for adherence to a range of healthy or unhealthy dietary patterns, there is a minimal impact on the adverse associations between UPF intake and a diverse range of health-related outcomes.
These findings strongly point towards aspects of ultra processing as being important factors that impact health and question the ability to conclude that the adverse outcomes from UPFs can be solely attributed to their nutritional quality.
Why are we eating so much UPF?
Ultra-processed foods typically benefit from extended shelf life, an important consideration for the way we eat now and for lower income consumers without reliable access to refrigeration or those not able to shop regularly. A focus on reduced food waste is another factor.
Among other reasons for the popularity of ultra-processed foods are the inexpensive cost of their main ingredients. They are therefore highly profitable, hence they often have aggressive marketing, especially toward youth consumers and particularly in middle income countries.
In addition, the way they are made makes them highly palatable, easy to eat with minimal preparation needed. Appealing in a time-poor society.
UPF and nutritional guidelines
Some countries have gone as far as to change their Government nutrition guidelines. For example, Brazil recommend limiting the consumption of processed food and avoiding ultra-processed food. France aims to reduce their consumption of group 4 ultra-processed foods by 20%.
The World Health Organisation and UNICEF, the United Nations’ Children’s Fund, both recognise the importance of addressing ultra-processed food consumption for ending childhood obesity. The UN Food and Agriculture Organization also recommends limiting UPF consumption.
In the UK it seems we have away to go to reduce UPF…
Taking the biscuit!
In the UK it seems we have a way to go to reduce UPF…
‘Taking the biscuit’ is a campaign launched by the Soil Association. It highlights examples of the NHS Food Scanner App endorsing ultra-processed foods, promoting them as good or healthier choice. Examples included: Alpen Light Cereal, Monster zero sugar energy drink and Aero Chocolate Caramel Bubbly Mousse.
Dimbleby’s National Food Strategy for England raised concerns about ultra-processed foods. The UK Government’s Food Strategy White Paper, published in June 2022, recognised UPFs as contributors to the “overconsumption of high calorie foods”.
The Government had announced plans for research funding in this area. However, it’s not clear how (or if) this funding will now be spent.
More positively, SACN (Scientific Advisory Committee on Nutrition), who advise the Government on nutritional recommendations, are due to publish a position statement on UPFs later this year. Watch this space!
Concerns around Nova classification
The BDA released a position statement on processed food in 2021 stating that it is important to think about the context when it comes to processed and ultra processed foods.
For example, fortified foods are designed to add nutrients to someone’s diet who may otherwise struggle to meet their requirements. The act of food fortification would put a food into the processed or ultra processed foods category. Take bread for example; the flour used is fortified with added iron, niacin and thiamine in the UK but because of this would be classed as processed or ultra processed. The dichotomy therefore is that in some cases, processing foods can actually make them healthier. Its this level of understanding and complexity that requires awareness…
A bowl of bran flakes for example is as much a UPF as a chocolate rice cereal or cereal based on choc-chip cookies. Yet this is despite the bran flakes being a good source of fibre and being fortified with numerous vitamins and minerals, and often being relatively low in added sugar or salt.
Processing that preserves food such as tinning, freezing etc, is also something to be valued, especially as it is often a key means for those on lower incomes to eat a more varied diet. It is also a way for all of us to reduce food waste and this has important associated environmental impacts.
It is so important that we do not allow ‘processed’ to become a confused and pejorative term when applied to foods such as this.
Does labelling foods as UPF solve problems or create problems?
Until there is clear agreement when it comes to linking UPF with the nutrient profile, there is a risk it will add confusion rather than transparency. For example, baked beans are often labelled as a healthy choice, high in fibre/ protein but would also have an UPF label on.
From the evidence, we know we need to reduce UPFs. We know we need to reduce the amount of sugar, fat, and salt we consume and eat more whole foods.
To do this, however, there needs to be a whole cultural shift. We have normalised this way of eating diets high in UPFs.
Political action is also required to force changes within the food industry. This means advertising, cost and availability.
Food manufacturers have a responsibility to develop healthier products, making healthy – and sustainable – choices easier, more convenient and accessible, and for them to be affordable. Until these changes happen, we are unlikely to see any big shifts occur.
As individual consumers or as caterers, we can all try to reduce the amount of UPF we eat or serve. Start by focusing on whole foods as much as possible.
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