Ultra-Processed Foods - The Low Down Part 1

Ultra-Processed Foods are hitting the headlines at the moment and there’s no sugar-coating the reports: modern day diets are having an alarming impact on our health.

“People consuming more ultra-processed food have higher risk of disease and death,” says Dr Sarah Berry bluntly on BCC’s Panorama Ultra-Processed Food: A recipe for ill health? amid a backdrop of pizza and sausage rolls.

“All of the crises we face – the climate crisis, the biodiversity crisis and the health crisis – all come together when we’re looking at ultra processed foods,” explains the organic charity Soil Association’s policy advisor Cathy Cliff.

“I think it’s one thing in nutrition that we all agree on, ultra-processed foods are bad,” states nutritionist Lucy Williamson.

The picture is bleak enough to drive you straight to comfort food – which, I have to admit, it did.

I’ve watched the Panorama episode twice. Once on my own for research purposes and once with my family, who I insisted also needed to see it. Both my parents are on medication for type-2 diabetes. My nieces and nephews would eat pizza seven days a week if they were allowed. We listened to Dr Kesar Sedhra say: “The chronic disease escalation is primarily related to food intake. There is no question about it”, while my mum drank a caffeine-free diet Coke, my sister-in-law ate salt-and-vinegar crisps, and my dad and I finished up the chocolate.

That’s how strong our pull to ultra-processed foods is – and we’re not alone in this. In the UK, ultra-processed foods make up 50% of diets for adults and 65% for children, and it’s increasing [1a].

Speaking on the same episode, Professor Tim Spector says:

“That means more type-2 diabetes, more cancers, more heart disease, more misery, more mental illness. This really is a future timebomb… and we’re sleepwalking into it.”

So, what exactly are ultra-processed foods? Why are they so addictive? Are any processed foods OK to eat? And what does a healthy diet look like?

What are ultra-processed foods?

Many foods fall into the ultra-processed category, according to the NOVA classification [2], which is widely used by research and scientific communities. Read more about the classifications from the British Medical Journal here.

Most foods are at least minimally processed in some way to make them edible or preserve them – pasta, frozen peas, milk, honey, dried fruit. These are not the problem.

Ultra-processed foods, however, have typically been altered in such a way that we don’t recognise the raw ingredients. They tend to have long ingredient lists that include additives, preservatives and emulsifiers – ingredients that you are unlikely to have in your kitchen cupboards.

Why are Ultra-Processed Foods so damaging to our health?

We no doubt all know people who are suffering with the physical and mental health issues being linked to Ultra-Processed Foods, because they are so prevalent today. These include: depression [3a], cardiovascular diseases [3b], higher risk of dementia [3c], chronic kidney disease [3d], inflammatory bowel disease [3e], diabetes [3f], colorectal cancer [3g], and eating disorders [3h].

A study at cancer research centre, the Ramazzini Institute, found links between aspartame – a sweetener often used instead of sugar in ultra-processed food and drink – and a number of cancers in different organs, including nervous system tumours, memory cancer, kidney, and leukaemia. [4].

One of the world’s biggest studies into food additives, Nutrinet Sante, which involves more than 174,000 people, also shows a strong correlation between the additives we ingest and the likelihood we are to develop cancer and other diseases [5].

The problem with ultra-processed foods is not only that they tend to be higher in fats, salts and sugars. Or that packaging which states ‘high in fibre’, ‘low in sugar’, ‘low in salt’ and ‘plant based’ leads us to believe we’re eating products that are healthier for us than they really are [6].

The issue is also that the processing and the additives all work together to create a product that’s typically high in energy (calories), low in nutritional benefit, and this is impacting our health in ways we are only just starting to understand.

Have you ever eaten a fast-food burger and felt hungry about an hour later?

Nutritionist Lucy Williamson explains when we ultra-process food, we change the structure of it and one result of this is that the sugars are much easier for us to absorb. This sugar-hit feeds the reward centre in our brain, so it gives us immediate pleasure.

It also leads to spikes in blood sugar levels. In response, our bodies produce insulin to regulate this, the drop in blood sugar stimulates our appetite again. Feeling peckish, we reach for more ultra-processed food because we’re looking for a repeat ‘hit’. Hence, its addictive nature.

Studies have shown that people who eat a lot of ultra-processed food typically eat up to 500 more calories each day than people who eat more whole-foods [7].

If we were eating whole foods or minimally processed foods our bodies take longer to break down the food, so we don’t have the highs followed by the lows.

These sugars are also problematic for our gut health. The gut is important for regulating our immune system and protecting us against certain types of cancer, just two of its many important functions. Williamson says:

“The greater the variety of microbes in our gut, the better. If you’re on a high ultra-processed food diet, there are more free sugars floating around in your gut and microbes do not thrive in a sugary environment. We know from really robust research that our gut microbiome impacts our whole health – it’s at the root of many of the chronic health issues of our time.”

Part two Lizzie discusses “So, what food can we eat? And what about my favourite Yeo products?” coming up in the next couple of weeks.

READ:

Ultra-Processed People: Why Do We All Eat Stuff That Isn’t Food … and Why Can’t We Stop? Dr Chris van Tulleken

LISTEN:

Radio 4’s The Food Programme podcast, titled UPF WTF

REFERENCES:

[1a]. Swinburn, B.A., et al. (2019), The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report, The Lancet, Volume 393, Issue 10173, 791–846 and Dr Sarah Berry, Kings College London, Panorama Ultra-Processed Food: A recipe for ill health?

[2] FAO (2019). Ultra-processed foods, diet quality, and health using the NOVA classification system. http://www.fao.org/3/ca5644en/ca5644en.pdf

[3] https://www.soilassociation.org/media/25469/taking-the-biscuit-2023-report.pdf:

[3a] Mazloomi, S.N. et al. (2022). The association of ultra-processed food consumption with adult mental health disorders: a systematic review and dose-response meta-analysis

of 260,385 participants. Nutritional Neuroscience. https://doi.org/10.1080/1028415X.2022.2110188

[3b] Debras, C. et al. (2022). Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort. BMJ; 378. https://doi.org/10.1136/bmj-2022-071204

[3c]. Li, H. et al. (2022). Association of Ultraprocessed Food Consumption With Risk of Dementia: A Prospective Cohort Study. Neurology, Jul 27. https://n.neurology.org/content/99/10/e1056

[3d]. Du, S. et al. (2022). Association Between Ultraprocessed Food Consumption and Risk of Incident CKD: A Prospective Cohort Study. American Journal of Kidney Diseases, Volume 80, Issue 5, November, Pages 589-598.e1. https://doi.org/10.1053/j.ajkd.2022.03.016

[3e]. Chen, J. et al. (2022). Intake of ultraprocessed foods is associated with an increased risk of Crohn’s disease: a crosssectional and prospective analysis of 187,154 participants in the UK Biobank. Journal of Crohn’s and Colitis, jjac167, https://doi.org/10.1093/ecco-jcc/jjac167

[3f]. Li, M. & Shi, Z (2022). Association between Ultra-Processed Food Consumption and Diabetes in Chinese Adults—Results from the China Health and Nutrition Survey. Nutrients, 14(20), 4241; https://doi.org/10.3390/nu14204241

[3g]. Wang, L. et al. (2022) Association of ultraprocessed food consumption with colorectal

cancer risk among men and women: results from three prospective US cohort studies. BMJ 2022; 378. https://doi.org/10.1136/bmj2021-068921

[3h]. Figueiredo, N. et al. (2022). Ultraprocessed food intake and eating disorders:

Cross-sectional associations among French adults. Journal of Behavioral Addictions. Volume 11: Issue 2. https://doi.org/10.1556/2006.2022.00009

[4] Panorama, Ultra-Processed Food: A recipe for ill health? https://www.bbc.co.uk/iplayer/episode/m001mp67/panorama-ultraprocessed-food-a-recipe-for-ill-health

[5] Panorama, Ultra-Processed Food: A recipe for ill health? https://www.bbc.co.uk/iplayer/episode/m001mp67/panorama-ultraprocessed-food-a-recipe-for-ill-health

[6] BBC One: King’s academics highlight impact of ultra-processed food on health

https://www.kcl.ac.uk/news/kings-college-london-ultra-processed-food-tim-spector

[7] https://pubmed.ncbi.nlm.nih.gov/31269427/

FURTHER READING:

Ultra-Processed People: Why Do We All Eat Stuff That Isn’t Food … and Why Can’t We Stop?

Dr Chris van Tulleken