The health risks of ultra-processed foods

According to Christina Roberto, director of the Psychology of Eating and Consumer Health Lab at the University of Pennsylvania's Perelman School of Medicine, foods are typically considered ultra-processed if they include ingredients that wouldn't be found in a home kitchen, such as high-fructose corn syrup and emulsifiers.

Many ultra-processed foods undergo some chemical modification to create other ingredients. For example, soy protein isolate is made from soybeans and the sweetener maltodextrin is made from corn, rice, or other grains. Ultra-processed foods also often include ingredients to enhance the color, flavor, or texture of a food.

These foods now make up a majority of people's diets in the United States. Around 58% of calories consumers by U.S. adults and children ages one and older come from ultra-processed foods, according to an analysis of federal data collected from 2001 and 2018. Among children ages two to 19, this number was even higher, reaching 67% in 2018.

Ashley Gearhardt, a professor of psychology at the University of Michigan, said ultra-processed foods are often high in fat and carbs, which means they have a more potent effect on the brain's reward systems and can be addictive.

Diets high in fat, sugar, and sodium have also been associated with cardiovascular disease and other health conditions. Ultra-processed foods can also contribute to visceral fat forming around the organs and imbalances in the gut microbiome, which has been linked to Type 2 diabetes and obesity.

People who eat a diet high in ultra-processed foods are also more likely to consume more calories and gain weight compared to people who eat a minimally processed diet, according to an influential NIH study. In the study, individuals who ate a majority ultra-processed diet consumed roughly 500 more calories a day and gained around two pounds after two weeks. However, after being on a minimally processed diet, the participants lost two pounds after two weeks.

According to Kevin Hall, an NIH scientist and the study's lead author, people who ate ultra-processed foods had to consume more calories to reach the same level of satisfaction and fullness as they did on the minimally processed diet.

People who want to reduce the intake of ultra-processed foods can add more whole foods, like frozen vegetables, to their diet. Adding unprocessed foods to ultra-processed meals can also make them healthier. For example, people can add fresh broccoli into boxed macaroni and cheese or add plain vegetables to a frozen meal.

Are all ultra-processed foods unhealthy?

Although ultra-processed foods have been linked to certain health risks, not all ultra-processed foods are the same, and some may even be healthy.

According to Lindsey Smith Taillie, an associate professor in the nutrition department at the University of North Carolina Gillings School of Global Public Health, many foods that have labels like "organic," "a good source of whole grain," or "low in sugar" are ultra-processed.

"The more of those you see on a product, the more likely it is to be ultra-processed," Taillie said. "Eggs or milk or plain fruit and vegetables don't carry claims." Foods like whole grain bread, strawberry yogurt, granola bars, meat substitutes like burgers from Beyond Meat, reduced fat peanut butter, and canned soup are all considered to be ultra-processed.

For their part, food companies have pushed back on the belief that their foods are unhealthy, arguing that packaged food is a convenient and affordable way for people to get nutrients. "Attempting to classify processed foods as unhealthy simply because they are processed misleads consumers," said David Chavern, CEO of Consumer Brands Association, a trade group that represents the consumer products industry.

Currently, there is no set definition of what makes certain foods ultra-processed, and researchers are still studying why eating a lot of these foods is associated with health problems. The U.S. government has also asked a scientific advisory committee to consider how diets with varying amounts of ultra-processed foods can influence body composition and obesity risk as new dietary guidelines are being developed. (Petersen, Wall Street Journal, 11/14)

In Advisory Board's annual survey of health system strategic planners, respondents ranked addressing social determinants of health (SDOH) as a top strategic priority for 2024. While increased pressure on health systems to address health equity may drive verbal commitments to SDOH, can we expect real action to follow? Discover the three key reasons why healthcare leaders are shifting how they think about SDOH to treat it as a critical business imperative.