Seven misleading statements and three rational ones about ultra-processed foods

Ultra-processed foods are in the news and the news is not good. Anything labeled ULTRA has to be either wonderfully good or horribly bad. There is nothing in between. The last several posts on this site have explored the world of ultra-processing. From a classical nutrition standpoint they were to be avoided. Public-health nutrition condemnation was more muted, but these food products are also not recommended. A review of the NIH study showing that ultra-processed foods promote weight gain followed. A more nuanced view of the category came next proclaiming that it really encompasses four distinctly different types of products. Last week ended with a plea for nutritionists and food scientists to find some common ground before rushing to judgement. This week I conclude this series of articles with my response to some key statements made online about ultra-processed foods. For those readers tired of reading about the topic, I promise that I will turn my posts to other topics next week.

Online articles seed their titles and lines with major click bait as success is measured in views and visitors. One way to achieve good stats is through partially true statements that obscure or oversimplify a very complex issue. In recent weeks I have found many misleading lines including some rather stark statements about ultra-processed foods. I present some of the more misleading ones and some very rational ones below in bold. I try not to take the statements out of context. I would love to get a discussion going on the topic.

SEVEN MISLEADING STATEMENTS ABOUT ULTRA-PROCESSED FOODS

“Often dubbed ‘convenience foods,’ they include pre-made easy snacks like chips, fries, biscuits, chocolate, sweets, nuggets, energy bars, and carbonated and sugared sweet drinks.Earlier I classified ultra-processed foods into four subcategories: junk, convenience, functional and distilled. I would not classify most of the above items as convenience foods. Rather most of them are high in sugar, fat and/or salt while low in nutrients. Energy bars would fit more into the functional foods category as they are generally high in nutrients and not so high in sugar. Products I would place in the convenience category would be breads, breakfast cereals, frozen entrees, and ready-made products such as refrigerated pasta or boxed grains (such as rice or couscous) with enclosed spice packets. Other functional foods would include liquid, fortified meal replacements, flavored yogurt with probiotics, and plant-based meat or milks. This statement is a classic bait-and-switch trying to categorize the whole class as junk.

UPFs are ready-to-eat snacks that: 4. Are low in vitamins and mineralsThis article tries to cast all ultra-processed foods (UPFs) as snacks. Some are, but many are not. It is the products low in vitamins and minerals that most stories about UPFs point too, but most are not that low in nutrients, unless all nutrients in UPFs are considered irrelevant. If that is true, then nutritional labels on UPFs are meaningless. Many whole fruits and vegetables are rather low in vitamins and minerals—take an apple which is a good source of dietary fiber and vitamin C but little else or head of iceberg lettuce which is only an excellent source of Vitamin K for example. Many fruits and vegetables are considered nutritious because they are low in calories and fats and high in water and dietary fiber.

bottle of a high-protein drink
Low in sugar, high in protein, B12 and minerals

My Iconic Protein Drink is a great source of protein, calcium, Vitamin B12, phosphorous, and magnesium with only 3 grams of sugar per serving. A bowl of Cheerios serves as a great source of iron and several B vitamins. I am not saying that we should abandon our fruits or salads, but not all ultra-processed foods are low in vitamins and minerals, and not all fruits and vegetables abound in them. That is, of course, unless nutrients don’t count in UPFs.

These foods are unhealthy not only because they contain bad ingredients or lack nutrients but also because they undergo processes like extrusion, molding and milling.As mentioned above, ultra-processing is NOT about the process—its only about too many “bad” ingredients. Extrusion many be the exception. I have consumed a single-ingredient, extruded product—made from black-eyed pea paste. We made it on a twin-screw extruder at the University of Georgia Food Science pilot plant. It had good texture but uninspiring flavor. To make an acceptable product would require added artificial or natural flavors and colors which would make it a UPF. Molding can be done in a processing plant or at home from a complex mix of ingredients or a few simple ones. An ice tray is an effective molding instrument for homemade frozen treats. Batter made from scratch can be poured into a mold and baked for homemade cupcakes. Only the commercial ones are ultra-processed.

Milling of grains does not make an ultra-processed bread. It is only when such additives as dough conditioners etc. are put in the mix that it becomes a “mass-produced bread.” Home-made and “unpackaged” bread made from traditional culinary ingredients are not considered ultra-processed. The only real “process” I see that converts a processed product to an ultra-processed one is distillation. Fermented alcoholic beverages are processed, but distilled spirits are ultra-processed.

box of Cheerios breakfast cereal
Low in sugar, high in B vitamins and iron

I think the front of pack labelling is the most tangible one at the moment,” Lawrence said. “It could be something as simple as this is an ultra-processed food or not.Mark Lawrence is a public health and nutrition professor at Deakin University in Geelong, Australia. He has written articles cautioning against consuming ultra-processed foods. Doesn’t the labeling of all foods designated as ultra-processed pose a danger of over-simplifying nutrition? If one labels all ultra-processed food as equally unhealthy all lines are blurred. For example, if presented with the choice between a bowl of ice cream or a bowl of whole-grain cereal for breakfast, which should I choose if both have the ultra-processed label? Is there no difference between a diet soda and a sugared one for a diabetic or someone trying to lose or maintain weight? Then there are the plant-based or clean meats. Do I avoid them because they are ultra-processed and go for the full-fat, whole-meat versions?

package of vegan "meat" crumbles
Plant-based meat is an ultra-processed food

We shouldn’t lump all meat into the same basket, which is why a blunt tax on meat won’t work. The clearest evidence is against ultra-processed meat and other ultra-processed foods, which have been allowed to dominate our daily diets. It’s time to challenge this and seriously consider the idea of an ultra-processed food tax.Dan Crossley, executive director of the Food Ethics Council, reported the results of its trial on the ethics of eating meat. Is he saying that the category of foods we call meat is much more complex than the class of ultra-processed foods as defined by NOVA? I assume he is not just talking about the differences between beef, pork, chicken, fish and wild game. I suspect that he is talking about grass-fed vs. grain-fed and cured vs. whole meats and maybe even from livestock vs. cultured. But, the greatest differences between any two meats has to be less than the differences between a Twinkie, Beyond Meat, Activia, and Jack Daniels. Do these critics really understand how broad the category of ultra-processed foods is?

These foods are made from cheap industrial ingredients and engineered to be super-tasty and generally high in fat, sugar, and salt.Not so fast! A Snickers bar may be high in fat and sugar and a Dorito may be high in fat and salt, BUT

  • a low-salt cracker can also be low in fat and sugar,
  • a sugar-free energy bar does not need to be high in fat,
  • a shot of Irish whiskey added to a Diet Seven Up has neither fat, sugar or salt,
  • a loaf of bread may represent the highest source of salt in the American diet, but it doesn’t have much fat or sugar in it until topped with peanut butter and jelly.

Crackers, energy bars, whiskey, diet sodas and bread are all classified as ultra-processed. It is so easy to generalize about this super-huge category of food products and so easy to come up with counterexamples to each claim.

“ ‘Let’s see if they can produce ultra-processed food that’s heathy and that won’t be as seductive and won’t make us eat so much extra,’ he says, ‘But they haven’t yet.’Barry Popkin, who has long been a critic of processed food and author of journal articles that have studied the nutritional composition of diets containing ultra-processed foods (1-2), made this statement. How does one reformulate a ultra-processed food when restricted to five ingredients or less? It is impossible for a chef to develop a varied and successful menu by relying on five ingredients or less per dish. The same restriction would stymie the most inventive home cook. This challenge to food processors is disingenuous. The NOVA group is apparently out to put an end to processed foods as we know them.

THREE RATIONAL STATEMENTS ABOUT ULTRA-PROCESSED FOODS

 “Policy makers should shift their priorities away from food reformulation—which risks positioning ultra-processed food as a solution to dietary problems—towards a greater emphasis on promoting the availability, affordability, and accessibility of unprocessed or minimally processed foods.This message comes straight from authors of the British Medical Journal article (3) which links ultra-processed foods and all-cause mortality. In contrast with Popkin’s quote above, the authors of the study reveal the real reason behind the ultra-processed food movement. It is not really against ultra-processing but against ultra-formulation. The goal is to greatly reduce if not eliminate all commercial food products with more than five ingredients. This effort is linked to the New Food Movement which has as one of its goals equal access to healthy foods as it defines them. Later this summer I will be exploring on this site goals of this movement as they relate to access to fresh foods in places referred to as food deserts, swamps and slopes.

Healthier diets—diets rich in fresh produce and lean proteins—generally cost more. The researchers who conducted the processed-food study recognize this: They note that the unprocessed diet they fed participants cost 40% more than the ultra-processed diet. And lots of American families don’t have more money to spend on food. In their book, Pressure Cooker, Bowen; Brenton and Elliot suggest that the “unprocessed” diet in the NIH study is beyond the reach of many Americans. They point out that it is more than cost. Factors such as irregular schedules making it difficult for some to properly plan home-cooked meals, lack of adequate cooking facilities, and poor access to fresh foods all contribute to an inability to consistently provide home-cooked meals by American families.

The classification of ultra-processed foods used by the researchers is very broad and so there could be a number of reasons why these foods are being linked to increased risk to our health, for example nutritional content, additives in food or other factors in a person’s life.Victoria Taylor, senior dietitian at the British Heart Foundation, cautions against an over-exaggeration of recent studies. The broad grouping of so many foods into the ultra-processed category is the biggest problem I have with the concept. There is definitely some smoke emanating from these studies, but can we attribute these health concerns to all foods within the group? Do we really want to distinguish between ham (processed) and pastrami (ultra-processed)? Is there any difference between the unhealthiness of a peanut butter cup and a lean cuisine since they are both ultra-processed? Is it better to down five beers (processed) or a 2-liter bottle of wine (processed) at a sitting than to have a couple of shots of vodka (ultra-processed)?

Note that there is no allowance for quantity even though over-consumption of a processed food is more likely to lead to weight gain than moderate consumption of an ultra-processed product. The NIH study indicates that it is easier to overeat ultra-processed foods than what they called unprocessed ones, but the foods served on the unprocessed diet led to an unintended weight loss. The unprocessed diet in the NIH study actually fits into the concept of the Volumetric Diet—high in water and dietary fiber. Incorporation of whole grains in breads and/or breakfast cereals (both ultra-processed foods) might have decreased calorie consumption on the ultra-processed diet. Likewise, beer and wine offered on the unprocessed diet might have increased calorie consumption by those participants.

SOME KEY CONCLUSIONS

Numerous articles on the dangers of ultra-processed foods ignore the vast array of products that fit into this class. They tend to paint all products with the same brush without carefully looking at differences in individual items. Ultra-processing is not really about the process. Rather, it is about the number and type of ingredients in formulated products. Warning labels on ultra-processed foods will clearly suggest that they are all unhealthy with no distinction between any two items such as a glazed donut and a slice of whole-grain bread. Future research on ultra-processed foods should look to develop potential mechanisms involved in possible health consequences. To be able to achieve this goal will probably require separating out distinct sub-categories such as: high-sugar/high-fat/high-salt foods; breads and breakfast cereals; high-protein medicinal foods; and liquor. The current rush to judgement seems to be fulfilling the agenda of food activists without providing clear nutritional guidance to the American public.

For two more scholarly articles on ultra-processed foods see those by Michael Gibney (4-5).

Next week: The Future of Shopping: Where Everyone is a Retailer

REFERENCES:

(1) The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study. E. Martinez Steele, B.M. Popkin, B. Swinburn, and C.A. Monteiro, 2017. Population Health Metrics 15:1-11.

(2) Is the degree of food processing and convenience linked with nutritional quality of foods purchased by US households? J.M. Poti, M.A. Mendez, S.W. Ng, and B.M. Popkin, 2015. American Journal of Clinical Nutrition 101:1251-1262.

(3) Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. A. Rico-Campa, M.A. Martinez-Gonzalez, I. Alvarez-Alvarez, R. de Deus Mendonca, C. de la Fuente-Arrillaga, C. Gomez-Donoso, and M. Bes-Rastrollo, 2019. BMJ 365:1949-1959.

(4) Ultra-processed foods in human health: a critical appraisal. M.J. Gibney, C.G. Forde, D. Mullaly and E.R. Gibney, 2017. American Journal of Clinical Nutrition 106:717-724.

(5) Ultra-processed foods: definitions and policy issues. M.J. Gibney, 2019. Current Developments in Nutrition 3: nzy077, https://doi.org/10.1093/cdn/nzy077

 

 

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