New research shows that the debate over UPFs is more complex than you might think and suggests that it’s too soon to make blanket recommendations.
New research shows that the debate over UPFs is more complex than you might think and suggests that it’s too soon to make blanket recommendations.
Mentioned in this episode:
Using Less Processed Food to Mimic a Standard American Diet Does Not Improve Nutrient Value
Nutrition Diva is hosted by Monica Reinagel, MS, LDN. Transcripts are available at Simplecast.
Hello, and welcome back to the Nutrition Diva podcast! I’m your host, Monica Reinagel, and today we are revisiting a hot topic that we’ve talked about before—ultra-processed foods, or UPFs.
Last Spring, in episode #735, USDA researcher Dr. Julie Hess joined me on the podcast to talk about a provocative study she and her team had just published, demonstrating that it’s actually possible to create a healthy diet that relies almost entirely on ultra-processed foods. In fact, the 7-day meal plan that Hess and her team developed rated significantly higher than the average American diet on the Health Eating Index score. While the typical diet rates a dispiriting 43 out of 100, Hess’ UPF diet scored an impressive 86.
I had an opportunity to hear Hess present her latest findings at the annual meeting of the Academy of Nutrition and Dietetics and I know you’ll be interested in what she found. As with her previous research, this latest analysis raises important questions about how we categorize foods and impact of processing on nutrition and health.
To back up, let me remind you what the NOVA system is. This classification system sorts foods into four categories, based on extent of their processing. As Carlos Monteiro, the chief architect of the NOVA system has written, “The most important factor now, when considering food, nutrition and public health, is not nutrients, and is not foods, so much as what is done to foodstuffs… before they are purchased and consumed”
The assumption appears to be that the more processed a food is, the less healthy it becomes. Although NOVA is not the only system for classifying foods according to their level of processing, it has quickly become the most widely used, especially in nutrition research.
Over the past few years, a slew of studies using the NOVA system have linked consumption of UPFs with everything from obesity to type 2 diabetes to cardiovascular disease. These studies have gotten a lot of media attention and have contributed to a growing perception that ultra-processed foods are a major threat to public health. In fact, one of the big questions that this year’s Dietary Guidelines Advisory Committee has been grappling with is whether to add a recommendation to avoid UPFs to the official Dietary Guidelines that are scheduled to be released in 2025.
To a lot of people, this seems like plain old common sense. But when you really dig into the research, the picture is quite a bit muddier.
One big problem is that nutrition researchers have found it very challenging to interpret the rules for which foods belong in which NOVA categories. As a result, foods may not be consistently categorized from study to study, which obviously muddies the results significantly.
As just one example, a food manufacturermanufacture has the option of listing the seasonings in a product individually on the label (garlic powder, celery salt, etc.) or they can choose to include them all in a single term of “spices.” The option they choose can change the classification of that food. Listed separately, these items are considered culinary ingredients. Described as spices, they are considered additives and would push a food into category 4–or, ultra-processed.
Here’s another example of the ways in which the classifications don’t always make sense: a loaf of 100% whole wheat bread from the store may be considered a Level 4 food in the NOVA. But a loaf of whole wheat bread that you make at home with the same ingredients would not be considered ultra-processed. Is there any meaningful difference in terms of nutrition?
Another nuance that has been largely glossed over in media coverage of the studies linking UPFs to adverse health outcomes is that the so-called “effect size” seen in these analyses is often quite small. While the link may be strong enough to be considered statistically significant, the actual impact on health is often too minor to make a meaningful difference in practical terms.
Another concern that I have about enshrining guidance about UPFs into our dietary policy is the impact on those who may not have the time, money, or other resources required to prepare all their meals from scratch.
For example, a parent juggling work and childcare might rely on a convenient, ready-to-eat cereal that is classified as ultra-processed, but provides essential nutrients like iron, fiber, and folate. Suggesting that such foods should be avoided paints an unrealistic picture of healthy eating and can alienate those who don't have the privilege of spending hours in the kitchen preparing unprocessed meals.
Instead of vilifying all processed foods, we need to offer more inclusive guidance that recognizes that even ultra-processed foods may play a legitimate role inrole in in providing nutrition and convenience, particularly for those balancing tight budgets and busy schedules. This was brilliantly demonstrated by Dr. Hess’ healthy 7-day meal plan based almost entirely on ultra-processed foods.
But that earlier study also begged the question: Is a diet made up of minimally processed foods guaranteed to be healthier? Once again, Dr. Hess is here with the answer.
Hess and her team started with a meal plan that represents a typical Western diet—which, unfortunately, is far from ideal. This representative meal plan had a score of 43 on the Health Eating Index score and got about 70% of its calories from ultra-processed foods.
They then built a new version of that same meal plan replacing as much of the processed food with minimally processed foods as they could. For example, instead of making chili with canned beans (which are considered ultra-processed), they cooked dried beans in a pressure cooker. They replaced the cornbread mix that included preservatives (which put it in the ultra-processed category) with another cornbread mix that didn’t contain any preservatives. They made some ingredients (such as jam) from scratch, in order to avoid additives. In the end, they were able to reduce the amount of ultra-processed foods from 67% of calories to about 20% of calories.
The resulting minimally-processed meal plan wasn’t necessarily any healthier. It had the same HEI score as the original and matched up in terms of calories, protein, carbohydrates, and fats. In other words, simply reducing the amount of ultra processed foods in the diet will not make it any better for you. But it will make it more expensive and time consuming.
Hess’ team calculated the cost and preparation time for their two diet plans and found that, in addition to its lackluster nutrient profile, the minimally processed meal plan cost at least 50% more and required significantly more preparation time than the meal plan composed mostly of UPFs.
Not surprisingly, the minimally processed foods also had a much shorter shelf-life than the processed foods, which raises the question of whether trying to minimize processed foods might have the unintended effect of increasing food waste.
So, what’s the takeaway from all of this? To me, Dr. Hess’s latest project is another cautionary tale about jumping on the anti-UPF bandwagon. Lately, I’ve noticed that journalists and nutrition experts are now pointing to the 'mountain' of studies linking UPFs to health problems. The suggestion seems to be that the sheer volume of research makes this a settled issue. But if these studies are all relying on the same problematic rating system—then we're not really building a stronger case. Instead, we’re simply reinforcing the same biases and assumptions without addressing the obvious problems with the rating system itself.
Meanwhile, the thoughtful and thought-provoking work being done by Hess’ team doesn’t appear to be driven by ideological bias but by a desire to question and test the validity of the assumption that avoiding foods characterized as UPFs in the NOVA system system will make us healthier before we bake it into our food policy and dietary guidelines. And for now, it appears to have been enough to cause the advisory committee to hit the pause button on inserting a new recommendation on UPFs into the next set of dietary guidelines.
This is especially important when we consider the practical realities of daily life. Many people, for various reasons, depend on the convenience, affordability, and accessibility of processed foods. Demonizing these foods, or making blanket recommendations to avoid them, not only oversimplifies the issue but also risks alienating those who may already feel like they can’t afford to eat "healthy."
As Dr. Hess’s previous work illustrated, even diets that include a majority of processed foods can support good health. And as this latest effort shows, both ultra-processed and minimally processed diets can fall short if we don’t pay attention to the overall nutritional profile.
Ultimately, good nutrition isn’t just about whether a food is processed or not—it’s about creating a balanced diet that meets your nutritional needs in a way that fits your lifestyle.
If you have a question you'd like me to answer, you can email me at nutrition@quickanddirtytips.com You can also leave me a message at 443-961-6206
I’d also like to invite you to check out my other podcast. It’s called the Change Academy, where we explore the art and science of creating positive behavior change, both in our own lives, and in our workplaces and communities. You can find it on all the major podcast platforms. Just search for Change Academy.
Nutrition Diva is a Quick and Dirty Tips podcast. Our team includes Brannan Goetschius, Nathan Semes, Davina Tomlin, Holly Hutchings, and Morgan Christianson.and Nathaniel Hoopes.
Thanks to all of them and thanks to you for listening! I'll see you next week.