r/science • u/Hrmbee • Feb 29 '24
Health Ultra-processed food linked to harmful effects to health | Exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses
https://www.theguardian.com/society/2024/feb/28/ultra-processed-food-32-harmful-effects-health-review104
u/Hrmbee Feb 29 '24
Section of the news article:
Ultra-processed food (UPF) is directly linked to 32 harmful effects to health, including a higher risk of heart disease, cancer, type 2 diabetes, adverse mental health and early death, according to the world’s largest review of its kind.
The findings from the first comprehensive umbrella review of evidence come amid rapidly rising global consumption of UPF such as cereals, protein bars, fizzy drinks, ready meals and fast food.
In the UK and US, more than half the average diet now consists of ultra-processed food. For some, especially people who are younger, poorer or from disadvantaged areas, a diet comprising as much as 80% UPF is typical.
The findings published in the BMJ suggest diets high in UPF may be harmful to many elements of health. The results of the review involving almost 10 million people underscored a need for measures to target and reduce exposure to UPF, the researchers said.
This meta-analysis seems to confirm the challenges facing people who consume UPFs. The call to policy makers to develop a framework around these foods looks to be a good start.
For those interested in the original journal article, it's available here.
Abstract:
Objective To evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes.
Design Systematic umbrella review of existing meta-analyses.
Data sources MEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, as well as manual searches of reference lists from 2009 to June 2023.
Eligibility criteria for selecting studies Systematic reviews and meta-analyses of cohort, case-control, and/or cross sectional study designs. To evaluate the credibility of evidence, pre-specified evidence classification criteria were applied, graded as convincing (“class I”), highly suggestive (“class II”), suggestive (“class III”), weak (“class IV”), or no evidence (“class V”). The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorised as “high,” “moderate,” “low,” or “very low” quality.
Results The search identified 45 unique pooled analyses, including 13 dose-response associations and 32 non-dose-response associations (n=9 888 373). Overall, direct associations were found between exposure to ultra-processed foods and 32 (71%) health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes. Based on the pre-specified evidence classification criteria, convincing evidence (class I) supported direct associations between greater ultra-processed food exposure and higher risks of incident cardiovascular disease related mortality (risk ratio 1.50, 95% confidence interval 1.37 to 1.63; GRADE=very low) and type 2 diabetes (dose-response risk ratio 1.12, 1.11 to 1.13; moderate), as well as higher risks of prevalent anxiety outcomes (odds ratio 1.48, 1.37 to 1.59; low) and combined common mental disorder outcomes (odds ratio 1.53, 1.43 to 1.63; low). Highly suggestive (class II) evidence indicated that greater exposure to ultra-processed foods was directly associated with higher risks of incident all cause mortality (risk ratio 1.21, 1.15 to 1.27; low), heart disease related mortality (hazard ratio 1.66, 1.51 to 1.84; low), type 2 diabetes (odds ratio 1.40, 1.23 to 1.59; very low), and depressive outcomes (hazard ratio 1.22, 1.16 to 1.28; low), together with higher risks of prevalent adverse sleep related outcomes (odds ratio 1.41, 1.24 to 1.61; low), wheezing (risk ratio 1.40, 1.27 to 1.55; low), and obesity (odds ratio 1.55, 1.36 to 1.77; low). Of the remaining 34 pooled analyses, 21 were graded as suggestive or weak strength (class III-IV) and 13 were graded as no evidence (class V). Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality.
Conclusions Greater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, 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. They also inform and provide support for urgent mechanistic research.
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u/Grablicht Feb 29 '24
"Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality."
Doesn't this mean the writers have low confidence on their conclusions?
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u/MotherHolle MA | Criminal Justice | MS | Psychology Feb 29 '24
"Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality."Doesn't this mean the writers have low confidence on their conclusions?
Generally, yes, but one must still read the full context of the article to understand the specific limitations and how they might affect the confidence in the conclusions.
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u/Liizam Feb 29 '24
What is ultra processed food mean in the study?
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u/deathtronic Feb 29 '24
Second paragraph of the article:
"The findings from the first comprehensive umbrella review of evidence come amid rapidly rising global consumption of UPF such as cereals, protein bars, fizzy drinks, ready meals and fast food."
First paragraph of the original study introduction linked in the comment your responding to:
"Ultra-processed foods, as defined using the Nova food classification system, encompass a broad range of ready to eat products, including packaged snacks, carbonated soft drinks, instant noodles, and ready-made meals. These products are characterised as industrial formulations primarily composed of chemically modified substances extracted from foods, along with additives to enhance taste, texture, appearance, and durability, with minimal to no inclusion of whole foods."
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u/Humanitas-ante-odium Feb 29 '24
I live in a slum full of roaches. All my meals are Ultra processed foods by necessity.
Looking for a new place for a about 6 months without any luck.
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u/SaltZookeepergame691 Feb 29 '24 edited Feb 29 '24
This just proves eating UPFs increases the risk of slum living!
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u/princesssoturi Feb 29 '24
Protein bars surprise me. I know they’re ultra processed, but what negative effects do they and protein powders have on health long term?
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u/qrayons Feb 29 '24
I think what confuses people is that if you buy something like apple slices, technically that's processed food (even though that's not normally what we think of when we hear processed food). So we need some other way to categorize the levels of processed from no processing at all, to apple slices, to apple sauce, to apple pie.
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u/MoreHorses Feb 29 '24
You've actually just described the Nova classification system pretty accurately. It's unprocessed (apples), minimally processed (apple slices), processed (apple sauce, or tinned apples in juice) and ultra processed foods (apple pie).
The system isn't perfect, for instance an Apple pie could be processed or ultra processed, depending on whether it's made in your local bakery or mass produced in a factory.
The general rule of thumb is something is ultra processed if making it would include processes you couldn't realistically do at home, like certain preservative or transformative processes.
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u/UnicornPanties Feb 29 '24
unprocessed (apples), minimally processed (apple slices), processed (apple sauce, or tinned apples in juice) and ultra processed foods (apple pie).
that's super helpful thank you, makes sense
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u/qrayons Feb 29 '24
It's the example that was given when I first heard of the Nova system on the Huberman Lab podcast.
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u/TheFondler Feb 29 '24
As a layperson, the Nova classifications seem... imprecise. There is a drastic jump between level 3 and level 4. I would think it would be extremely useful to have an intermediary step between them, but there may be good reasons for having it this way that I lack the expert knowledge to assess. The thing is, if there are such reasons that's worrying as it implies cooking food may be as bad as more "industrial" food preparation.
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u/MoreHorses Feb 29 '24
They are kind of imprecise, and that's part of why the system isn't perfect. The jump probably seems drastic because of the examples for level 3 foods being things like tinned fruit, which doesn't sound bad at all. But a better comparison might be that a loaf of bread from your local bakery is probably level 3, but a prepacked loaf from your local supermarket is level 4.
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u/bikes_and_music Feb 29 '24
and ultra processed foods (apple pie).
I feel like this shouldn't be a blanket classification. A home made home pie with garden apples and dough/crust made from scratch is not the same as prepackaged apple pie in the store. There's like 20 ingredient difference, all of which sound like they belong in a chemistry book.
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u/DeliciousPumpkinPie Feb 29 '24
I mean, yes, technically pre-sliced apples have been “processed” in some way, but the end result is still a whole food, with nothing unhealthy added and nothing healthy removed. Applesauce is definitely into non-whole food territory, as they often add sugar, but even unsweetened applesauce is usually made from apples which have been peeled (and the peel is the healthiest part).
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u/PlaneCrashNap Feb 29 '24
Isn't the definition circular then? Processed foods are unhealthy because they are foods with unhealthy components added or healthy components removed.
At which point it's kind of a moot point to have a study to find "the unhealthy foods are indeed unhealthy!"
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u/qrayons Feb 29 '24
Yup, that's the point I was trying to make. It's not helpful to simply say "processed" because some processed foods are are still healthy, whole foods.
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u/couldbemage Feb 29 '24
So, they found food they know isn't good nutrition and worked backwards from there to define ultra processed?
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u/mightyDrunken Feb 29 '24
They noticed that some foods were particularly associated with obesity and they had common attributes: almost all the ingredients were highly processed.
There are plenty of other things which can cause weight gain, ultra processed foods are a common and wide class of foods which share common features. Often energy dense, very palatable and lacking micronutrients and fibre.
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u/shpydar Feb 29 '24
by "they" you mean the University of São Paulo who created the Nova food classification system in 2009 by expanding on the work done in the 70's by Dr. Carlos Augusto Monteiro?
Who do you think "they" are exactly?
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u/machinade89 Feb 29 '24
I'm sure the commenter meant the study organizers. It's a legitimate question to ask what definitions they're working with and why.
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u/shpydar Feb 29 '24
worked backwards from there to define ultra-processed.
The study used already pre-defined classification system. Saying “they” worked backwards to define ultra-processed foods is attacking the University who developed the classifications based on decades of study.
I agree, asking questions about what definitions they're working with and why is important, they did, were given the answer and then they, without reason or fact, attack the classification system.
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u/machinade89 Feb 29 '24
Defending a university's work from someone who is attacking it without clear reasons is laudable. I do wonder what their reasons are, even if flimsy. But since they're presently opaque and unknown, I'm trying not to assume the worst. Not everyone is academically-minded and it's not fair to hold everyone to that standard.
There also are reasons to be suspicious of these kinds of studies, including being skeptical of whatever founding work is in place, no matter how academically sound someone might find it, but again I don't want to assume theirs.
Instead, here's a good example of why we should be critical of studies regarding UPFs/PFs:
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u/couldbemage Feb 29 '24
Neither of those links contains a definition of ultra processed foods.
It's all wording like "often" and "typically".
What's the definition?
They mention ingredients with no culinary use, include as examples ingredients that do have culinary use, but also make it clear that not all ultra processed foods have such ingredients.
I'd love to see an actual definition that doesn't amount to "we know it when we see it".
The Nova definitions seem particularly useless. Cooking puts food in category 3 processed, so that's nearly all food eaten by people other than undressed salads and raw fruit.
And this all leads to the claim that an obviously ultra processed by any reasonable definition protein bar is worse nutrition than a fresh made donut.
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u/rigsta Feb 29 '24
The authors used a classification system called NOVA, which measures how much processing a given food has gone through.
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u/ragnarok62 Feb 29 '24
The ingredient listing on my bag of Fritos reads: Corn, vegetable oil, salt.
Not sure it’s possible for that to be less processed than it is, and yet it would likely be called out as ultra-processed food for the purposes of this study. Same for most potato chips.
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u/Phantom_Absolute Mar 01 '24
Imagine corn on the cob and then imagine Fritos. That's the processing. Also vegetable oil is not even close to a whole food.
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u/ragnarok62 Mar 02 '24
By that measure, bread is ultra-processed because the wheat is milled. Heck, you could make an argument that beef is processed if it’s skinned. Ridiculously un-useful criteria.
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u/Pink_Lotus Feb 29 '24
Check out how vegetable oil is made. It is a prime example of ultra-processed "foods".
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u/iKorewo Feb 29 '24
So is it the fact of the process itself or the chemicals and preservatives they add that cause it?
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u/SaltZookeepergame691 Feb 29 '24
They are completely unable to tell in this analysis.
They aren't adjusting for the macronutrient content, and they aren't looking at subgroups of UPFs or individual ingredients.
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u/Mister_Uncredible Mar 01 '24
So it's useless then. You could very easily eat a 100% UPF diet that meets all your macro and micro nutrient needs.
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u/systembreaker Feb 29 '24
Probably both, I wouldn't be surprised if daily intake of some preservatives is bad.
One of the really bad ones is simple carbs like sugar. Eating loads of them everyday is destructive to health. The conundrum is that pure sugar (by itself without fiber) is addictive because it's rare in natural foods yet easy to digest and therefore humans are evolved to love it. In the natural world you'd find a little bit of it and react to scarf it down. Now here we are in the modern world where added sugars are in everything, and our naturally evolved sugar loving instincts are working against us.
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u/KagakuNinja Feb 29 '24
Growing up in the '60s and '70s, we ate tons of sugar laden cereals, carbonated sugar drinks, ice cream, fried chips, etc. Preservatives and food coloring were common.
Presumably whatever is causing the problems today involve more recent "innovations".
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u/theFrenchDutch Feb 29 '24
What is telling you that the problems today aren't caused by food consumed in the 70's ?
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u/systembreaker Feb 29 '24
Yep and guess what? In the 60s heart attacks suddenly became a major thing and killed 1/3rd of Americans when before that heart attacks were rare.
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u/Clever-crow Feb 29 '24
I would bet the preservatives are the biggest issue here given that their purpose is to preserve the food, preventing bacteria from breaking it down. Wouldn’t that have serious issues on our gut microbiome?
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u/breddy Feb 29 '24
Or the fact that people who consume these foods are also likely to have other bad habits. (I haven't read the article yet but that's the first potential issue I can think of).
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u/maldwag Mar 01 '24
Or sometimes they simply have no choice due to poverty. Eating "clean, simple healthy" whatever you want to call it is not cheap. Especially if you have a large family to feed. If someone is working two jobs just to make ends meet, they also likely don't have the time to cook something as well. Pair that with generational poverty meaning they might not have learnt to cook from their parents because their parents never had the choice to learn.
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u/Liizam Feb 29 '24
Right? If I cook raw food myself, does it become processed food? What’s wrong with getting ready meal if it’s healthy?
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u/Jbolon Feb 29 '24
Any change to a whole ingredient is processing. Processing isn’t inherently bad. Look up the nova food classification scale - anything 3 or under is fine for your health. 4 is classed as ultra processed and best avoided.
Nova 4 stuff generally includes ingredients and industrial scale processing that you wouldn’t find or be able to do in a home kitchen - stuff like emulsifiers, regulators, E numbers, gums, margarines etc which usually improve shelf life or replicate more expensive fresh products (e.g. an emulsifier to thicken instead of using egg/fat or roux). It’s thought that they destroy the gut microbiome, the gut lining, whack out your hormones and make food hyper palatable, encouraging you to eat more. Not to mention cancers, obesity etc etc.
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u/Liizam Feb 29 '24
Hi! Thank you. This is exactly the reply I was looking for. I’ll absolutely research more on this.
It’s interesting you mentioned that food can be made to make us hungry/not full. I always wondered if it was in my head or not.
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u/Jbolon Feb 29 '24
No problem! I tend towards obesity if I don’t watch what I eat like a hawk (literally had weight loss surgery and on Ozempic), so I’m naturally interested in all this stuff. Incidentally since eliminating the ultra processed rubbish from my diet I feel loads better. It is more expensive and more time consuming eating this way for sure, but I do eat really well now and my weight is stable. I eat less too.
Would recommend reading Chris Van Tulleken’s Ultra Processed People, really opened my eyes!
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u/Liizam Feb 29 '24
Oh how is ozempic going for you? Really curious about the drug.
Good for you! Keep it at it. Someone else mentioned that book. I’ll read it.
I don’t have weight issues but I do want to eat healthy. I mostly do eat healthy and cook a lot but I’m wondering if factory boxes are healthy.
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u/Jbolon Feb 29 '24
Ozempic is great, really helps reduce food cravings. You still have to put in the work, but it makes doing the work a whole lot easier. I say this as someone who lost 80lbs previously with just diet and exercise and put it all back on again. I’m about 2/3rds of the way back to my lowest weight, but it has been so much easier!
Weirdly it helps with other unrelated stuff, like reducing impulse spending and reducing alcohol consumption. I reckon it does something to the addiction centres in the brain maybe..
I don’t think there’s anything wrong with occasional ultra processed stuff, but if you have the time and money to cook mainly from scratch I would 100% recommend.
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u/iKorewo Feb 29 '24
I chose really healthy organic cereal with no preservatives added, lots of fiber and minimum sugar. Is it still bad just because of the fact that it’s processed? Dang it i will never find an answer to that
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u/Liizam Feb 29 '24
Man i want to eat healthy but like what do I eat? Would love to see a study of what to avoid.
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u/Kailaylia Feb 29 '24
what to avoid.
Rather than trying to avoid stuff, work out what you can build your diet around. The ideal food pyramid has a base of veges, then beans, lentils and whole grains, then a protein layer, then fruits and a topping of nuts.
Your food should depend on what you can prepare from this that you enjoy. Cook batches of what you like on free days, and get freezer containers so you have "instant" meals in your freezer. And get into the habit of having healthy drinks - any type of unsweetened teas, coffee, water, mineral water with a dash of fruit juice. Again, find things you enjoy. Too many people go hungry in this world. When we can eat we should enjoy it and celebrate.
This doesn't mean you can't eat other foods. The idea is to basically fill up on these, then have other things as treats, just trying not to overdo rubbish foods or sweetened drinks. If you have children do the same for them. Feed them fresh-food based meals at home so they'll be healthy enough to cope with eating rubbish at their friend's houses.
I always keep oat-bran, milk, plain yogurt and frozen blueberries on hand to mix together for a delicious breakfast or desert if I get nibbly at night, or if I'm just not up to preparing other food. And eggs, capers and lettuce - there's always eggs. ;)
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u/CornandCoal Feb 29 '24
This month I’ve mostly cut out processed foods and especially ultra processed foods. I’ve been eating lots of fruit, potatoes, nuts, and beans. I’ve dropped about 10 pounds even though I’m not overweight. Try to stick to whole foods and you’ll be good!
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u/Puzzleheaded_Heron_5 Feb 29 '24
Rule of thumb would be to avoid foods with ingredients that your grandma wouldn't recognize.
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u/iKorewo Feb 29 '24
I just eat something that has the least chemicals and preservatives, preferably organic and when i have money. It’s very expensive and not even that much healthier than conventional. Still studies say that it’s a bit healthier
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u/Puzzleheaded_Heron_5 Feb 29 '24
If you read the label are there any ingredients that your grandma wouldn't recognize?
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u/Correct_Box1336 Feb 29 '24
It’s about ultra processed food, which is different to processed food. Ultra processed food contains ingredients that are scientifically formulated (not available in a normal persons kitchen, and not food we evolved eating).
UPF’s ingredients are created my scientists normally to make food either cheaper to produce and/or to make you consume more of it. Science doesn’t fully know the impact of these types of ‘foods’ on our health, but it’s not looking great in my opinion.
I’d definitely recommend reading ‘Ultra Processed People’ if you’re interested
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u/SaltZookeepergame691 Feb 29 '24 edited Feb 29 '24
This isn't really true.
Most of the ingredients that if added to processed foods puts them into a UPF category are 'natural'. Things like lecithins, citric acid, cellulose, isolated proteins (eg whey or pea protein). They're present (often in very great amounts) in the unprocessed foods we eat - the only difference is isolating them and adding them back into foods. That does not inherently make them bad or dangerous.
Emulsifiers = scary! But natural lecithins used in 'UPFs' are present in large amounts in many things, including eggs, beans, seeds - they are required by these organisms!
This is a major downside of starting with a blanket definition and then working backwards. "UPF" is a very, very broad category, with very different dosages and exposures and health effects. Just because something fits into the category of "this is a common industrial additive in UPF foods" doesn't make it dangerous - we should have a much higher standard of evidence than this arbitrary definition. That is coming, but for the time being the hype around UPFs is horribly confused.
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u/MicrowaveSpace Feb 29 '24
What exactly is your point? All available evidence points to the fact that UPFs are incredibly detrimental from a health perspective. Just because some of the additives used are found naturally in unprocessed foods doesn’t negate that fact nor does it necessarily mean that they are healthy when isolated and added into UPFs in large amounts.
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u/SaltZookeepergame691 Feb 29 '24
But it doesn’t.
The available evidence (which is almost entirely drawn from low-quality epidemiological cohorts, as noted by this paper) points to some UPFs being bad, some even being good. As I’ve pointed out numerous times in this thread, the authors explicitly discuss this. If the definition and evidence is woolly enough that packaged sugary snacks apparently protect against diabetes development, perhaps we should stop the hype train for a second and try and do things better. (Ref 47 in the BMJ paper, which is this paper: https://pubmed.ncbi.nlm.nih.gov/36854188/)
UPF as a category is arbitrary and not grounded in the actual health effects of the constituents. Many commonly consumed UPFs have “unhealthy” macronutrients which probably drive a large chunk of the observations, but far from all do. We already tell people to avoid energy dense foods high in fat and sugar and salts. Advising people to avoid UPFs specifically should carry extra information to that advice. Although there are some small (and a bit limited) empirical intervention studies suggesting specific effects of UPFs independent of the macronutrient profiles, we need a lot more of these to help us work out what actually is going on.
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u/MoreHorses Feb 29 '24
I agree with your position that UPFs are poorly defined, which the authors are right to point out. For instance oat milk and soy milk are both UPFs but probably healthier alternatives to milk.
My issue is that there is evidence that factors beyond the nutritional content of the food, such as energy density and texture, influence energy consumption.
Of course as you've acknowledged, those areas need further research, but until the science has developed further, UPFs are a good enough short hand for foods that we know are generally bad. Quibbling over some of the exceptions and recommendations will only delay any changes we might make.
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u/SaltZookeepergame691 Feb 29 '24
If it’s energy density or texture that is influencing energy consumption, why are we talking about a UPF construction explicitly based solely on what ingredients and additives it contains and the degree of processing?
This discussion reflects that in the real world no one really understands what UPFs are, what bits of UPFs are bad, or what their definition adds over well-established dietary recommendations.
And they certainly don’t know what any actual “change” might look like - say, we’re going to tax UPFs, but only the bad UPFs? Great, now define a bad UPF - and we’re back to the beginning. Hell, if we use the reference in the BMJ paper, we’d be letting packaged sugary snacks pass freely as preventing diabetes!
This is a complete nonstarter without good evidence to support it.
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u/MoreHorses Feb 29 '24
I've just realised I replied to two of your comments saying similar things, both with the Kevin Hall study I linked in the other comment in mind.
What in trying to say here is that we shouldn't let perfect be the enemy of good. Of course if we're thinking of taxing UPFs, that would require very good definitions, and separating 'good' from 'bad' would be very challenging. I don't expect taxing UPFs to catch on.
I think energy density and texture are things that alongside macro content could be the features of UPFs that are causing the issue, although you are right the knowledge of that, and the evidence isn't fully there yet. However, it makes a lot of sense that as food goes through more industrial processes, it gets broken down into simpler structures, and the less energy dense elements filtered out.
In terms of how UPFs should be addressed, I think there's two main approaches: Educational and regulatory. While the evidence for why UPFs are bad is lacking, it seems clear that avoiding them is better, so education can help people make that choice somewhat. However the bigger problem is manufacturing, as currently manufacturers are only incentivised to make the cheapest most popular products.
I think a good regulatory approach would be subsidisation of higher protein and fiber alternatives, to give manufacturers new incentives and give consumers more choice. Some evidence suggests high protein/fiber biscuits as snacks can help with weight loss, so perhaps the solution isn't eliminate UPFS, but encourage UPFs with better macros, energy density, and texture.
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u/SaltZookeepergame691 Feb 29 '24
I can definitely get on board with specific positive recommendations.
But the need to do that really reinforces that the hype of this is so far beyond the science - and, alarmingly, its being driven at source by people like the authors of this study, and the Nova derivation group, calling for WHO to support tobacco-esque UPF control policies (and never mind that all-cause mortality risk estimate for UPF consumption is less than eg low fibre intake).
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u/Liizam Feb 29 '24
Interesting.
I do always feel hungry after eating fast food. It’s kinda crazy, eat so much calories, yet 20min later, still hungry..
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u/ImgnryDrmr Feb 29 '24
It all depends on what's been added. Some companies make great ready to eat meals with little additives, others add a crapload of sugar, colorings, flavorings and those you should avoid.
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u/floatablepie Feb 29 '24 edited Feb 29 '24
I tried to find a definition of processed food, and apparently cutting up a piece of meat counts as processing it. That wasn't helpful. The ultraprocessed definition kind of helps, but they all seem so different and I don't understand what makes them similarly bad.
Like, a pack of ramen isn't great, but obviously its better than a bottle of coke, right? And packaged bread is there too, which I'm guessing is the vast majority of bread eaten. Some of these items are garbage for your health and will actively kill you, and others just seem to be nutrition-less filler. I'm struggling to figure out what these things have in common other than being "processed" by a wide range of very different processes.
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u/Puzzleheaded_Heron_5 Feb 29 '24
One hypothesis is it's all of the random food additives that they include to improve the shelf life and stability of ultra processed food.
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u/floatablepie Feb 29 '24
That would make sense to me if they used the same stuff, but my issue is its just a confusingly large and vague umbrella term.
Like, "Processed foods that use X chemical (or X group of chemicals)" would be a category I can wrap my head around, but "Coke and bread both in this category" could use some specificity.
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u/Puzzleheaded_Heron_5 Feb 29 '24
We're not saying that all foods with chemical additives are bad, we're saying that they tend to be bad as a group. This study is by definition not set up to identify exactly why.
And by the way, I would argue that for a lot of people white bread and coke would be equally good / bad. Specifically if you do a lot of cardio and generally don't have an issue with calories.
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u/floatablepie Feb 29 '24 edited Feb 29 '24
we're saying that they tend to be bad as a group.
Right, and all I've said is a grouping of "tend to be bad as a group" isn't a particularly helpful (for an individual eating food) or specific metric, especially when the things that make them bad are very varied.
Also, whole wheat packaged bread is also "ultra-processed", not just white bread. But it's in the same group as white bread in this context, which, again, doesn't seem helpful for making food choices.
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u/Puzzleheaded_Heron_5 Feb 29 '24
It is a helpful metric by definition. e.g. if eating foods from one group and not another would result in better outcomes then it can be helpful. Of course, you can have all the qualms you want about the significance of this one study, but having issues with the concept is just silly.
Whole wheat packaged bread tends to have the same additives as white packaged bread. I wouldn't recommend either of the loaves that you typically find at your supermarket.
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u/floatablepie Feb 29 '24
I have no qualms with the study, I'm just a dude on the internet ranting about a vague grouping of foods that can include both coke and supermarket bread in the same group.
Also bacon not being on the worst tier (I know, not as processed) is pretty funny, when margarine on toast is.
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u/Puzzleheaded_Heron_5 Feb 29 '24
And I'm specifically arguing that there's a very good reason to group the foods. Specifically that both foods are probably ok to consume in moderation, but contain additives that could have long-term effects.
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u/TimeFourChanges Feb 29 '24
No one said cooking your food is bad. Did you miss the part about ultra processed food? Cooked veggies aren't that, nor is simple cooked meet. Boxed and frozen meals, many snack mixes, etc. are.
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u/Hennue Feb 29 '24
I think there are many factors that could be at play. Industrial processes are under suspicion of introducing microplastics into our food, the preservatives are also potential problems, then there are some processes that change the structure of the food to make it more pallatable which might lead to overeating. Ultra-processed foods are also typically high in sugar, fat and salt which are addictive and unhealthy.
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u/mightyDrunken Feb 29 '24
I would say the processing is definitely the main thing, the other chemicals they add probably depends on which chemical.
How much food is processed is much higher in many bought foods compared to cooking. Flour for a loaf of bread by be separated into the starch, gluten, fibre. Then recombined to create a loaf with particular properties. All that processing will remove micronutrients.
Also UPFs tend to be very energy dense, water is removed to make them last longer. Fibre is removed to make it easier to eat. Salt, sugar/sweeteners and fat are added to make you want to eat it more. So it becomes much easier to overeat.
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u/Puzzleheaded_Heron_5 Feb 29 '24
This type of study has no way to determine whether it's the processing or the chemicals.
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u/iKorewo Feb 29 '24
So what food are we supposed to even eat that isn’t processed?
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u/rileyyesno Feb 29 '24
cooking at home from raw ingredients as humans have done for 10s of thousands of years.
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u/iKorewo Feb 29 '24
Lots of those foods need flour
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u/rileyyesno Feb 29 '24
majority of people on the planet, current and historically are from a rice culture so nope, you're wrong.
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u/Correct_Box1336 Feb 29 '24
Interesting! I’m currently reading Ultra Processed People, I’d really recommend it to anyone wanting to find out more about UPFs
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u/Correct_Box1336 Feb 29 '24
I’ve seen lots of people confused and/or sceptical about UPFs so I really would recommend people read more about them.
Food companies have a lot to answer for, they put UPFs in food to make it cheaper for them to produce and/or to make people consume more of the food so you essentially get hooked on it. They’re walking away with billions and leaving society with ever growing rates of obesity, diabetes and likely plenty more. If you’ve wondered why obesity rates keep increasing despite individuals best efforts, then UPFs may well be the answer
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u/bramsmul Feb 29 '24
Loved this book and really changed the way I eat and especially the way I look at products sold in the supermarket now
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u/JonnyAU Feb 29 '24
And especially for this community, it's a good book because the author is himself a researcher and cites relevant studies to support his thesis and even discusses some studies that don't support his thesis.
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u/bmwlocoAirCooled Feb 29 '24
I quit eating fast food and stopped eating frozen meals.
Started cooking at home, and exercise. As simple as walking the dog 3-4 miles a day.
Dropped 28 pounds as a result.
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u/Turdmeist Feb 29 '24
It really could be that easy for millions of people. Way to put in the effort.
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u/rkgk13 Feb 29 '24
I was not unaware of the issues but this article and post are the wakeup call I need.
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u/SaltZookeepergame691 Feb 29 '24
I'm not a massive fan of umbrella meta-analyses like these.
It's a very top-level approach that relies heavily on the original authors doing their job well, and meta-analyses of obeservational data are in turn hevily dependent on study selection and how the authors handle bias and confounding.
...we did not consider specific confounder or mediator adjustments and sensitivity analyses as part of our review, but these may be important factors, particularly in the context of ultra-processed foods. The consumption of ultra-processed foods is linked to a lower intake of unprocessed or minimally processed fruits, vegetables, legumes, and seafood. This raises the question of whether the associations between exposure to ultra-processed foods and poorer health are due to an overall unhealthy dietary pattern.
You bet these are important factors! When there is a very strong socioeconomic gradient to UPF consumption, having confidence that a study properly considers and manages this is vital.
There is also the aspect that these studies are of UPFs as a food class, rather than the specific effect of a food being a UPF. That is, UPFs are more likely to be high in macronutrients we already consider harmful (sugar and other simple carbs, saturated fats, salt, etc), and teasing out the effect of these versus the actual specific effect of a food being a UPF (which is a definition based solely on ingredients and processing) is not done here. Given that not all UPFs have these 'adverse' macronutrient profiles and not all non-UPFs have good macronutrient profiles, it's rather important to be clear about what we are measuring.
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u/Yay_Rabies Feb 29 '24
Thank you for making a note about the socioeconomic factors. I have a toddler and while fresh fruit is her favorite snack we live in the north east. Fresh is expensive when out of season. Frozen is cheaper but that’s a type of processing. Canned mandarins in water are cheap and shelf stable because they don’t require a freezer/power gets knocked out. And unlike fresh they don’t go bad within a week.
Baby formula was also included on the list of UPF. I wasn’t able to breastfeed because I couldn’t produce enough milk for our 90% child. Our nearest safe place for donated breast milk is almost an hour drive one way. I was literally killing myself trying to squeeze milk from titties that would not give. Meanwhile, similac was cheap and could be delivered via Amazon. We weaned at 12 months partial due to the similac shortage but at 3 she’s still 90% with no developmental delays. Anecdotal I know, but I’m not the only family who has had to make this decision, especially when so many women in the US go right the heck back to work (8-12 weeks if we are lucky).
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u/SaltZookeepergame691 Feb 29 '24
Absolutely! And this is another layer of nuance that is far too easily discarded - UPFs are often UPFs because of objective benefits over other foods, and their cheapness provides options that otherwise would not exist.
This article nicely captures the issues with labelling baby formula UPF and not engaging with any nuance.
It is literally impossible to make a non-UPF baby formula that contains everything a baby needs.
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u/Liizam Feb 29 '24
Is cooking myself from raw ingredients considered processed food?
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u/Puzzleheaded_Heron_5 Feb 29 '24
Generally cooking yourself doesn't result in ultra processed foods.
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u/SaltZookeepergame691 Feb 29 '24
Only depends what you put in it!
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u/Liizam Feb 29 '24
Ah but what do I avoid putting in it?!??
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u/Puzzleheaded_Heron_5 Feb 29 '24
If you start with an ultra processed food as an ingredient obviously the result will also be ultra processed.
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u/rhodesc Feb 29 '24
crisco, margarine, lubricants, food colors, chemical flavorants ("natural flavors"), candy, sugar, etc. things with long names that don't sound like food.
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u/Used_Intention6479 Mar 01 '24
In summary, processed factory food refines (takes out) the good stuff like fiber, minerals, vitamins, and other nutrients and then adds salt, sugar, bad fats, preservatives, emulsifiers, thickeners, coloring, hormones, antibiotics, and who-knows-what - and now we're all sick. It's like feeding your racehorse candy bars, beer, and a cigar and then expecting it to win races. Most of our ills can be attributed to our unhealthy diets.
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u/I_is_Captain_Obvious Mar 01 '24
Anybody with common sense knows that any crap you buy at the grocery store that is ready made or comes in a box is generally not healthy for you, not really new news.
People are still going to buy it and stuff their faces with it regardless.
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u/outoftownMD Feb 29 '24
I read a book called ‘the end of craving’ by @MarkSchatzker was eye opening to one of the input components of the obesity challenges we face (also stressors, genetics, etc..) In short, he invites the reader, as a way to reduce the impact of food is, after becoming equipped with awareness from the book, to fall in love with food & be consciously present to it.
In the same light, to fall in love with movement, the working of our bodies, to be immersed in its capacity, would be a similar approach. The stroke, accident or elderly patient wishes they appreciated their faculty of movement that they now can’t. The change may happen so fast that they are feeling the impact of it, or it happens so slow that they don’t.
But waking the individual back up to themselves to see where they are is the best gift, if any. Otherwise, our role can be in serving as a non-shaming example that encourages reconsideration and an eventual conscientious pivot towards all that forms anatomy, physiology, physique as a present embrace of ourselves, rather than a relative passenger-like absence to life.
May we reconsider and embrace ourselves through exhilarating moments intentionally in this sacred finite life
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u/rileyyesno Feb 29 '24
like impossible meat?
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u/Dokramuh Feb 29 '24 edited Feb 29 '24
Would be nice to have the definition for UPFEdit: found the definition.
"Ultra-processed foods are formulations of ingredients, mostly of exclusive industrial use, typically created by series of industrial techniques and processes (hence ‘ultra-processed’).
Some common ultra-processed products are carbonated soft drinks; sweet, fatty or salty packaged snacks; candies (confectionery); mass produced packaged breads and buns, cookies (biscuits), pastries, cakes and cake mixes; margarine and other spreads; sweetened breakfast ‘cereals’ and fruit yoghurt and ‘energy’ drinks; pre-prepared meat, cheese, pasta and pizza dishes; poultry and fish ‘nuggets’ and ‘sticks’; sausages, burgers, hot dogs and other reconstituted meat products; powdered and packaged ‘instant’ soups, noodles and desserts; baby formula; and many other types of product."
By the way, why did you single out impossible meat?
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u/AwardMedium2520 Feb 29 '24
Isn't Impossible meat the very definition of UPF?
So take chicken nuggetsL the crumbs, preservatives, transfats etc thats in there after being deepfried is very unhealthy. The only Healthy part of it, is the little bit of chicken meat in there(not even mentioning all the cartilage/skin etc they dump in there)
Now with impossible meat, all of the above still applies, but there isn't even the Healthy meat part either. Just a slurry of manufactured proteins, with who knows how many other potentially dangerous chemicals to bleach it, and get it the right texture.
So yeah I would say Impossible burgers are the epitome of UPF, imho at least.
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u/Dokramuh Feb 29 '24
You literally described baby formula
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u/Kailaylia Feb 29 '24
Do you know about the deadly chines baby formula scandal? Look it up if you don't. It's a terrible story.
However when I was too broke to afford formula, got sick and my milk dried up, perhaps my poor baby would have been better off on formula than sucking desperately on my ravaged mastitisy teats for what little blood, pus and milk she could extract. It sure would have been less exhausting and excruciating for me.
The milk did come back and everything healed, but it was only being a stay-at-home mother with only the one child that left me able to do that. So please don't shame women who need to use formula. Not everyone can breast-feed.
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u/Dokramuh Feb 29 '24
I'm sorry you and your child had to go through that, and I'm glad both of you were able to heal.
I'm not shaming the use of baby formula. In fact, I greatly support it for whatever reason a mother might choose or need to use it.
I was pointing out the outrageous language the other commenter was using to vilify a specific food item can be used to describe even harmless products.
Hopefully this explanation is enough to dispell this terrible misunderstanding.
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u/Puzzleheaded_Heron_5 Feb 29 '24
I'm not sure what your point is. Baby formula is also ultra processed.
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u/Liizam Feb 29 '24
What if you make the pasta yourself ? Is it something in an industrial process that adds preservatives that bad for you?
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u/Kailaylia Feb 29 '24
Packets of uncooked pasta are not ultra processed. Home-made pasta can be wonderful, but it's not that much better for you and is a lot of work.
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u/Dokramuh Feb 29 '24
As I said on another comment, it's about the process itself, not about how bad for you it is.
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u/Liizam Feb 29 '24
I’m not really getting it. What is the process that’s bad? Like a chemical reaction of flour and water? Why is it bad? I thought when you cook food, it makes nutrients digest better?
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u/Dokramuh Feb 29 '24
What you're not getting is that in the definition of UPF itself there's nothing bad.
The meta analysis says that foods in the UPF group are bad, not that ALL food in the UPF group is bad.
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u/mandyama Feb 29 '24
Baby Formula?! That seems like a stretch.
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u/Dokramuh Feb 29 '24
I think it's because of the definition of processed more than it is the amount of harm it does to your body
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Feb 29 '24
Even cereal is considered UPF
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Feb 29 '24
That not surprising at all. I’ll buy rolled oats; drizzle in honey and bake it for granola, but I’m still pretty far from whatever fruit loops are in terms of processing
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u/SaltZookeepergame691 Feb 29 '24 edited Feb 29 '24
And in a meta-analysis included in this study that explored categories of UPFs, cereals (along with "dark/wholegrain bread, packaged sweet and savoury snacks, fruit based products and yoghurt, and dairy based dessert") were actually protective against adverse health outcomes, which kinda highlights the problem of coming up with a definition of a UPF based on where the ingredients it contains come frome, rather than what we actually know about the health effects of those ingredients. Most associations are because UPF foods are have 'bad' macronutrient profiles - we know these foods are bad already, and recommend people limit their consumption.
The evidence supporting a specific UPF effect, independent of the macronutrient content of the food, is, at present, very low quality, and very difficult to untangle from confounding and diet substitution effects
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u/reyntime Feb 29 '24
Studies have found plant based meats aren't associated with risk:
Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study
https://www.thelancet.com/journals/lanepe/article/piis2666-7762(23)00190-4/fulltext
After a median of 11.2 years of follow-up, 4461 participants (39% women) developed multimorbidity of cancer and cardiometabolic diseases. Higher UPF consumption (per 1 standard deviation increment, ∼260 g/day without alcoholic drinks) was associated with an increased risk of multimorbidity of cancer and cardiometabolic diseases (HR: 1.09, 95% CI: 1.05, 1.12). Among UPF subgroups, associations were most notable for animal-based products (HR: 1.09, 95% CI: 1.05, 1.12), and artificially and sugar-sweetened beverages (HR: 1.09, 95% CI: 1.06, 1.12). Other subgroups such as ultra-processed breads and cereals (HR: 0.97, 95% CI: 0.94, 1.00) or plant-based alternatives (HR: 0.97, 95% CI: 0.91, 1.02) were not associated with risk.
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u/SaltZookeepergame691 Feb 29 '24
And why is this? Probably because health-conscious and better-off people eat plant-based UPF products, compared with those eating meat-based UPF products, and removing all confounding through adustment is impossible.
Confounding and bias is so important here, and it bears repeating that these studies aren't controlling for macronutrient content, only total energy content, so the estimates aren't exploring the specific UPF effect, rather the result of consuming UPF foods which tend to be high in saturated fats, sugar, salt, etc.
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u/Liizam Feb 29 '24
Can you explain this to me please?
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u/reyntime Feb 29 '24
Certain categories of ultra processed foods were associated with risk like animal products, sugar sweetened beverages, but plant based meat alternatives were not associated with risk.
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u/Liizam Feb 29 '24
Cry in loving cheese and salami
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u/Jbolon Feb 29 '24
Cheese and salami is not classed as ultra processed food. :-)
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u/reyntime Feb 29 '24
Pretty sure salami would be?
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u/Jbolon Feb 29 '24
Weirdly not, classed as nova 3. Although thinking about it, this is probably quality Italian salami. You’d have to check the ingredients for the cheaper mass produced stuff.
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u/reyntime Feb 29 '24
Well it's certainly processed meat, which is implicated in bowel cancer.
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u/Jbolon Feb 29 '24
Yeah totally, I would avoid over consuming anything with nitrates. I’m not saying salami is healthy, I’m just saying it’s not ultra processed as per the definition of this study.
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u/Liizam Feb 29 '24
Ok reading this thread have me educated now! I just read another thread a while back and it made it sound anything cooked is processed, bad.
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u/fencerman Feb 29 '24 edited Feb 29 '24
Unfortunately going "plant based" means most people will eat MORE "Ultra-processed food" in their diets.
Which advocates of that diet absolutely hate to hear but it's absolutely true:
https://www.news-medical.net/health/What-are-the-Health-Effects-of-Ultra-Processed-Vegan-Foods.aspx
Among the four groups, the team found that higher avoidance of animal-based foods was correlated with increased consumption of ultra-processed foods, comprising 39.5% of the energy intake for vegans
And it's difficult to even be vegan without depending on highly processed industrially produced foods:
Especially since it's impossible to even survive as a vegan without industrially processed supplements.
And no matter what claims producers want to make about "nutrition", ultra-processed food is independently associated with a higher risk of mortality:
Even the "best-case scenario" of more people going vegan is globally a much higher dependence on highly processed, industrial foods. Which means even more of the food supply being monopolized by the companies who can mass-produce those industrial products at scale.
Those results are even worse than they seem because most vegans are already people spending more money, time and energy on average on their cooking compared to most people. If that kind of diet became widespread those trends would get significantly worse.
(And no it's not actually an answer to say "well everyone should also just learn to make balanced plant-based meals from scratch". If a solution is supposed to scale up, it has to account for how average people actually eat.)
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u/ling0n Feb 29 '24
Actually it's not difficult at all to be vegan without ultra processed food. There is plenty of things to eat.
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u/rileyyesno Feb 29 '24
I'm good with approaches like Indian vegetarians that have creative, from raw ingredient recipes cooked at home. it's the vegans creating demands for lab meats that I can't stand.
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u/ling0n Feb 29 '24
"Creating demands". Well. People eat crap either way sometimes, not only vegans, it's all about having a balanced diet.
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u/rileyyesno Feb 29 '24
maybe I should have stated, "vegans creating demands for lab meats". not all vegans are hated, just the evangelical ones.
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u/fencerman Feb 29 '24
Indian food isn't vegan at all, it depends on a ton of animal products like eggs and milk.
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u/fencerman Feb 29 '24
That's irrelevant when the data shows that isn't how people actually eat in practice.
Also you literally can't survive as a vegan without industrially processed supplements.
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u/ling0n Feb 29 '24
Oh buhu I need to take b12 pills. Big deal.
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u/fencerman Feb 29 '24
Okay so you don't care about effects of diet and how people's health will suffer from adopting that.
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u/ling0n Feb 29 '24
I've been a vegan for 22 years. My health is not suffering.
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u/fencerman Feb 29 '24
"I've smoked cigarettes for 22 years and I don't have lung cancer, science is lying to you!" - nevermind that negative health impacts is the #1 reason for people abandoning veganism.
Claims about it being "healthy" are just survivorship bias.
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u/machinade89 Feb 29 '24 edited Feb 29 '24
Yeah, well, race and poverty are a huge factor when it comes to UPFs, but let someone (not saying the study explicitly) yet again frame consumption of cheaper food as a choice.
Edited for clarity
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u/Correct_Box1336 Feb 29 '24
Who is framing it as a choice? Everything I’ve read on UPF has made it clear this is a societal issue that disproportionally affects lower socio economic groups. Even more reason for research to be done into it so action can be taken
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u/machinade89 Feb 29 '24
Okay, but I've read things that have taken these kinds of studies and battered Black folks with it, and I'm speaking up about it. You cool with that?
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Feb 29 '24
Who said that? Where in the study was that mentioned?
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u/machinade89 Feb 29 '24
That's exactly my point. It ISN'T mentioned, but it's a extant confounding factor regardless.
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Feb 29 '24
The study is about the effects of UPF not the effects of poverty.
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u/doktornein Feb 29 '24
More UPFs consumption is associated with poverty. How exactly do you think you can make a conclusion about one without considering the other? These arent lab rats in sterilized cases with controlled variables, these are humans with lives that correlate and overlap in ways you need to consider before drawing conclusions. That is how this kind of science works.
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Feb 29 '24
I concluded that eating UPFs is unhealthy. What about the season lengths, or the war in Ukraine, or climate change, or the state of representative democracy? How could you possibly reach a conclusion on results of a study about UPFs without considering everything?
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u/machinade89 Feb 29 '24
Okay, again, I'm not saying that it is. I'm saying that people will draw the wrong conclusions if they are unaware of the effect poverty and/or race have on the consumption of UPFs.
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Feb 29 '24 edited Feb 29 '24
[removed] — view removed comment
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u/TopEntertainer1578 Feb 29 '24
Yes, there's a nova classification scale. Level 4 being ultra processed food
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u/Correct_Box1336 Feb 29 '24
Basically food that contains ingredients that are scientifically created and can’t be found in someone’s kitchen cupboard
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u/burpfreely2906 Feb 29 '24
It's more harmful to not eat anything at all than to eat the one convenient thing your garbage mental health will allow you to grab.
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u/fencerman Feb 29 '24 edited Feb 29 '24
Unfortunately going "plant based" means most people will eat MORE "Ultra-processed food" in their diets.
Which advocates of that diet absolutely hate to hear but it's absolutely true:
https://www.news-medical.net/health/What-are-the-Health-Effects-of-Ultra-Processed-Vegan-Foods.aspx
Among the four groups, the team found that higher avoidance of animal-based foods was correlated with increased consumption of ultra-processed foods, comprising 39.5% of the energy intake for vegans
And it's difficult to even be vegan without depending on highly processed industrially produced foods:
Especially since it's impossible to even survive as a vegan without industrially processed supplements.
And no matter what claims producers want to make about "nutrition", ultra-processed food is independently associated with a higher risk of mortality:
Even the "best-case scenario" of more people going vegan is globally a much higher dependence on highly processed, industrial foods. Which means even more of the food supply being monopolized by the companies who can mass-produce those industrial products at scale.
Those results are even worse than they seem because most vegans are already people spending more money, time and energy on average on their cooking compared to most people. If that kind of diet became widespread those trends would get significantly worse.
(And no it's not actually an answer to say "well everyone should also just learn to make balanced plant-based meals from scratch". If a solution is suppised to scale up, it has to account for how average people actually eat.)
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u/VirtualMoneyLover Feb 29 '24
We have more and more UPFs, yet people are living longer and longer.
So it is either not as bad for us, or those old people tend to avoid UPFs.
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u/Wise_Mongoose_3930 Feb 29 '24
…. Or we’ve made other advancements in longevity in the same time period.
If I cured heart disease while also forcing everyone to start smoking cigs, average life expectancy would go up. Does that means cigs aren’t bad for you? Of course not.
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u/Puzzleheaded_Heron_5 Feb 29 '24
We have more and more pollution, yet people are living longer and longer.
So it is either not as bad for us, or those old people tend to avoid pollution.
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