Understanding Ultra-Processed Foods
There has been lots of recent chatter about ultra-processed foods and health risks. Several recent scholarly articles showed a link between ultra-processed foods and cancer. From ovarian to colon cancer, it appears that those who eat the most processed foods have the greatest risks. And as many of us try to use foods to minimize risks and maximize benefits – what do we do now?
What are ultra-processed foods?
My first quest in reviewing these articles was to determine what is considered ultra-processed foods. When I pose the question to my husband his response is something like, “you know, hot dogs, packaged cupcakes, and chips.” And my first assumption around ultra-processed foods were nutrient poor foods that are so altered from their natural context with artificial colors and flavors that our ancestors wouldn’t know they were food – like cheese curls, fruit bites, and animal shaped chicken nuggets.
On a deeper dive, however, the definition of processed foods is much greater and actually accounted for some of the cereals, breads, and yogurts that are staples for my family and made of whole grain or high nutrient foods.
In two of the studies I reviewed, they used the NOVA Food classification system to determine which foods were ultra-processed. NOVA categorizes foods into four categories:
Group 1: This is unprocessed foods – fruit, vegetables, meat, milk, grains, legumes, nuts. The foods can be frozen, bottled, squeezed, pasteurized or vacuum sealed, etc, for preservation purposes
Group 2: This group accounts for food that is extracted in a minimally processed way that serves as ingredients: salt, sugar, oils, honey, flour, vinegar.
Group 3: Processed foods – this is where group 1 and group 2 foods come together in some process like cooking at home or getting something packaged at the store like salsa.
Group 4: Ultra-processed foods – foods that are created by using parts of other foods – like starches, fats, salts – and often have chemical additives to help increase shelf life, increase flavor or color, or make the texture of the foods come together in ways not naturally found. These foods may also be molded to look like other things. This group includes salty and sugary packaged snacks, candy, soda, sports drinks, flavored yogurts or milk, pre-prepared hotdogs, burgers, sausages, industrially made bread or buns, breakfast cereals, etc.
Now that I understood the grouping system, how should I apply this knowledge to my real life?
For this question I enlisted registered dietician and Chef Sarah Dayton of Dash Meal Solutions in Danville, PA to help me sort it out.
Pro Tip #1: Look at the ingredients to see if you can pronounce what’s in the food.
Sarah says, “avoid foods with ingredients that are chemicals and not foods. If you can’t pronounce the ingredient, it is likely ultra-processed.” Common food additives include: calcium propionate, high fructose corn syrup, hydrogenated oils, sodium, glutamate, and soy lecithin – much to my disappointment, found in my “healthy bread.”
As for citric acid, I give it a pass. It is an organic acid found in citrus fruits and is the component in lemons that when added to other fruits keep them from browning -- think adding lemon juice to apples so they don’t turn brown.
Pro Tip #2: Shop in areas of the grocery store that are more likely to have Group 1 food
Sarah says, “shopping around the perimeter of the grocery store is still the best way to get mostly whole or wholesome foods.” The perimeter of the grocery store tends to have the fresh fruits, veggies, bakery breads, meats, and cheeses. She acknowledged that packaged breads and cereals are included in the ultra-processed category but perhaps they are not all the same as some of the other products with less Group 1 ingredients and more chemicals. We discussed how whole grain bread with one shelf-stablizing ingredient is likely better than cereal packed with sugar, artificial colors and flavors.
Pro-Tip #3: Less ingredients is better
Sarah says, “Less ingredients is better but many ingredients does not make something ultra-processed.” For example, salsa may have lots of ingredients but they are typically spices, vegetables, and salt. Again, looking at the ingredient label to see if the ingredients are food is helpful. Also, adding vitamins does not make something ultra-processed. Pasta is a great example of this. Often it is wheat and water but may be fortified with folic acid and other vitamins. This makes it healthier for us and it does not cross over to the ultra-processed category.
Pro-Tip #3: Health food labeling is sometime deceptive
Sarah says, “Just because foods advertise that they are low fat, low sodium, gluten free or advertise other health benefits does not mean they are not ultra-processed.” Particularly foods that are gluten free may need to use chemical additives to, for example, make cauliflower into a pizza crust. Sugar free foods often use chemical sweeteners. Low fat versions of common foods sometimes increase sweetness with more sugar or artificial sweeteners to increase taste appeal. Always remember to check the ingredients.
As more food companies are trying to make factory made convenient foods that have more nutrients and less chemicals, I hope that the classification systems and how we research this will take those “healthier” foods into account. Perhaps 5 groups that delineate the more nutrient ultra-processed foods from the nutrient poor ultra-processed foods. For now, my family and I will do our best trying to sort out which ultra-processed foods to keep as staples – our whole grain bread is staying! And generally we will continue to do what seems to be most healthy and tasty -- cooking in our home kitchen with our favorite fruits, veggies, meat, herbs, beans, and grains.
To your health and well-being,
Dr. Jen
