Avoiding Ultra-Processed Foods – Useful Advice or Useless Label?
Dr Sean Wheatley, MSc, PhD. Science and Research Lead.
One of our recent blogs (available here) talked about polarised views in the world of nutrition. This theme is continued here. On this occasion, the debate is specifically around the use of the term “ultra-processed” in relation to foods. Specifically, whether advice to avoid ultra-processed foods (UPFs) is helpful*. This terminology is often used to support people in making informed dietary choices. For some though, the term is considered unscientific and unhelpful. But who is right?
The case for useless
In the blog referred to above, the often-repeated claim that “fat is bad” was criticised. The crux of this criticism was that there are lots of different types of fat that are contained in lots of different foods in lots of different ways. Therefore, not all fat-containing foods are the same, so to universally paint them all as “bad” is non-sensical. It is also just plain wrong.
A similar argument could be made for UPFs. There are lots of different ways to process foods (or other ingredients), and then lots of different ways to combine them. As such, there is certainly some truth in the argument that grouping a wide range of different foods together under the “ultra-processed” banner has limitations.
Further, some foods that are classified as ultra-processed might have some potential benefits. For example, some have ingredients that could have health-promoting effects, and some have been fortified with nutrients which might be missing from people’s diets. Another part of the criticism around demonising UPFs is therefore that it wouldn’t just be the “bad” ones that were cut out as a result.
These points are not untrue. That does not mean advice to avoid UPFs cannot be useful from a public health perspective, though.
The case for useful
The primary basis on which advice to avoid UPFs might be considered useful is that, if followed, it does lead to many foods which are detrimental to health being avoided.
Most UPFs have limited nutritional benefit (if they have any at all). Important nutrients – like good quality protein, healthy fats, fibre, and a range of vitamins and minerals – are usually lacking. Instead, UPFs are often made of refined carbs (including sugar) and processed fats; these are far from healthy. UPFs often contain other additives too (e.g., stabilisers, preservatives and/or flavour enhancers), which, generally speaking, are unlikely to be good for us.
Many UPFs also lead to overeating (and potentially cravings, or even addiction). This is because the ingredients they include and the way they are combined override the signals our body uses to regulate hunger. Other properties of such foods – such as their taste, texture and how easy they are to chew – exacerbate these issues.
As noted above, some foods that are classified as “ultra-processed” may have some benefits, and it is true that these foods would also be omitted if someone were to strictly adhere to guidance to avoid all UPFs. However, any benefits of such foods are limited if the rest of someone’s diet is made up of minimally processed, nutrient dense, real foods. You don’t need fortified foods if what you are eating already contains all the nutrients you need!
Supporting the likely negative impact of UPFs (when treated as a broad group), there is a significant and growing body of evidence linking increased consumption with a wide range of negative health outcomes. This includes in relation to body size, type 2 diabetes (e.g., here and here), cardiovascular disease, cancer, the risk of having cardiovascular disease and cancer, sleep-related issues (including insomnia), mental health issues (including depression) and of accelerated aging, and of dying earlier (e.g., here, here and here).
There are therefore lots of potential downsides to UPFs.
Getting real
In an ideal world, the nuance and complexities around different foods would be captured in public health messages**. In practice however, what we need is clear and concise advice that will help people make practical changes. To this end, it can certainly be argued (and I would argue) that the demonisation of UPFs is likely to have a significant net-benefit, despite the possible limitations around such messaging.
That is to say, if this advice is followed it is much more likely to lead to people cutting out unhealthy foods than it is to cause people to miss out on potentially healthy ones. Plus, as discussed before, the potentially healthy UPFs are less likely to be needed if people are eating lots of nutritious, real foods anyway.
Identifying ultra-processed foods
It is also sometimes argued that the term “ultra-processed foods” is not practical in the real world, as people do not know it means or what foods it includes. In many cases this is simply not true, and people have a good idea of what types of foods would be included in this category. In other cases, it is more helpful to support people in understanding what UPFs are rather than simply abandoning a potentially useful concept. There is always nuance in public health, and there are always caveats and complexities. That doesn’t mean we should give up trying to help people to make lifestyle changes though!
Some foods (such as most sweet and savoury baked goods, and many takeaways) are clearly ultra-processed. Most people would be able to identify these foods as such. Even if these were the only foods that people cut out through trying to follow advice to avoid UPFs, then this could still result in significant health benefits for many people.
Whether or not something is ultra-processed isn’t as clear for all foods though, at least in part as many UPFs are promoted as being healthy. Breads and breakfast cereals, for example, are often ultra-processed, but you wouldn’t know that from how they are marketed.
Perhaps the single best indicator of whether a food is ultra-processed is the ingredients list. Real foods usually have few ingredients, if any. They are an ingredient! Trying to avoid foods with long ingredients lists is therefore a good place to start. This is particularly true if you do not recognise the ingredients as being foods in their own right. As a general rule of thumb, try to avoid foods with more than five ingredients.
The differences between real and ultra-processed foods are explored further in one of our “What I Need to Know” leaflets. These leaflets, which are available from here, are printable and can be freely shared (physically or electronically).
What’s the bottom line?
Although there are some valid concerns when it comes to advising people to avoid ultra-processed foods, we should not let perfect get in the way of good. In general, following this advice is more likely to lead to people cutting out unhealthy foods than it is to cause people to miss out on healthy ones. Dietary advice to prioritise minimally processed (“real”) foods and to avoid ultra-processed ones is therefore sensible, and is likely to lead to improved physical and mental health and wellbeing for those who follow it.
* This blog focuses on this question from a health perspective, but there are also debates around other practical implications of this advice, such as in relation to the cost of living. Although it is beyond the scope of this article to consider this in detail, it is important to note that real food (and leading a healthy lifestyle in general) does NOT have to be expensive. For advice on staying healthy on a budget, you may be interested in some of our previous blogs (e.g., this and this).
** Actually, in an ideal world many of the products that would be classified as ultra-processed would not exist, but that ship has sailed.
