10-second summary: Ultra-processed foods are defined by the NOVA classification system. They are typically nutrient-poor, calorie-dense and associated with negative health outcomes, therefore healthcare professionals should ensure patients are aware of their level of intake. 

What are ultra-processed foods?

The term “ultra-processed foods” refers to a group of foods defined by the NOVA food classification system established by nutrition researchers at the University of São Paulo, Brazil. 

The NOVA system categorises food into 4 categories:

1. Unprocessed or minimally processed foods
2. Processed culinary ingredients
3. Processed foods
4. Ultra-processed food and drink products

Although the definition of “ultra-processed foods” (UPFs) is quite loose, it generally relates to foods that are industrially manufactured, contain ingredients not normally found in domestic kitchens and contain little or no “whole” foods. 

How do ultra-processed foods affect health?

Since the introduction of NOVA categories in 2009, an increasing body of research has linked high consumption of UPFs with a range of chronic inflammatory diseases including metabolic syndrome, inflammatory bowel disease and various cancers. Recent evidence has also linked high consumption of UPFs with negative mental health outcomes.

The category of UPFs contains a wide variety of products including ice-cream, fizzy drinks, mass-produced baked goods, breakfast cereals and ready meals. As such, it is hard to pin down specifically what it is that is responsible for their impact on health. However, UPFs tend to be low in fibre, micronutrients and antioxidant phytonutrients, while being higher in salt and sugar, compared less processed foods. They are also characterised by their inclusion of commercial additives, some of which have been linked to adverse health conditions and changes in the gut microbiome.

There is significant evidence linking high consumption of UPFs with obesity, although the mechanisms for this are complex. They are widely characterised by their hyper palatability and are typically calorie-dense. Additionally, they are generally less satiating than whole foods, which makes them easy to overconsume. 

The challenge for healthcare professionals 

Although there is increasing awareness of the dangers of overconsuming UPFs, research from the retail analysis group IGD has indicated that the general public tend to significantly underestimate the quantity of UPFs they consume. 

The public perception tends to be limited to only the most highly processed products such as instant noodles and fizzy drinks. Many foods such as ready-made pizzas and breakfast cereals are not perceived to be ultra-processed which puts the public perspective at odds with the scientific research.

In summary, diets based on whole foods are consistently associated with better physical and mental health outcomes compared to diets with a high proportion of UPFs. Importantly, the classification used in the research is not just related to the most highly processed foods, but foods that are commonly perceived as merely “processed” or “processed culinary ingredients”. It’s important to be aware of how much ultra-processed food you and your patients are eating and the impact it may have on health.

Key takeaways

• Ultra-processed foods, as defined by the NOVA classification system, are industrially manufactured foods containing ingredients not typically found in domestic kitchens, with little to no whole foods.
• Research to date has linked the high consumption of ultra-processed foods with adverse health outcomes including various chronic inflammatory diseases, negative mental health outcomes and obesity. 
• Healthcare professionals should advise patients to monitor their ultra-processed food intake, as there is a public underestimation of the consumption of ultra-processed foods with a misconception that only the most highly processed items are ultra-processed

 

Looking for more high-quality lifestyle medicine education? Make sure to explore our free CME-accredited webinars and the latest series of our Nutritank podcast.

 

About the author

David Titman is a registered nutritionist (RNutr) and food scientist with multinational experience in advising the food sector. He takes creative, pragmatic approaches to working with companies in developing their responsible food strategies, which has led to significant positive change in charitable, commercial and educational settings. He is the director of Raising Nutrition, an innovative social enterprise that educates and empowers organisations to raise nutrition standards and knowledge. 

 

To view David’s recent webinar on ultra-processed foods, you can sign up for a free Nutritank membership here.

 

Reference list

IGD, 2023. Ultra-processed foods: a consumer perspective. Available at: Ultra processed foods: a consumer perspective (igd.com) [Accessed 24/08/2023] 

Lane, M.M., Gamage, E., Travica, N., Dissanayaka, T., Ashtree, D.N., Gauci, S., Lotfaliany, M., O’neil, A., Jacka, F.N. and Marx, W., 2022. Ultra-processed food consumption and mental health: A systematic review and meta-analysis of observational studies. Nutrients, 14(13), p.2568. https://doi.org/10.3390/nu14132568 

Srour, B., Kordahi, M.C., Bonazzi, E., Deschasaux-Tanguy, M., Touvier, M. and Chassaing, B., 2022. Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights. The Lancet Gastroenterology & Hepatology. https://doi.org/10.1016/s2468-1253(22)00169-8 

Valicente, V.M., Peng, C.H., Pacheco, K.N., Lin, L., Kielb, E.I., Dawoodani, E., Abdollahi, A. and Mattes, R.D., 2023. Ultra-Processed Foods and Obesity Risk: A Critical Review of Reported Mechanisms. Advances in Nutrition. https://doi.org/10.1016/j.advnut.2023.04.006 

Zhou, X., Qiao, K., Wu, H. and Zhang, Y., 2023. The Impact of Food Additives on the Abundance and Composition of Gut Microbiota. Molecules, 28(2), p.631. https://doi.org/10.3390/molecules28020631