What are ultra-processed foods and are they unhealthy?
I have been hearing the term “ultra-processed” more and more lately without really knowing what it truly meant, even as a dietitian. This seemed like a new term so I was surprised to learn that it had actually been coined in 2009 by an epidemiologist, Carlos Augusto Monteiro as part of the NOVA food classification system.
So what does this term mean?
From what I gathered in my research it seems that there was an attempt to classify different food types into categories including unprocessed, culinary processed, processed and ultra-processed. This was not only to provide guidelines for people for healthy eating, but also to be used in research. The set up of the categories appears to make sense on the surface: define what “processed” means, and the different degrees. However, when you get into the details of how to do that and what they came up with, it gets muddled real quick.
Some examples of how the categories are organized: foods that “increase shelf life” are in the “processed foods” and any foods that “increase convenience” are in the “ultra-processed” category. Seems simple enough right? Already I’m sure you can see how we are going to pick this apart.
For some examples, these categories mean that salted nuts and yogurt can be in the processed category, same as beer - things that we can agree all have different nutritional value and health effects. Both white and whole wheat breads would be in the same category, also with different nutritional content.
Along these lines, some of the foods in ultra-processed category could range from hummus to soda, and so on and so forth.
Given these wild ranges of foods and their nutritional content, does this this food classification help guide nutritional choices?
As a dietitian, I am going to say that overall categorizing foods into unprocessed, processed and ultra-processed does not improve health choices. Why do I say such a strong statement? I am for nutrition education and public knowledge of foods and nutrition in order to help guide themselves on the health choices that they want to make. However, this classification system is extremely flawed and doesn’t actually help guide in nutritional content or that not all things that help convenience and longevity of shelf life are treated the same. I would love if there was this similar concept but from a shame-free lens and actually pulling apart different additives and preservatives to see if there are differences in health effects and nutritional content rather than having these broad categories.
Based on how this classification system has been used and interpreted since 2009, my assessment of it is that it strengthens the idea that there are “good” and “bad” foods and that “processed” = bad. This creates more shame and stigma for people who consume these foods and rely on the convenience to be able to feed themselves and their family. When we create these shame-ridden narratives around food it actually decreases our ability to assess and make the choices that are the most supportive for our health. Every individual is unique on what a healthy choice would look like for them, and we should be open to that including processed foods in the mix with whole foods, especially when there has been no scientific evidence showing that these foods are harmful outside of the extremes (as with any type of eating). This is also the case because we don’t have a proper classification system and examples that everyone can agree on because everyone interprets these categories differently.
Conclusion
I know there are going to be a lot of arguments for this classification system and how people in theory know which foods are “healthy” and which ones are “processed”. However, when that is put to the test using this classification system, I know that you would be surprised at the results. There have also been studies showing that people tend to eat in balance when given the ability to do so, and that even in the “ultra-processed” category there is a wide range of nutritional differences.
Further reading and information:
I highly recommend the Maintenance Phase podcast episode: Ultra-Processed Foods where they dive in more on how studies have tried to use this classification system and why it creates flawed narratives.
Article from Academy of Nutrition: https://www.eatrightpro.org/news-center/practice-trends/examining-the-nova-food-classification-system-and-healthfulness-of-ultra-processed-foods
Article from dietitians on more of the flaws: https://www.todaysdietitian.com/newarchives/0325p20.shtml