Ultra-processed food – processing NOT guilty

Ultra-processed food – processing NOT guilty

Allan J. Main B.Tech (Food Tech) FNZIFST

In the past few years there has been a growing groundswell, initially amongst nutrition and public health academics and latterly with popular media and food activists, pointedly accusing food processing of being a leading contributor to the explosion of public health problems. Foremost in this attribution is rampant growth of diet-associated non-communicable diseases such as obesity, type 2 diabetes, cardiovascular disease, and others. The accused culprit in this doctrine is a group of foods termed “ultra-processed food”.

So what constitutes “ultra-processed food”?

The concept of "ultra-processed food" is a recent construct. It was invented then popularised by Brazilian epidemiologist and professor of nutrition Prof Carlos Monteiro and his colleagues from the University of Sao Paulo. The term was first coined in a four-group graded food classification schema called NOVA, created in 2009 by Montiero and his academic colleagues.(1)In the subsequent decade NOVA was widely adopted by nutrition researchers, NGOs, and later activists as a short hand for food quality, particularly nutritional worth and attributed public health consequences. In that context UPFs were the ultimate villain. Since the original NOVA schema was published by its Brazilian “inventors” it has generated its own momentum, first in the scientific literature of nutrition and public health and more recently amongst food activists and conspiracists. Today the adoption and proliferation of the term “ultra-processed food” has inflated to the point it is now entrenched in the lexicon of nutrition scientists and food activists as a shorthand for “bad food”.

In brief summary the NOVA Food Classification system comprises these four sets:

• NOVA Food Group 1 claims “unprocessed or minimally processed foods,” things like meat, fruit, flour and pasta.

• NOVA Food Group 2 is “processed culinary ingredients” exemplified by oils, butter, sugar, honey and starches, intended to be extracts of group 1 foods (honey??) used in culinary preparations.

• NOVA Food Group 3 is “processed food”: ready-to-eat mixtures of the first two, processed for preservation, meaning canned beans, salted nuts, smoked meat (and, pointedly, “proper freshly made bread”, as opposed to “commercial bread”).

• NOVA Food Group 4 is “ultra-processed foods”: compounded preparations of ingredients, “mostly of exclusive industrial use”, made by a series of industrial processes, many requiring sophisticated equipment and technology.

A deeper description of the NOVA classification system (tailored after a decade of scrutiny) is also published.(2)

To exhibit the irrationality of the terminology a brief lesson in basic etymology is called for. The prefix “ultra” (which hails from the same word in Latin meaning “beyond”), generally modifies the word to which it connects to indicate “extreme” or “excessive”. Thus it is inherent in the term that “ultra-processed food” must be a food that has been subjected to an abnormally extreme degree or excessive amount of processing.

Muddled thinking

That is not an aspect that characterises the foods grouped as “ultraprocessed” in NOVA Group 4. Simple investigation reveals that the group of foods defined as “ultra-processed” have very little reliance on the extent or intensity of their processing to take that designation. What characterises this set of foods is not the extent of processing they undergo but their contributing ingredients and their resultant composition. They are often high in sugar, salt, “unhealthy” fats, and low in essential nutrients like fibre, vitamins, and minerals. These foods typically also contain additives aimed at enhancing flavour, appearance, and shelf-life, which promote consumer appeal. Their inherent consumer allure has led to these foods being eaten to excess, often at the exclusion of more nutritious and healthful alternatives. Their nutritional composition – energy-high, micronutrient-sparse – and their excessive consumption are implicated in several dietrelated non-communicable disease epidemics causing public health concerns. Were these foods to be consumed as infrequent “treats” they would offer no problem. But for many people this food group has been increasingly normalised to the extent that it defines their nutritional status.

However, it is critical to recognise that whatever the failings of the foods called UPFs these are not a consequence of their degree of processing.

Indeed, the entire NOVA schema provides no consistent trend in degree or intensity of processing interventions embedded in the food. Some “minimally processed foods” of Group 1 (e.g. pasta) require more extensive processing than some foods allocated to Group4 “ultra-processed foods” (e.g. potato crisps). Many foods of Group4 UPF (e.g. carbonated beverages) have minimal and quite simple processing in their manufacture. To assign pasta, a product that undergoes extensive processing through about ten sequential unit operations(3) to “NOVA1 – unprocessed or minimally processed foods” but a commercial cookie/biscuit, with comparable unit operations assigned to “NOVA4 – Ultra-processed Food” is irrational, should the driving criterion be the extent of processing. Obviously the distinctive features of these two foods are ingredient-based, and particularly attributable to the high sugar content of the biscuit.

A scathing public rebuke

It is apparent that the NOVA inventors framed their nomenclature ignorant of the distinction between food formulary and food processing. That is an intriguing error when it is realised that the Sao Paulo University nutrition and public health inventors of the NOVA system did so without apparent reference to their institutional food technology colleagues. University of Sao Paulo has a faculty of Animal Science and Food Engineering through which undergraduate and postgraduate qualifications in Food Engineering are awarded. It seems that there was no consultation of these in-house experts when the nutrition and public health academics were formulating their NOVA schema. That has led to the bizarre situation whereby a team of Sao Paulo University food engineers published(4) a scathing public rebuke of NOVA to their nutrition and public health colleagues. Their insights into the inadequacies of their colleagues’ schema are so compelling that their summary is provided here in full (my emphasis through underscoring and emboldening):

Although the consumer enjoys many benefits provided by the current food processing technology, some health professionals and digital influencers suggest that there is little benefit and serious harm that could be due to poor nutrition, which was caused by the consumption of processed foods (PF). A new classification, known as NOVA, which classified foods into four groups, according to the level of processing was proposed. However, this classification does not accurately categorise food products by the level of the processing. In contrast, it considers the quantity of ingredients contained in the food. Therefore, the NOVA classification can lead to a negative perception by many consumers, because it neglects well-established science concepts from the food science domain. NOVA is based on the erroneous assumption that all commercially manufactured foods have low nutritional value, promote weight gain and chronic diseases to consumers because they contain sugar, salt and additives. It dismisses the proven benefits of diets chosen with the right mix of foods at all levels of processing. Disagreeing with some scientific studies, the NOVA classification suggests with inadequate data, that food prepared from basic ingredients at home has superior nutritional qualities to those produced by processors. Thus, some concepts have emerged in the public health field with special highlights to the term “ultra-processed” foods (UPF).

So the NOVA system, despite its formative thesis, shows no evidence whatsoever, whether causal or casual, associating the level of nutritional imbalance (energy-dense/nutrient-poor) of a food with any aspect of its processing. In reality, that should not be surprising as there can be no such linkage since the necessary principle that the physical actions of food processing cause the final food composition is ridiculous. Yes, processing can provide nuanced compositional changes, but at a micro- rather than macro-level, and it is the formula that primarily drives final composition, both chemical and nutritional.

An unnecessary denigration of food processing

So in designing their system without reference to readily available local food engineer experts that could have navigated them away from a spurious taxonomy the NOVA inventors have, in their ignorance, unnecessarily denigrated food processing. Food processing provides a set of benign technologies that are generally applied to enhancing the safety, quality, nutritional value, and shelf life of food products. Food processing should be viewed as propitious and not malicious but when processing is maligned in the abusive term “ultra-processed food”the lay person will naturally look at food processing as abhorrent. However, food processing provides the only credible avenue for the world to feed its future population so to destroy consumer trust and faith in that toolset is to undermine the opportunity to innovate towards our future security. It is imperative that public acceptance of processing technologies be restored to allow food technologists the means to deliver the existential requisite of a sustainable (environmental, economic and nutritional) food supply in the near future.

Which is not to deny that there is an issue with the way the average Joe Blogg’s diet has changed over recent decades – there is; but it has nothing to do with the number and type of unit operations embedded in the foods Joe Bloggs elects to consume and EVERYTHING to do with its nutritional imbalance, generally an excessive energy to micronutrient ratio, exacerbated by extravagant consumption. So the public health issue is real, but the defendant, food processing, is falsely accused.

Proliferation of the disinformation

Proponents of the UPF concept further signal how preposterous is their nomenclature when they define how to discern whether a food is “ultra-processed”; these definitions are wholly comprised of compositional and/or ingredient factors. For example, Dr Chris van Tulleken(5), a leading UK antagonist against UPFs and author of the UK Sunday Times No.1 best seller “Ultra-processed People - Why Do

We All Eat Stuff That Isn’t Food … and Why Can’t We Stop?”(6) provides a simplified definition of UPFs for his lay audience as follows: “If it is wrapped in plastic and it contains at least one ingredient that you don’t typically find in a domestic kitchen then it is ultra-processed food.” The astute will note that there is not a lot of processing going on in that definition! A further irony is the reality that the food ingredients in the UPF group that most contribute to public health concerns, they being refined sugar, starches, salt and saturated animal fats, are widely prevalent in domestic kitchens, which van Tulleken’s definition seems to imply is a redemptive feature. Bizarre!

But Van Tulleken has public traction so his views proliferate. Therein lies the challenge we must resolve; in allowing technologically inept academics the space to perpetuate a misconception that food processing has caused disease-promoting foods, we now have an ingrained issue of popular adoption of the untruth that processing causes nutritionally imbalanced foods.

NZ media are spreading the fallacies

And lest it is assumed that this is exclusively a problem outside New Zealand these same concepts are infiltrating our local popular media. In the populist New Zealand magazine Consumer, Belinda Castles introduces her item on the danger of UPFs(7) with this statement (again my emphasis):

We know eating less processed food is better for our health but research is mounting that the degree of processing also plays a part. Ultra-processed foods (UPFs) are being linked to a number of illnesses, such as heart disease, cancer and stroke.

Ironically the body of the article later quotes University of Auckland nutritionist Dr Sally Mackay as saying “… the degree of processing isn’t always a direct link with nutrition. Some core foods that form the basis of a healthy diet, such as many breads and breakfast cereals, are classified as UPFs.” Similarly, later in the article University of Otago’s head of Dept Medicine Prof Rachael Taylor is quoted saying “… lack of consistency means we should be cautious when we interpret data relating to UPFs.”

Despite these cautionary statements the core tenor of the article is to hang the public health issues on food processing.

A further local example hails from Newshub(8) last August in which Niki Bezzant, founding editor of Healthy Food Guide and a regular media contributor on food and health issues, states (again my emphasis):

...we should be wary of what are known as Ultra Processed Foods (UPFs). The term describes foods that have been through industrial processing to such a degree that it results in energy-dense products that are also nutrient-poor and high in sugar, unhealthy fats and salt.

While foods that exhibit the cited characteristics undoubtedly contribute to unbalanced diets and likely associate with poor health when over-consumed, the statement that processing is the cause of energy-dense/nutrient-poor foods is quite ludicrous. Such assertions would be laughable were it not for the fact that vectors like Newshub/RNZ and Consumer provide street cred to these messages when delivered to the concerned lay person and lead them to regard food processing as a route to toxicity.

Furthermore, the public interface of NOVA has been substantially increased through a generally available smart phone app developed by a French non-profit organisation Open Food Facts that provides as a feature identification of foods that are “ultra-processed”.(9)

Why we should care

Why does this matter? Why should we food technologists care that food processing is being unjustly maligned? After all this is not the first time a benign term has been usurped by activists as a coat hook to stigmatise technology. “Biotechnology” used to mean “any process reliant on biological processes in an industrial manufacturing environment” before it was redirected by activists to be narrowly applied to “gene technology” with a consequent popular revolt against the term.

The problem with perpetuating the mis-calling of nutritionally unbalanced foods “ultra-processed” is that such use undermines the public perception of the benefits of food processing. By demonising processing, there is a risk of stigmatising the means to adequately feed future humanity, particularly marginalised populations. Through allowing the spurious term “ultra-processed food” to perpetuate we risk “food processing” being redirected from its core, historical, benign meaning to a totally toxic connotation of “making bad food”. We must not allow that to happen. Despite the mis-use being strongly entrenched in nutritionist circles it is imperative that we food technologists do all in our power to quench the fires before the term “processing” when applied to foods assumes the toxic default meaning of detrimental activities that destroy food quality and cause public health catastrophe.

Food processing is an ubiquitous and necessary element of modern food production and distribution systems and is indispensable in resolving emerging issues fundamental to our food supply, notably availability and sustainability. Without innovative processing, it will be impossible to meet the nutritional needs of a growing global population efficiently. Processing helps make food safer, more convenient, and often more affordable.

My concern is that by allowing the misrepresentative nomenclature to embed further, consumer attitudes to food processing and the food industry will be further degraded. We start from a base point where consumers are at best neutral and frequently antagonistic to the concept of food being factory processed irrespective of the benefits such processing frequently provides to their lives. In calling villain foods “ultra-processed” the act of processing food is generally and indiscriminately maligned when the core cause of the public health problem (diet-related non-communicable disease) is not the processing performed but the proliferation of calorie-dense/nutrientsparse foods through irresponsible formulary and promiscuous marketing.

Despite the mis-use being strongly entrenched it is imperative that we food technologists do all in our power to quench the fires before the term “processing” when applied to foods by default is a toxic term assumed to indicate destructive actions that diminish food quality and cause public health catastrophe. Somehow, we need to turn the worm that is the denigration of food processing deriving from its abuse in the NOVA food classification system now proliferated through the scientific and popular media. Given how embedded the malignant term “ultra-processed” has become in the vernacular of nutritionists, public health specialists and particularly food activists/conspiracists, that will not be an easy task.

Perhaps we are already too late, but we dare not abdicate. As a starting point we need to be active proponents for the benefits of food processing and particularly to ensure that our nutrition and public health peers in New Zealand understand the anomalies of using the NOVA terminologies and encourage them towards a more meaningful vocabulary, even if that is reverting to the abhorrent phrase “junk food”. At least that term is directed to the nature of the foods’ compositions.

In parallel with that we must be seen to taking seriously the problem of dietary impact on the explosion of non-communicable diseases and to be using our skills and influence to ameliorate the food supply issues contributing to that epidemic.

The effect of maligning food processing is to impugn the entire food industry, as processing is core to all food production. General denigration of food processing undermines the essential tools necessary to enable essential redistribution of foods between where/ when they are available and where/when they are needed. This is a requisite to enable sustainably feeding a projected global population of 10bil. That need cannot be delivered without use of food processing technologies to prolong the nutritional life of food be they traditional or novel. Public trust in their food supply is imperative to allow the technology-led improvements to be widely implemented. Our advocacy for the benefits of responsible food processing is essential if we are to have the social license we need to create the safe, sustainable, available and affordable food demanded for our continued existence. It really is that important.

Explanatory notes and References

1. Monteiro, C. A. (2009). Nutrition and health. The issue is not food, nor nutrients, so much as processing. Public Health Nutrition, 12(5), 729–731. https://doi.org/10.1017/S1368980009005291

2. Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J.-C., Louzada, M.L. C., Rauber, F., et al. (2019). Ultra-processed foods: What they are and how to identify them.

3. Commercially manufactured pasta from whole wheat typically undergoes the processing steps of grain milling, flour fractionation, batching, mixing, kneading, steam pasteurisation, forming (generally extrusion), cutting, drying, packing. Further processing occurs in the kitchen when pasta is prepared for consumption.

4. Petrus, R.R., do Amaral-Sobral, P.J. et al (2021):”The NOVA classification system: A critical perspective in food science” Trends in Food Sci & Technol 116 (Oct 2021) p603-608 HERE

5. Van Tulleken, C (2023): “Ultra-processed People - Why Do We All Eat Stuff That Isn’t Food … and Why Can’t We Stop?” Publ Penguin ISBN 9781529160222

6. Castles, B and Rangahau, K (undated): “Ultra-processed foods: Are they the latest nutritional baddie on the block?” Consumer Magazine website retrieved 16 March 2024 at https:// www.consumer.org. nz/articles/ultra-processed-foods-are-theythe-latest-nutritional-baddie-on-the-block

7. Bezzant, N (2023): “Ultra-processed foods: Here's what you need to know” Newshub/RNZ 10 Aug, 2023 retrieved 14 Mar 2024 from https://www.newshub.co.nz/home/ lifestyle/2023/08/ultra-processed-foods-here-s-what-you-need-toknow.html

8. Open Food Facts (2024) List of NOVA groups – World. (accessed March 20, 2024 at https://world.openfoodfacts.org/novagroups )

9. Open Food Facts (2024) List of NOVA groups – World. (accessed March 20, 2024 at https://world.openfoodfacts.org/novagroups)

• Allan Main B.Tech (Food Tech), FNZIFST is in his 50th year as a practising food technologist having graduated in the class-of-75 from Massey University. Most of Allan’s career has been at the interface of technology and markets working in innovation management including spells in dairy, food ingredients, brewing and food research, spanning product development, research management, technology transfer and intellectual property management. Recently Allan retired from the full-time workforce but he keeps his interest in the food industry and innovation current through continued involvement with NZIFST where he is an elected member of the Executive. Allan is also Principal of MAINly Consulting, a company he established in 2007 to provide specialist but practical support to innovators in the food and primary industries. Apart from his professional interest Allan is a passionate foodie enjoying time in the kitchen, dining out and his malt whisky collection.