Long read: How Bad Are Ultraprocessed Foods, Really?

Our colleague in America sent us this eye-opening article from the NYT which says that rather than obsessing about whether we are having too much by the way of fats, carbs or sugar what we should really worry about is whether we having too much “Ultra Processed Food” (UPF). So what is UPF? And why is it bad for our bodies? We would urge you to read the NYT piece in full to understand this tricky subject properly. Here are the key points from the piece.

30 years ago a Brazilian epidemiologist, Carlos Monteiro, noticed rising obesity rates in the country and found that Brazilians were buying less sugar, salt & staples and more aerated beverages, sausages, cookies, instant noodles and packaged bread. His pathbreaking work linked the latter (i.e. UPFs) to a range of health conditions “including heart disease, Type 2 diabetes, obesity, gastrointestinal diseases and depression, as well as earlier death”.

Around the world, UPFs are now thought to account for a majority of what people eat. Mr Monteiro defined UPFs thus: “Ultraprocessed foods made using industrial methods and ingredients you wouldn’t typically find in grocery stores — like high-fructose corn syrup, hydrogenated oils and concentrated proteins like soy isolate. They often contain additives like flavorings, colorings or emulsifiers to make them appear more attractive and palatable. Think sodas and energy drinks, chips, candies, flavored yogurts, margarine, chicken nuggets, hot dogs, sausages, lunch meats, boxed macaroni and cheese, infant formulas and most packaged breads, plant milks, meat substitutes and breakfast cereals.

“If you look at the ingredient list and you see things that you wouldn’t use in homecooking, then that’s probably an ultraprocessed food,” said Brenda Davy, a nutrition professor at Virginia Tech.”

So why are UPFs bad for us? After all, UPFs like infant formula or breakfast cereals contain useful vitamins and minerals. Whilst the correlation between high UPF consumption and poor health outcomes is established, the causality is still not 100% clear. The NYT piece lays out what research in this area has thrown up so far:

“Most research linking UPFs to poor health is based on observational studies, in which researchers ask people about their diets and then track their health over many years. In a large review of studies that was published in 2024, scientists reported that consuming UPFs was associated with 32 health problems, with the most convincing evidence for heart disease-related deaths, Type 2 diabetes and common mental health issues like anxiety and depression.

Such studies are valuable, because they can look at large groups of people — the 2024review included results from nearly 10 million — over the many years it can take for chronic health conditions to develop, said Josiemer Mattei, an associate professor of nutrition at the Harvard T.H. Chan School of Public Health. She added that the consistency of the link between UPFs and health issues increased her confidence that there was a real problem with the foods….

Clinical trials are needed to test if UPFs directly cause health problems, Dr. O’Connor said. Only one such study, which was small and had some limitations, has been done, she said.

In that study, published in 2019, 20 adults with a range of body sizes lived in a research hospital at the National Institutes of Health for four weeks. For two weeks, they ate mainly unprocessed or minimally processed foods, and for another two weeks, they ate mainly UPFs. The diets had similar amounts of calories and nutrients, and the participants could eat as much as they wanted at each meal.

During their two weeks on the ultra-processed diet, participants gained an average of two pounds and consumed about 500 calories more per day than they did on the unprocessed diet. During their time on the unprocessed diet, they lost about two pounds.

That finding might help explain the link between UPFs, obesity and other metabolic conditions, said Kevin Hall, a nutrition and metabolism researcher at the National Institutes of Health, who led the trial….

…scientists think that the foods could be having more direct effects on health. They can be easy to overeat — maybe because they contain hard-to-resist combinations of carbohydrates, sugars, fats and salt , are high-calorie and easy to chew.

It’s also possible that resulting blood sugar spikes may damage arteries or ramp up inflammation, or that certain food additives or chemicals may interfere with hormones, cause a “leaky” intestine or disrupt the gut microbiome.”

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