Ultra-processed foods (UPFs) with their brightly coloured packaging, tempting price tags and convenience have become a staple in many UK households, but there is growing evidence linking these foods to serious health risks, ranging from obesity and heart disease to cancer.
These foods are concerning because they are richly processed and often contain few ‘natural’ ingredients. Common examples of UPFs include sausages, carbonated drinks, crisps, ice-cream and biscuits, all of which are rarely considered nutritious. But UPFs can also appear innocuous and be marketed as ‘healthy’, leading people to consume them without questioning whether they may be harmful in the long term. These include mass-produced bread, some breakfast cereals, instant soup and fruit-flavoured yoghurts that often have extra ingredients added during production, including emulsifiers, sweeteners and artificial flavours and colours.
Public health nutritionist and director of First Steps Nutrition Trust Dr Vicky Sibson warns that the consumption of UPFs is higher in the UK than other countries. In the UK, 61 per cent of the total mean energy intake of two- to five-year-olds comes from UPFs, compared with 58 per cent in the USA, 47 per cent in Australia and only 18 per cent in Colombia. ‘We are all beholden to what’s available in our shops and public services, and unfortunately the UK retail offer has become dominated by UPF,’ she says.
WHAT ARE UPFs?
The term ‘ultra-processed foods’ comes from the NOVA Food Classification System, developed by researchers at the University of São Paulo in Brazil. NOVA defines UPFs as ‘formulations of ingredients, most of exclusive industrial use, that result from a series of industrial processes, many requiring sophisticated equipment and technology’.
Sibson explains, ‘A simple way of looking at it is that UPFs are typically packaged foods made in factories, usually comprised of a long list of ingredients including those that you wouldn’t usually find in your kitchen cupboard. They don’t resemble the real foods the ingredients come from.
‘Most of the time, UPFs are also high in fat, salt and sugar, but packaged products that are low-fat, low-sugar, etc. are much of the time UPF too – think coke and diet coke.’
She cautions that the NOVA classification was not created for individual foods, and not all UPFs are equal or ‘bad’. Formula milk is a special case; it is ultra-processed but also nutritious and legally has to meet a strict set of nutrition composition requirements. However, growing-up and toddler milks are not regulated.
THE CONCERNS
More research is needed to understand exactly why UPFs are bad for our health, but studies have found that eating higher amounts of UPFs is linked to a greater risk of:
- high blood pressure
- heart attacks and strokes
- cardiovascular disease
- obesity.
‘The available evidence is nearly entirely epidemiological, so it’s about diets and health at population level,’ explains Sibson. ‘This evidence strongly suggests that diets that contain a lot of UPF are linked to non-communicable diseases. The evidence is strongest for an association between UPF-rich diets and obesity or adiposity [body fat] measures in children. This is concerning, as infants and young children who gain weight too fast are also more likely to carry excess weight into their adolescent and adult life.’
She says there are likely to be a range of factors that make UPFs unhealthy, including them acting as vectors for fat, salt and sugar, their displacement of healthier, less processed foods, disruption of the gut microbiome and increasing energy intake.
‘A small number of experimental studies indicate that UPFs drive overconsumption, and the reason seems to be ease of eating – UPF is softer – and taste: UPF is designed to be “hyperpalatable”,’ she adds.
HOW ARE CHILDREN AFFECTED?
Along with the long-term health dangers, consuming high levels of UPFs can potentially affect a child’s relationship with food. ‘Especially in early childhood, “real”, minimally processed nutritious food is important because as well as getting the nutrients they need to grow, develop and stay healthy, babies and young children need to learn to chew and swallow and develop the muscles and physical capacity to eat,’ says Sibson.
‘They also need to learn the taste of “real” foods and to develop healthy preferences.’ She emphasises that this does not mean all meals must be prepared from scratch, but that there needs to be a balance. ‘It needs to be better understood that packaged foods are on the whole not equivalent to home-prepared foods, and a diet based on real, nutritious, minimally processed foods and drinks is especially important in the early years,’ she says.
WHAT SHOULD PROVIDERS DO?
‘Flip the concept on its head,’ advises Sibson. ‘A healthy diet is one with few UPFs, and that means being based largely on nutritious, unprocessed and minimally processed foods.
‘Make the majority of your meals and snacks from scratch, using plenty of whole vegetables and fruits; minimally processed carbohydrates like potatoes, pasta, rice; minimally processed protein from meat, fish, eggs, pulses; appropriate servings of dairy source foods, etc.
‘Serve only water or milk to drink, and facilitate continued breastfeeding for your babies and toddlers for as long as their mums want to. Doing this means you will automatically end up limiting any UPFs on the menu.’
CASE STUDY: Orchard Trees Day Nursery, Thorganby, York
‘I was shocked when I started reading about UPFs,’ says director Lindsay Oates. ‘The number of foods marketed as healthy but are actually not really surprised me. We bought yoghurts, but I realised that, although they contain calcium, they also contain nearly half of children’s daily amount of sugar and other ingredients I didn’t recognise. It’s these added ingredients that are worrying because we don’t yet know what they are doing to our bodies.
‘Another problem with heavily processed foods is they lack flavour, and we want the children to be exposed to lots of different flavours.
‘We already cooked from scratch as much as possible, including our own puddings, where we try to use natural sweeteners, such as dried fruits and honey. But my research made me re-evaluate our menus and cut UPFs right down. Simple swaps include using full-fat natural yoghurt and adding fruit – fresh fruit, our compote or stewed apples. Instead of margarine we use real butter and make our own hummus and flatbreads. We have our own sourdough starter that we’ve named Mabel, and bake bread with the children.
‘We’re double checking all the ingredients on our menus and trying to eliminate UPFs. My advice is to start with the simple things like yoghurt or butter and make a swap. Then look at menus and question the ingredients. Instead of using a stock cube, can you use fresh herbs to flavour the food?
‘It’s all about reducing our intake of UPFs and trusting nature to provide us with the nutrients our bodies need.’
FURTHER INFORMATION
- NOVA food classification
- First Steps Nutrition Trusts
- DFE menu guidance
- Food for Life’s Cook and Share: https://bit.ly/4eCQKfd
