Everything in moderation? Focusing on ultra-processed foods

We all know what processed foods are, but what about ultra-processed foods? It doesn’t take too long to find them at the grocery store; all you need to do is read the ingredient list on a packaged food item. If you wouldn’t use these ingredients for cooking at home, then they’re likely an ultra-processed food. You might find high fructose corn syrup, invert sugar, modified starches, hydrogenated oils, and colourings, as well as de-foaming, bulking, and bleaching agents on the food label. These are just a few examples of ultra-processed food ingredients.

This article focuses on ultra-processed foods, their effects on health, and how we consume them in Canada. One of the best things you can do for your health is to eat more unprocessed food and less ultra-processed foods. Yes, food manufacturers aggressively market these very addictive products, and I certainly don’t blame anyone for eating or wanting to eat them. That said, I think it’s time to aggressively market real food instead, which is why I’m writing this article. For many people, the more unprocessed food you eat, the less you’ll crave the artificial stuff as time goes on. Trust me, I’ve been there too.

Ultra-Processed Foods

The term comes from the NOVA food classification system, a system created to classify foods based on how they are processed and for what purpose (extending shelf life, fortifying with vitamins and minerals, creating ready-to-eat or ready-to-heat foods, etc.).¹ They classify food into four groups: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. Ultra-processed foods are defined as “formulations of several ingredients which, besides salt, sugar, oils, and fats, include food substances not used in culinary preparations, in particular flavours, colours sweeteners, emulsifiers, and other additives used to imitate sensorial qualities of unprocessed or minimally processed foods and their culinary preparations or to disguise undesirable qualities of the final product”.² I can’t imagine ever having to disguise undesirable qualities of the final product of something that I’m cooking at home, unless something has gone terribly wrong with the recipe.

NOVA food classification system: examples*

Group 1

Unprocessed or minimally processed foods

• vegetables and fruits (fresh or frozen)
• dried fruits with no added sugar, honey, or oil
• grains and legumes (chickpeas, lentils)
• meat, poultry, fish, seafood, eggs
• milk without added sugar
• plain yogurt with no added sugar
• nuts and seeds
• spices and herbs
• tea, coffee, water

Group 2

Processed culinary ingredients

• iodized salt
• salted butter
• sugar and molasses from cane or beet
• honey extracted from combs
• syrup from maple trees
• vegetable oils crushed from olives or seeds
• butter and lard from milk and pork
• starches extracted from corn and other plants
• vegetable oils with added anti-oxidants
• vinegar with added preservatives

Group 3

Processed foods

• canned vegetables, fruits, and legumes
• fruits in syrup
• salted or sugared nuts and seeds
• salted cured or smoked meats
• canned fish
• artisanal breads and cheese

Group 4

Ultra-processed foods

• pop and fruit drinks
• sweetened yogurt
• sweet or savoury packaged snacks (e.g., cookies)
• candies and cake mixes
• mass-produced packaged breads and buns
• margarines and spreads
• breakfast cereals
• cereal and energy bars
• energy drinks
• instant soups, sauces, and noodles
• poultry and fish nuggets, hot dogs
• many ready-to-heat products: pre-prepared pies, pasta, and pizza dishes

*Adapted from PAHO 2015³

Nutrition and Inflammation

Ultra-processed foods are less filling and raise our blood sugars higher than minimally processed foods. They are generally higher in calories and sugar, lower in protein and fibre, and are associated with obesity.¹ They are nutritionally inferior and eating them replaces healthier nutrient-rich foods that you could be eating instead (crispy veggies and hummus instead of pop and chips). Many of them are snack foods and promote mindless eating, replacing the need or desire for a real meal. Not only that, they contain pro-inflammatory ingredients, such as refined sugars (carbohydrates), and unhealthy fats, like corn oil.⁴ I recommend avoiding pro-inflammatory foods to my clients, especially for those with inflammatory conditions such as inflammatory bowel disease (IBD) and obesity, or digestive health conditions like irritable bowel syndrome (IBS) and diverticular disease.

Refined sugars (carbohydrates), such as high fructose corn syrup, are one of the primary dietary factors that affect inflammation.⁴ They can be hard to avoid when they are found in so many foods at the grocery store, especially when they’re hidden in foods you wouldn’t suspect (e.g., coconut milk). The World Health Organization (WHO) recommends limiting free sugar (also known as added sugar) intake to no more than 10% of total energy intake, and ideally less than 5% of total energy intake for greater health benefits. Less than 5% of total energy intake amounts to approximately 25 grams, or six teaspoons of sugar. One cup (250 mL) of regular Coca-Cola has 27 grams of added sugar. That’s more than enough for the day if you’re not looking to exceed the 5% limit.⁵

Consumption in Canada

The United States wins first place for largest buyers of ultra-processed foods and drinks in the world and, sadly, Canada comes in second.¹ A study released in 2017 looked at the consumption of ultra-processed foods and diet quality in Canada. They found that 48% of calories consumed by Canadians came from ultra-processed foods such as soft drinks, packaged juices, fast food, and mass-produced breads.¹ Their data was from the Canadian Community Health Survey. The people who had the highest intake of ultra-processed foods were those of a younger age and males. Compared to other high-income countries, such as France and Italy, Canada and the United States still consume significantly more of these products. Food processing has not always been a factor in measuring diet quality, but it should be.

Bottom-line

Ultra-processed foods are everywhere. They are addictive, nutritionally void, and contain pro-inflammatory ingredients that we should avoid. So how can you eat less of them? I suggest adding real food back into your diet, one meal or snack at a time. This could mean simply replacing your afternoon snack with some grapes and walnuts, instead of a packaged granola bar. Cooking at home is a great proactive way to eat less ultra-processed foods. If you’re not used to cooking, no worries, it takes time to develop this habit, and I suggest starting small, like making one batch meal on Sundays. You may find you actually enjoy the time you spend and many find that cooking helps reduce and minimize stress too. How would you benefit from eating fewer ultra-processed foods? It’s something to think about.

Anne-Marie Stelluti, RD

First published in the Inside Tract® newsletter issue 212 – 2019

Image: pixabay. com | igorovsyannykov

1. Moubarac J-C. et al. Consumption of ultra-processed foods predicts diet quality in Canada. Appetite. 2017; 108: 512-520.
2. Martinez Steele E. et al. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open. 2016; 6.
3. PAHO. Ultra-processed food and drink products in Latin America: Trends, impact on obesity, policy implications. Washington, D.C.L Pan American Health Organization. 2015.
4. Ricker, M. et al. Anti-Inflammatory Diet in Clinical Practice: A Review. Nutrition in Clinical Practice. 2017; 32: 318-325.
5. WHO. Guideline: Sugars intake for adults and children. 2015.