A review has found that ultra-processed foods (UPF) are directly linked to 32 harmful effects on health, including a higher risk of heart disease, cancer, type 2 diabetes, adverse mental health and early death. The world’s largest review, published in the BMJ, comes as global consumption of UPF, such as cereals, protein bars, fizzy drinks, ready meals and fast food, rapidly increases. In the UK and US, more than half of the average diet now comprises ultra-processed food.
The review, involving almost 10 million people, suggests diets high in UPF may harm many health elements. Researchers say there is a need for measures to target and reduce exposure to them. The review involved experts from a number of leading institutions, including Johns Hopkins Bloomberg School of Public Health in the US, the University of Sydney, and Sorbonne University in France.
Writing in the BMJ, they concluded: “Overall, direct associations were found between exposure to ultra-processed foods and 32 health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes.” They added: “Greater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorders and mortality outcomes.” “These findings provide a rationale to develop and evaluate the effectiveness of using population-based and public-health measures to target and reduce dietary exposure to ultra-processed foods for improved human health.” The researchers graded the evidence as convincing, highly suggestive, suggestive, weak, or no evidence. They also assessed the quality of evidence as high, moderate, low, or very low.
The British Heart Foundation defines ultra-processed food as products that “typically have five or more ingredients” and have “industrial substances” such as preservatives, emulsifiers, sweeteners and artificial flavours. Examples include sausages, ice cream, breakfast cereals, fizzy drinks, ready-made meals, and spirits, including gin, rum and whisky, because of the distillation after fermentation.
The only sure way to find out whether a product is ultra-processed is by looking at the packaging label. If you see a long list of ingredients that you don’t recognise, it will be heavily processed. Other red flags include high fat, sugar and salt content, a suspiciously long shelf life (with the exception of UHT milk), and aggressively strong branding.
Those who consumed these foods regularly had a 28 per cent faster rate of cognitive decline, according to a JAMA report. For the minimum recommendation of 2,000 calories a day, eating 400 calories in ultra-processed foods would hit the 20 per cent limit.
Calls for warning labels
Ultra-processed food should come with a warning label due to the dangers it poses to our health, a doctor says. Dr Chris van Tulleken called for the move after recent studies linked eating ultra-processed food (UPF) to an increased risk of heart attacks, strokes and high blood pressure.
UPF, a category which includes items such as ready meals, breakfast cereals, baked beans and sliced bread forms more than 50 per cent of the average British diet. This has promoted some experts to warn of a ‘tidal wave’ of harm in the UK in the future. Dr van Tulleken, whose book Ultra-Processed People was recently serialised in the Daily Mail, told MailOnline the new studies added weight to calls for a warning label system in the UK to ward people away from eating them.
While the UK already uses a traffic light system on food, warning people of high fat and salt content with amber and red, Dr van Tulleken called for a simpler system for UPF. ‘We need warning labels on packets – not the confusing and optional traffic lights but a single black label indicating UPF,’ he said. The infectious diseases doctor said other countries were already using similar systems with some success. ‘Chile and Mexico have done this using effective black hexagons,’ he said.
‘When packages are labelled properly we have evidence that children ask their parents to buy different food just like we told our parents to quit smoking.’ Dr van Tulleken also called for increased regulation on the marketing of UPFs, particularly in products targeted at children. ‘We need to stop all marketing of UPF, especially the use of cartoon characters to market these products to children,’ he said.
Half of UK adults (50%) don’t look at food labels when buying food with one in four (25%) saying they find the back labels, which list the ingredients and nutritional information, difficult to understand. As individuals turn their focus towards well-being, the question of clearer labelling on food packaging gains more significance. Nearly half (44%) of UK adults are influenced by front nutritional labels, and one-third (32%) by back labels. At the same time, more than half (51%) of adults say they find back labels for non-processed foods easier to understand compared to processed alternatives.
Those aged 18-34 are statistically less likely than the average to eat fruit and vegetables (66% v average 80%), and eggs (60% vs average 68%). This trend extends to fizzy drinks, where younger generations are statistically more inclined, with 51% saying they drink them versus an average of 42%. Older generations are the highest consumers of sweet or savoury snacks (73% v average 68%), but are also the highest consumers of fresh fruit and vegetables (90% v average 80%), eggs (76% v average 68%) and dark chocolate (31% v average 29%).
The preference for processed foods over whole foods among younger generations raises concerns about the long-term health implications as they age. A diet heavy in processed foods, lacking essential nutrients found in whole foods, may contribute to health issues such as obesity and chronic diseases. Addressing these dietary trends early is crucial to prevent potential health risks and promote a healthier future for younger generations.
With the ongoing increase in the consumption of processed foods among specific groups, the need for improved labelling becomes apparent. Three in four (76%) people say that there should be a label for UPFs, and a similar proportion (74%) would find this beneficial when making decisions about food purchases.
As people try to align their diet choices with their health objectives, the lack of a label indicating the degree of food processing poses a challenge. For the time being, consumers just have to make do when making decisions about their dietary choices.
Would warning labels work?
Labelling foods as ultra-processed might not be so helpful for consumers who want to know how healthy a product is, UK experts say. Currently, packs must show whether a food item is high in fat, salt and sugar but not how processed it is. Scientists who analysed different products say it is too simplistic to brand all ultra-processed foods (UPFs) as very bad.
Technically, sliced bread is ultra-processed, for example. Though many UPFs are clearly unhealthy, some could fall into the “healthy” green category of the “traffic-light” system. This was the case for meat-alternative products, the University College London team said, and some people may be unaware what they were buying was ultra-processed.
UCL senior research fellow and weight-management specialist Dr Adrian Brown told BBC News he had looked at a “meat alternative”, for example. “Generally, it can be considered highly processed – but if you look at front-of-package labelling for energy, fat, saturated fat and sugar, they’re all green, which would be considered healthy,” he said. And there was too little research into the effect of UPFs on general health. “There’s a bit of a grey area [with UPFs] as, at this present time, we only have association data between ultra-processed food and health outcomes such as diabetes and heart disease,” Dr Brown said.
People who rule out different foods based on whether or not they are ultra-processed could potentially be denying themselves some healthier food options, a new study suggests. While ultra-processed foods tend to be higher in fat, saturated fat, sugar, and lower in fibre, protein and micronutrients, not all are unhealthy, researchers said. Standard front-of-package food labels in the UK do not include information about food processing, but there have been calls for more to be done to provide consumers with information about how their food is made.
As a result, academics from University College London (UCL), used different food classification systems to examine a large number of foods which are popular in Britain. They looked at almost 3,000 different food items and compared their nutritional content with front of pack traffic light labelling, this system provides consumers with colour-coded nutritional information about whether foods have high, medium or low amounts of fat, saturated fat, sugars and salt, and where they would fall in the Nova food classification system which categories food and drink into four groups: minimally processed food, processed culinary ingredients, processed food and ultra-processed food.
Over half (55%) of the food and drink items included in the final analysis were ultra-processed, 33% were minimally processed, 10% were classed as processed while 2% were deemed to have “processed culinary ingredients”, according to the British Journal of Nutrition study. Minimally processed foods were found to have significantly lower average fat, saturated fat and energy content per 100g than other groups.
Dr Adrian Brown, the lead author of the study and a specialist dietitian from UCL Division of Medicine, said: “Having worked with patients for nearly two decades, one of the biggest challenges for people is to identify what’s healthy and what’s not in a supermarket environment. “On the face of it, a low-fat yoghurt may look healthy, but it may also be high in sugar. Adding that it’s also ultra-processed will only make these decisions harder.
Ultra-processed foods typically have five or more ingredients added during their production, generally to give them a long shelf life. They tend to include many additives and ingredients that are not typically used in home cooking, such as preservatives, emulsifiers, sweeteners, and artificial colours and flavours. According to studies, ultra-processed foods correlate with a considerably higher risk of early death. Which does not sound good.
Ultra-processed foods are foods that have undergone several transformation processes including heating at high temperatures and include the presence of additives and emulsifiers. These are added to enhance the flavour, taste and appearance. Examples include sweet or savoury packaged snacks like crisps, packaged baked goods like cakes, cookies, frozen ready meals, reconstituted meat products, instant noodles, soups and soft drinks. These foods tend to have a long list of ingredients and are high in sugar, salt, and low in vitamins, minerals and fibre.
The negative impacts on health are visible around us as many individuals consuming these foods are overweight and have a myriad of other health issues including type 2 diabetes and digestive complaints. Eating processed foods is linked with weight gain, as the combination of sugar and processed fats together is addictive and tastes good, thereby leading to the over-consumption of calories. Furthermore, artificial sweeteners may have appetite-stimulating effects. They may get stored in the body’s cells as they are not properly broken down. It is a heavy burden for the liver which has a major role in processing and detoxifying anything entering the body.
With the ongoing increase in the consumption of processed foods among specific groups, the need for improved labelling becomes apparent. Three in four (76%) people say that there should be a label for UPFs, and a similar proportion (74%) would find this beneficial when making decisions about food purchases.
As people try to align their diet choices with their health objectives, the lack of a label indicating the degree of food processing poses a challenge. For the time being, consumers just have to make do when making decisions about their dietary choices.
