Essential Insights on Eating in a World of Ultra-Processed Foods – The Irish Times

“Ultra-processed food is linked to damage in every significant organ of the body.”

“Hidden additives in food are associated with premature mortality.”

“Ultra-processed foods could help explain the increasing rates of bowel cancer among individuals under 50.”

Despite alarming headlines, many of us continue to indulge, with reports suggesting that as much as half of the average diet in the Republic consists of ultra-processed foods. But how do these foods truly affect our health?

A compelling study published by The Lancet medical journal at the end of last year presents a troubling overview. The research indicates that ultra-processed foods (UPFs) are a fundamental contributor to a surge in various diet-related chronic diseases globally, including obesity, heart disease, renal problems, different cancers, and even depression.

Such insights might deter anyone from reaching for their favorite ultra-processed breakfast cereal; even those who opt for plant-based milks may be disheartened to learn that these alternatives are categorized as ultra-processed.

Do these findings from The Lancet definitively prove that UPFs pose a risk to our health, beyond their well-known association with obesity?

Researchers are investigating this issue, though proving causal relationships remains challenging due to the multitude of variables at play.

The Lancet’s extensive analysis of over 100 studies unveiled numerous “plausible mechanisms for harm” associated with diets rich in UPFs. Factors include overeating, nutritional imbalances, harmful contaminants from processing and packaging, as well as detrimental additives.

[ How Ireland became captivated by ultra-processed foodsOpens in new window ]

Moreover, there’s a concern regarding the diminished health benefits from whole foods that UPFs often replace.

Collectively, this casts doubt on the safety of many packaged products lining supermarket shelves. However, given that a significant portion of our diet consists of UPFs, completely avoiding them is unrealistic for most individuals. Many consumers may wonder how to proceed if UPFs are perceived as wholly negative.

Registered dietitians often advocate for a broad perspective in dietary choices.

Focusing on overall eating patterns, cooking from scratch grants control over ingredients, portion sizes, and flavorings (recognizing that this isn’t always feasible). A loose guideline, often suggested, is an 80:20 approach where 80 percent of foods are healthier options, with a Mediterranean-style diet serving as a reliable reference.

It’s important to note that nearly all foods undergo some processing; the demarcation for what qualifies as “ultra” is debated, with no universally accepted definition. This ambiguity understandably leaves many shoppers feeling frustrated.

To gain clarity, we look back to Brazilian health expert Carlos Monteiro, who coined the term UPF while creating the Nova food classification system. This system outlines four categories.

The first involves “unprocessed or minimally processed foods,” including fresh meats, fish, fruits, and vegetables.

The second comprises “processed culinary ingredients,” such as butter, oils, sugar, honey, and vinegar.

Third, we have “processed foods,” like canned items, cured meats, bread, and cheese.

Lastly, “ultra-processed” refers to ready-to-eat, commercially formulated products containing substances sourced from foods and additives – ingredients typically not used in home cooking. Examples include mass-produced burgers, ice cream, biscuits, and infant formula. Even certain mueslis fall under this classification if they contain barley malt extract.

The Nova system categorizes foods based on their level of processing rather than their nutritional quality. Monteiro, also a lead author of the Lancet series, argues that the profit-driven motives behind ultra-processing make food “intensely appealing yet fundamentally unhealthy.”

However, critics of Nova argue it is too broad to classify different foods together indiscriminately. For instance, including wholegrain sliced bread, flavored yogurts, and baked beans alongside reformulated snacks, sodas, and candies can be confusing. The late Irish food scientist Mike Gibney authored a posthumously published book, In Defence of Bread, to highlight perceived flaws in this classification system.

The differences in perspectives among scientists, compounded by the tendency of non-experts to share sweeping theories, can quickly become overwhelming.

It may be beneficial to take a step back and consider the broader context.

According to Josh Percival, a dietitian and co-founder of a personal training gym in south Dublin, we must learn to navigate a reality where ultra-processed foods are ubiquitous.

While Percival argues for stricter regulations on advertising and placement of unhealthy products, he cautions that widespread improvements in our food environment are unlikely to materialize in the near future. The demand for better options is increasing, but meaningful changes are typically slow to initiate.

He emphasizes that companies are aware of our natural inclination toward high-energy foods and tailor products for rapid, large-scale consumption. For a deeper insight into food marketing tactics, Chris van Tulleken’s book, Ultra-Processed People; Why do we all eat stuff that isn’t food … and why can’t we stop, sheds light on the perils of convenience food engineered for taste and aggressively marketed to us. He purports that neither exercise nor willpower can mitigate the effects of consuming too many convenience products.

Percival takes issue with the simplistic categorization of foods as either “non-processed” or “ultra-processed” since it encompasses a broad array of options. He encourages individuals to evaluate their plates: is there enough protein? Are there fiber and carbohydrate sources? Are vegetables included? For those looking to alter their diets, he advocates starting with current eating habits and making incremental adjustments, rather than overhauling everything at once for sustainable change.

“I always remind people that bread isn’t inherently good or bad; it exists on a scale from highly nutritious to lower nutritional quality,” he adds. He cautions against using apps that assign numerical ratings based on ingredient lists as they often lack context or nuance.

“Such assessments can negatively impact people’s relationships with food. They overlook crucial factors like affordability, convenience, and taste, alongside nutrition.”

The tendency to obsess over dietary purity, referred to as orthorexia nervosa, is not yet a formally recognized eating disorder, though many individuals resonate with its notion, says Ellen Jennings from Bodywhys – The Eating Disorders Association of Ireland. This preoccupation can lead to significant dietary restrictions as individuals seek only perceived “healthy” options.

Such rigidity may impose strict rules leading to feelings of guilt, anxiety, and shame if those guidelines are broken, leading to more extreme dieting behaviors, she explains.

Dietitian Jess Willow argues that there has been too much fearmongering surrounding UPFs. “There are no foods that we categorically need to eliminate unless they trigger an allergy or intolerance,” she states. The challenge arises when UPFs dominate someone’s diet, displacing vegetables, whole grains, and lean proteins—essential components of a balanced diet. “It’s about adding beneficial foods rather than framing it as a prohibition against UPFs.”

In her practice at Willow Nutrition, she emphasizes intuitive eating, focusing on listening to internal cues related to hunger, fullness, and satisfaction, moving away from restrictive eating patterns.

Dietitian Sarah Keogh asserts that the notion that all ultra-processed foods are harmful is not grounded in science. While people may fixate on the potential impact of additives, she considers the issue of UPFs replacing healthier options to be the more critical concern, particularly regarding their influence on appetite satisfaction.

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“When you consume whole foods, you have to chew more, which signals your brain to feel full sooner.” Furthermore, UPFs are often lower in fiber, which is essential for good gut health and satiety. Keogh emphasizes that the age-old advice to limit foods high in sugar, fat, and salt, such as desserts and snacks, remains valid. However, she believes the monotony of traditional healthy eating advice can lead people to seek out the latest trends and sensational claims from so-called health gurus.

Keogh frequently encounters individuals expressing confusion over healthy eating guidelines, fearing what to avoid—sugar, food additives, certain oils (“which are perfectly acceptable”), and even nightshade vegetables like eggplant and potatoes. The list of concerns continues to grow. Regarding palm oil, while sustainable sources should be prioritized, it’s essentially just another saturated fat, “not arsenic,” she notes.

Criticism of the advice suggesting the avoidance of foods containing more than five ingredients is termed “arbitrary” by her. “That’s just this year’s ‘clean eating’ trend,” she articulates.

Keogh recommends avoiding UPF products mainly found atop the food pyramid. If choosing a convenience meal, she suggests selecting one that is lower in salt and saturated fat.

Those who engage in “extreme healthy eating” might be in good physical shape but often have poor mental relationships with food. They are burdened by their constant fixation, while the average person understands the need to eat fruits and vegetables while allowing for occasional indulgences.

It’s one challenge for adults to navigate dietary choices; steering children away from an abundance of UPFs presents a more significant hurdle.

[ Ultra-processed food: ‘They are essentially designed for us to overeat’Opens in new window ]

“I would never ban foods for children, as it only elevates their desirability,” advises Keogh. Children should learn to cultivate a healthy relationship with high-fat, sugary products, which she refers to as “sometimes foods.”

Deirdre Doyle of The Cool Food School observes a significant gap in students’ understanding of real food. When querying about protein sources, responses often include “protein powder,” “protein bar,” or “protein shake,” with approximately 70 percent of answers falling into these categories.

“Few kids understand sources like beans, and even fewer connect it to milk,” she notes, highlighting disparities between children from disadvantaged backgrounds and those in socioeconomically advantaged environments. The introduction of a €300 million hot school meals initiative aiming to tackle health disparities has faced criticism for the ultra-processed nature of much of its provided food.

Children, notes Doyle, gravitate towards what they see in our “obesogenic” environment, where UPFs dominate grocery stores and convenience outlets. Despite existing restrictions on junk food advertising during broadcast hours, these measures have been criticized as inadequate in fostering protection for today’s digitally savvy youth. In the UK, legislation now bans junk food advertising online and extends restrictions on television up to 9 PM.

At home, Doyle advises parents to make healthy food options readily accessible—keeping fruits on the kitchen counter and presenting salads on the dinner table. Since children might need to try a food multiple times before they accept it, a patient approach in offering small portions is vital.

Referencing the debate surrounding sliced bread in the context of UPFs, Norah Campbell, a lecturer in critical marketing at Trinity College Dublin, argues that it represents a common “whataboutery” tactic. “This often arises in cultural and political discourses where the more challenging nuances are overlooked,” she notes, emphasizing the distinction between individual food items versus broader dietary patterns.

In Ireland, taxpayers indirectly fund the marketing of unhealthy food brands, Campbell highlights, as such expenses are tax-deductible. “Were advertisers responsible for their costs, we could potentially generate millions towards initiatives like supporting local bakeries to produce affordable whole grain bread.”

As the government drafts a comprehensive obesity strategy, Campbell senses a growing willingness among the public for structural changes. She asserts that simply urging individuals to make better food choices is unrealistic given our current food landscape has become increasingly difficult to navigate.

“You’re asking people to learn how to swim harder when you’re in toxic water, instead of questioning, what is this water?”

Campbell insists that everyone must evolve from being mere consumers to active citizens advocating for changes in how food is processed. She encourages individuals to query political candidates on issues such as why junk food companies enjoy tax deductions for advertising or why school meals come primarily from large processing kitchens.

Reforming our UPF-dominated food system is not insurmountable, according to Campbell.

“The major challenge is finding political parties ready to recognize the significant economic and health benefits that could be achieved.”