I recently wrote about the how we can classify the processing of foods. There are basically four categories under the scientifically based NOVA classification. To review:
Group 1 — unprocessed or minimally processed foods (fruit, vegetables, eggs, meat, milk, etc.).
Group 2 — foods processed with culinary ingredients used by a typical cook that might include oils, butter, sugar, molasses, honey, maple syrup, salt, pepper and simple spices or spice combinations with or without salt.
Group 3 — minimally processed foods that usually have two or three ingredients, including food preserved in salt or vinegar, pickles, canned fish such as sardines and tuna, canned fruit in syrup, freshly made cheeses, bakery-made bread, beer, wine or alcoholic cider.
Group 4 — ultra-processed foods that are industrial formulations.
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Foods in the last category are made entirely or mostly of substances extracted from foods (oils, fats, sugar, starch and proteins), derived from food constituents (hydrogenated fats and modified starch) or synthesized in laboratories from food substrates or other organic sources (flavor enhancers, colors and food additives). Such ingredients are used to make the product hyper-palatable.
Ultra-processed foods also are identifiable by their manufacturing techniques, which include extrusion, moulding and preprocessing by frying. Group 1 foods are usually only a small proportion of, or are even completely absent from, ultra-processed products.
You can imagine some examples of ultra-processed foods. Just go into a local convenience store and see what’s on most of the shelves.
But these foods also can include premade pizza and pasta dishes, burgers, hot dogs, sausages, chicken nuggets and fish sticks; ice creams, frozen desserts, chocolates, candies, pastries, including cake mixes, and sweets in general; margarines and spreads; most packaged breads, canned or packaged soups, noodles and sauces; and drink mixes, soda and other carbonated soft drinks.
When you see ingredients such as hydrogenated vegetable fat, sugar, yeast, whey, emulsifiers and other additives, those are signs of ultra-processed foods. And even flavored yogurts, breakfast cereals and bars, dairy drinks, meal replacement shakes, sweetened juices and infant formulas can be in this category.
Health hazards
Now, you might ask why I’m writing about this again. It’s because a brand new study in the British Medical Journal just hit home the importance of this topic. I want to share this with you because it’s an actionable thing you can do to improve your health.
Bottom line first: There is now consistent evidence identifying ultra-processed foods as a contributing factor in more than 32 damaging health outcomes, including cancer, major heart and lung conditions, mental health such as depression disorders, and many forms of early death.
Ultra-processed foods undergo multiple industrial processes and often contain colors, emulsifiers, flavors and other additives not seen in normal life. They tend to be high in added sugar, fat and salt, and low in vitamins, fiber and other important nutrients.
These foods can account for up to 60% of total daily energy intake of many people in the U.S. and other higher-income countries, and their intake has rapidly increased in many low- and middle-income nations, with people beginning to suffer many of the same problems we have in the U.S. So let me unpack the study.
How it was done
Researchers carried out a high meta-analysis of 45 recent major research studies and 14 review articles, looking at ultra-processed foods with bad outcomes. All told, the research analyzed involved roughly 10 million people. And, by the way, none of the research was funded by companies involved in the production of ultra-processed foods.
Estimates of exposure to ultra-processed foods were obtained from a combination of food frequency questionnaires, 24-hour dietary recalls and dietary history. The exposure was measured as higher vs. lower consumption, servings per day, etc.
The convincing, good-quality evidence showed that consuming too much ultra-processed food put people at around a 50% increased risk of heart disease and stroke, a 53% higher risk of anxiety, a 22% higher risk of depression, and a 12% greater risk of type 2 diabetes.
It was also associated with a 21% risk of simply dying prematurely from any cause at all. Asthma, some cancers and gut problems were also high on the list of what ultra-processed foods seem to cause.
Why is this? It’s the chemically manipulated cheap ingredients such as modified starches, sugars, oils, fats and protein isolates, with little if any whole food added. Ultra-processed foods shorten the time we need to chew and swallow, make food more palatable and attractive by using combinations of flavors, colors, emulsifiers, thickeners and other additives, leaving out the natural nutrients that make our food wholesome.
They also stimulate our appetite so we eat more and reduce the sated feeling food normally gives us. And they have been associated with increased blood-stream concentrations of acrylamide and phthalates, known environmental toxins created during processing and released from packaging materials.
My spin: If you want optimal health, read those labels and take action. Stay well.
This column provides general health information. Always consult your personal health care provider about concerns. No ongoing relationship of any sort is implied or offered by Dr. Paster to people submitting questions. Any opinions expressed by Dr. Paster in his columns are personal and are not meant to represent or reflect the views of SSM Health.