Not all ultra-processed foods are bad in your health, whatever you may have heard

In recent years, there’s been increasing hype concerning the potential health risks related to so-called “ultra-processed” foods.

But latest evidence published this week found not all “ultra-processed” foods are linked to poor health. That includes the mass-produced wholegrain bread you purchase from the supermarket.

While this newly published research and associated editorial are unlikely to finish the wrangling about how best to define unhealthy foods and diets, it’s critical those debates don’t delay the implementation of policies which are more likely to actually improve our diets.

What are ultra-processed foods?

Ultra-processed foods are industrially produced using a wide range of processing techniques. They typically include ingredients that may’t be present in a house kitchen, similar to preservatives, emulsifiers, sweeteners and/or artificial colors.

Common examples of ultra-processed foods include packaged chips, flavoured yoghurts, soft drinks, sausages and mass-produced packaged wholegrain bread.

In many other countriesultra-processed foods make up a big proportion of what people eat. A recent study estimated they make up a mean of 42% of total energy intake in Australia.

How do ultra-processed foods affect our health?

Previous studies have linked increased consumption of ultra-processed food with poorer health. High consumption of ultra-processed food, for instance, has been related to a higher risk of type 2 diabetes, and death from heart disease and stroke.

Ultra-processed foods are typically high in energy, added sugars, salt and/or unhealthy fats. These have long been recognised as risk aspects for a variety of diseases.

It has also been suggested that structural changes that occur to ultra-processed foods as a part of the manufacturing process may lead you to eat greater than you need to. Potential explanations are that, resulting from the best way they’re made, the foods are quicker to eat and more palatable.

It’s also possible certain food additives may impair normal body functions, similar to the best way our cells reproduce.

Is it harmful? It relies on the food’s nutrients

The latest paper just published used 30 years of knowledge from two large US cohort studies to judge the connection between ultra-processed food consumption and long-term health. The study tried to disentangle the results of the manufacturing process itself from the nutrient profile of foods.

The study found a small increase in the danger of early death with higher ultra-processed food consumption.

But importantly, the authors also checked out weight loss plan quality. They found that for individuals who had prime quality diets (high in fruit, vegetables, wholegrains, in addition to healthy fats, and low in sugary drinks, salt, and red and processed meat), there was no clear association between the quantity of ultra-processed food they ate and risk of premature death.

This suggests overall weight loss plan quality has a stronger influence on long-term health than ultra-processed food consumption.

When the researchers analysed ultra-processed foods by sub-category, mass-produced wholegrain products, similar to supermarket wholegrain breads and wholegrain breakfast cereals, weren’t related to poorer health.

This finding matches one other recent study that means ultra-processed wholegrain foods are usually not a driver of poor health.

The authors concluded, while there was some support for limiting consumption of certain sorts of ultra-processed food for long-term health, not all ultra-processed food products must be universally restricted.

Should dietary guidelines advise against ultra-processed foods?

Existing national dietary guidelines have been developed and refined based on a long time of nutrition evidence.

Much of the recent evidence related to ultra-processed foods tells us what we already knew: that products like soft drinks, alcohol and processed meats are bad for health.

Dietary guidelines generally already advise to eat mostly whole foods and to limit consumption of highly processed foods which are high in refined grains, saturated fat, sugar and salt.

But some nutrition researchers have called for dietary guidelines to be amended to recommend avoiding ultra-processed foods.

Based on the available evidence, it might be difficult to justify adding a sweeping statement about avoiding all ultra-processed foods.

Advice to avoid all ultra-processed foods would likely unfairly impact people on low-incomes, as many ultra-processed foods, similar to supermarket breads, are relatively reasonably priced and convenient.

Wholegrain breads also provide essential nutrients, similar to fibre. In many countries, bread is the biggest contributor to fibre intake. So it might be problematic to recommend avoiding supermarket wholegrain bread simply because it’s ultra-processed.

So how can we improve our diets?

There is powerful consensus on the necessity to implement evidence-based policies to enhance population diets. This includes laws to limit children’s exposure to the marketing of unhealthy foods and types, mandatory Health Star Rating nutrition labelling and taxes on sugary drinks.

These policies are underpinned by well-established systems for classifying the healthiness of foods. If latest evidence unfolds about mechanisms by which ultra-processed foods drive health harms, these classification systems will be updated to reflect such evidence. If specific additives are found to be harmful to health, for instance, this evidence will be incorporated into existing nutrient profiling systems, similar to the Health Star Rating food labelling scheme.

Accordingly, policymakers can confidently progress food policy implementation using the tools for classifying the healthiness of foods that we have already got.

Unhealthy diets and obesity are among the many largest contributors to poor health. We can’t let the hype and academic debate around “ultra-processed” foods delay implementation of worldwide really helpful policies for improving population diets.