There’s much debate around ultra-processed foods and the damage they might be doing to our health. One recent study linked a diet high in these foods with an increased risk of cancer, while another warned that the more ultra-processed food we eat, the more likely we are to develop diabetes.
It’s even been suggested these foods are so dangerous they should carry health warnings.
In a recent parliamentary debate, the Scottish National Party MP Carol Monaghan claimed: “One of the issues with ultra-processed food is that it’s also ultra-addictive, and then people want to have more of it and we can’t help ourselves. But we don’t treat it like other ultra-addictive things like cigarettes and alcohol.”
Yet there are also experts who believe the focus on how and where foods are made is muddling an important health message. So, what is ultra-processed – and should we be worried?
We asked Bridget Benelam, a nutrition scientist at the British Nutrition Foundation, and Gunter Kuhnle, a professor of nutrition and food science at Reading University, to sort the myths from the misinformation.
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Junk food or junk science?
A lot of ultra-processed foods, such as cakes and confectionery, greasy takeaways, sugar-coated cereals and heavily sweetened carbonated drinks, are generally accepted as ‘junk food’.
And there is no doubt that foods and drinks which are high in sugar, fat or salt, as well as being low in nutrients and fibre, are bad for our health.
If a food ticks all of these boxes, as many ultra-processed foods do, it’s likely to be particularly unhealthy. But Bridget points out: “You could make a cake at home and it would not be considered ultra-processed, but that doesn’t mean it’s healthy. It’s still going to be high in sugar, it’s still going to be high in saturated fat. There’s a disconnect.”
Another concern is that science relies on clear definitions. Everyone knows what a vitamin or mineral is, and these nutrients are easily identified and measured. We don’t have the same precision with ultra-processed foods.
Professor Kuhnle says: “Because the definitions always differ, ever so slightly, it makes it very difficult. We need precise definitions to understand things.” Bridget agrees, adding: “There are so many grey areas and so many things that, when you boil them down, just don’t make sense.”
So what is ultra-processed?
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A recent report from the Scientific Advisory Committee on Nutrition found seven different ways to classify what is, and isn’t, an ultra-processed food. The most widely used is called NOVA and ultra-processed foods are classified as NOVA4.
The current definition runs to around 700 words and starts by explaining they are “formulations of ingredients, mostly of exclusive industrial use, typically created by a series of industrial techniques and processes”. It gives examples including commercially wrapped breads and packaged cakes and pies, and describes ultra-processed foods as “highly profitable” and “powerfully branded”.
But packaging, pricing and advertising don’t alter the nutrient content of a food and, as Prof Kuhnle points out, “you can take completely fine, healthy foods, put them together in a factory and package them – and suddenly they become ultra-processed”.
He adds: “Some breakfast cereals are essentially just a wholegrain, sometimes with added vitamins, pushed into a nice shape. Yet a fortified wholegrain cereal is put into the same ultra-
processed category as brightly coloured or incredibly sweet cereals. Infant formula is another can of worms. There are children who rely on formula, for whatever reason, to survive and I don’t think it’s helpful to tell parents ‘oh, you’re doing something really bad for your child’.”
Even the experts find the classifications confusing. When researchers asked more than 150 food and nutrition specialists to assign NOVA classifications to over 200 foods – ranging from commercially packaged foods and ready meals to everyday items such as bread and cheese – they agreed on only four foods.
Does processing make food unhealthy?
Some forms of processing – such as fermenting cabbage to create sauerkraut or kimchi, or milk to make yoghurt – actually make foods healthier by creating gut-friendly probiotics.
“There are foods, like dried beans, that you have to process in order to make them edible,” Prof Kuhnle points out. This is because in their raw form, many varieties, including red and white kidney beans, have toxins which cause severe stomach pains, vomiting and diarrhoea.
Castor beans, which are processed to make castor oil, contain the poison ricin. Similarly, tapioca, once a school-dinner staple, is extracted from the cassava plant, which has to be processed to remove naturally occurring cyanide.
Using the NOVA descriptions, this level of processing would probably be considered NOVA2 or 3. But when beans are processed in a factory and then combined with a tomato sauce to make baked beans, they become a NOVA4 ultra-processed food.
Fish fingers also fall into this category because the fish is shaped, coated and packaged in a factory, although fish coated with the same ingredients at home would probably be classified as NOVA 3.
Bridget says: “What worries me is that it seems to be targeting a lot of foods, like baked beans, breakfast cereals and fish fingers, that people on a tight income would consider staples. When many people are having a difficult time with food prices, saying, ‘you should buy bread from an artisanal bakery for three times the price of a loaf at the supermarket’, is a tough message.
“If we are going to say that, we have to be very sure it’s evidence based – and I don’t think we have the evidence to say that these foods, as a whole, are a problem for our health.”
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What about additives and E-numbers?
Another feature of ultra-processed foods are E-numbers and ingredients you might not recognise, but not even this is straightforward.
For instance, E948 is oxygen, which is used to stop packaged red meat changing colour.
There is growing evidence that some of the additives used in ultra-processed foods negatively impact our gut bacteria. These include the emulsifiers polysorbate 80 (E433), carboxymethylcellulose (E469) and the artificial sweeteners saccharin (E954), sucralose (E955) and aspartame (E951 and E962).
But there is stronger evidence that alcohol – regardless of whether it is ultra-processed gin or minimally processed beer – damages gut bacteria and digestion.
And E-numbers are not necessarily unhealthy. Those from 300 to 399 are antioxidants that extend the shelf-life of processed foods and include vitamin C, vitamin E, calcium and lecithin, which is associated with cardiovascular benefits.
The food colouring E101 is vitamin B2, also known as riboflavin, and other colourants include the spices curcumin (E100), paprika (E160c) and saffron (E164), as well as flavonoids including lycopene (E160d), lutein (E161b), zeaxanthin (E161g) and anthocyanins (E163) which have been linked to a range of health benefits.
Should I avoid foods that have gone through a lot of processing?
There is growing evidence that the structure of the food we eat, known as the matrix, is a factor in how much we consume and how quickly food is converted into blood sugar – and this might account for some of the risks which have been linked to ultra-
Many highly processed snack foods and confectionery are also laden with sugar, salt or fat and are also high in calories. These are a recipe for obesity and increase our risk of heart disease, diabetes and other health problems.
They may also contain trans fats – sometimes listed as partially hydrogenated oils – which increase levels of unhealthy LDL cholesterol and raise the risk of developing heart disease, diabetes, stroke and dementia.
However, intensive processing doesn’t automatically make something unhealthy. A fruit juice made from a concentrate is ultra-processed because it has been mechanically crushed, filtered, heat treated and then frozen or dehydrated for shipping to another factory where it is reconstituted by adding water.
Yet compared to a juice squeezed at home, which is not ultra-processed, these commercially squeezed juices contain comparable amounts of vitamin C and fruit sugars, but higher levels of the flavonoids hesperidin and naringenin, which protect against coronary heart disease and stroke.
Similarly, compared to minimally processed butter, ultra-processed margarines and spreads have a healthier nutritional profile and contain fewer calories, less saturated fat and more vitamins E and D.
Both experts agree. While concerns about ultra-processed food have become the latest health fad, when you pare it back to the basics, the message is nothing new.
Reduce your consumption of sugar, salt, fats and alcohol, and eat more fish and high-fibre foods such as fruit, vegetables and wholegrains.
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