Sunday, November 3, 2024

How Bad Are Ultraprocessed Foods, Really

Casey Zhang for The New York Times

They’re clearly linked to poor health. But scientists are only beginning to understand why. In the mid-1990s, Carlos Monteiro, a nutritional epidemiologist in Brazil, noticed something alarming: Obesity rates among children in his country were rising rapidly. To understand why, he and his colleagues at the University of São Paulo scrutinized data on the food buying patterns of Brazilian households to see if they had changed in recent years. The researchers found that people were purchasing less sugar, salt, cooking oils and staples like rice and beans….Story continues….

Source: NewYork Times

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Critics:

An ultra-processed food (UPF) is an industrially formulated edible substance derived from natural food or synthesized from other organic compounds.The resulting products are designed to be highly profitable, convenient, and hyperpalatable, often through food additives such as preservatives, colourings, and flavourings.UPFs have often undergone processes such as moulding/extruding, hydrogenation or frying.

Ultra-processed foods first became ubiquitous in the 1980s, though the term “ultra-processed food” gained prominence from a 2009 paper by Brazilian researchers as part of the Nova classification system. In the Nova system, UPFs include most bread and other massed-produced baked goods, frozen pizza, instant noodles, flavored yogurt, fruit and milk drinks, “diet” products, baby food, and most of what is considered junk food.

The Nova definition considers ingredients, processing, and how products are marketed; nutritional content is not evaluated. As of 2024, research into the effects of UPFs is rapidly evolving. Since the 1990s, UPF sales have been increasing or remained high in most countries. In the limited available national data, as of 2023, consumption is highest in the United States (58% of daily calories) and United Kingdom (57%), and ranges widely, with Chile, France, Mexico and Spain among the countries in the 25-35% range, and Colombia, Italy, and Taiwan among those at or below 20%.

Epidemiological data suggest that consumption of ultra-processed foods is associated with non-communicable diseases and obesity. A 2024 meta analysis published in The BMJ, identified 32 studies that associated UPF with negative health outcomes, though the specific mechanism of the effects was not clear. Some authors have criticised the concept of “ultra-processed foods” as poorly defined, and the Nova classification system as too focused on the type rather than the amount of food consumed.

Other authors, mostly in the field of nutrition, have been critical of the lack of attributed mechanisms for the health effects, focusing on how the current research evidence does not provide specific explanations for how ultra-processed food affects body systems. Concerns about food processing have existed since at least the Industrial Revolution. The origin of ultra-processed food is more recent: Michael Pollan’s influential book The Omnivore’s Dilemma (2006) referred to highly processed industrial food as ‘edible food-like substances’.

 Carlos Augusto Monteiro cited Pollan as an influence in coining the term ‘ultra-processed food’ in a 2009 commentary. Some sources have described UPF as “predigested food”. Monteiro’s team developed the Nova classification for grouping unprocessed and processed foods beginning in 2010, whose definition of ultra-processing became the most widely accepted, refined through successive publications.

The identification of ultra-processed foods, as well as the category itself, is a subject of debate among nutrition and public health scientists, and other definitions have been proposed. A survey of systems for classifying levels of food processing in 2021 identified four ‘defining themes’:Extent of change (from natural state),Nature of change (properties, ingredients added),Place of processing (where/by whom) & Purpose of processing (why, essential/cosmetic).

Ultra-processed foods often use less expensive ingredients, allowing ultra-processed food to be priced lower. Furthermore, ultra-processed foods are more consistently available in stores. Global production networks of multinational food companies creating ultra-processed food are supported by high brand awareness, aggressive globalization tactics, and the purchasing of local companies selling similar products.

Companies selling ultra-processed food frequently target youth consumers and middle income countries. Many of these companies use big data to choose which consumers to market to.Furthermore, the ultra-processed food industry uses indirect and direct lobbying in large countries to influence local food policy. They often have an extended shelf life, an important consideration for lower income consumers without reliable access to refrigeration. Among other reasons for the popularity of ultra-processed foods are the inexpensive cost of their main ingredients.

The price of ultra-processed food fluctuated less than unprocessed food over a twelve-year period. The effect of ultra-processed foods on health has mainly been investigated using nutritional epidemiology and so far there has been no randomized controlled trial to investigate the effect of these foods on any health outcome other than weight gain. These studies have shown an overall increased risk for disease, although studies separating different types of ultra-processed food have found adverse effects mainly for only some sub-groups such as soft drinks.

Overall, there is an association between certain poor health outcomes – including poor cardiometabolic and mental health, and reduced life expectancy – and consumption of UPF. One study proposed that food addiction may also be associated with consumption of ultra-processed foods. One possible explanation for the adverse effect on health are the high amounts of sugar, fat and salt in these foods, although that does not apply to all ultra-processed foods.

Other potential explanations are the presence of contaminants, certain food additives, and the high heat treatment of these foods. There is currently however no scientific consensus. The publicizing of these findings has sparked debate over the categoric demonization of ultra-processed foods, with some critics calling for a more balanced view, and others arguing that promoting UPFs could undermine public health communication about their risks.

Jessica Wilson, a registered dietitian in California, challenged the negative stereotypes with an experiment where she consumed 80% ultra-processed food for a month. Contrary to expectations, Wilson reported she felt less hungry, experienced less fatigue, and was more physically active. She highlighted that UPFs are a significant part of the diet for many low-income families due to their affordability and convenience, and said that the public deserves more nuanced discussions rather than just “scary stories” about them.

Her stance is partly driven by the view that fearmongering around UPFs overlooks socioeconomic factors like access to healthier alternatives. Beyond health implications, the production of ultra-processed foods also has significant environmental impacts. These foods require extensive processing and packaging, resulting in higher energy consumption and waste production compared to minimally processed foods. Moreover, the globalized supply chains for the ingredients of ultra-processed foods contribute to greenhouse gas emissions.

Given the health and environmental impacts of ultra-processed foods, there have been calls for better regulation and policy surrounding these products. These measures face significant challenges, including industry opposition and the global nature of food supply chains. Future policy efforts may require a combination of regulation, education, and incentives to promote healthier, more sustainable food choices.

Four Latin American countries Brazil,Uruguay, Peru, and Ecuador have so far published national official dietary guidelines that recommend avoiding ultra-processed foods. Chile requires warning labels on some ultra-processed foods and taxes sugar-sweetened beverages. A report on obesity published by the World Bank in 2020 mentions ultra-processed foods as a potential contributor.

In 2022, the Scientific Advisory Committee on Nutrition (SACN) reviewed scientific literature to consider whether the British government should adopt a position on ultra-processed food and recommended further research, scheduling a review on its position for June 2024.

‘I quit ultra-processed foods for a week’ Cosmopolitan.co.uk 16:50 

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