How do we differentiate not demonise – Is there a role for healthier processed foods in an age of food insecurity? Proceedings of a roundtable event

Abstract

The ‘ultra‐processed food’ (UPF) concept, with classification of foods by ‘level of processing’ rather than nutrient profiles, and its relationship with health outcomes, is currently a topic of debate among academics and increasingly referred to in the media. The British Nutrition Foundation convened a virtual roundtable on 6th July 2022 to gather views on the use of the term (and current definitions of) UPF for public health messaging, seeking to establish areas of consensus and disagreement and identify topics for further research. A small group of invited expert stakeholders attended, including representatives from academia, policy, behavioural science, communications, health, food science, retail and consumer interests. Participants' discussions clustered into cogent themes which included: problems with the use of definitions for UPF, the lack of causal evidence and defined mechanisms linking processing per se with poor health outcomes, and advice that may result in consumer confusion. There was agreement that many foods classified as UPF are high in fat, sugars and/or salt and public health messages should continue to focus on reducing these in the diet since it is unclear whether reported associations between high intakes of UPF and poor health reflect poorer dietary patterns (defined by nutrient intakes), and nutrient‐health relationships are well established. Examples of misalignment were also highlighted (i.e. some foods are classified as UPF yet recommended in food‐based dietary guidelines [featuring in healthy dietary patterns]). This raises challenges for consumer communication around UPF. Concern was also expressed about potential unintended consequences, particularly for vulnerable groups, where advice to avoid UPF could create stigma and guilt due to lack of time or facilities to prepare and cook meals from scratch. It could also impact on nutrient intakes, as some foods classified as UPF represent more affordable sources of important nutrients (e.g. packaged wholemeal bread). Discordance between the concept of UPF and current strategies to improve public health, such as reformulation, was also discussed. The group concluded that the use of the concept of UPF in UK policy (e.g. dietary guidelines) would be unhelpful at present. Overall, participants felt that it was more important to focus on providing practical advice around selection of healthier processed foods and making healthier foods more accessible rather than promoting the avoidance of UPF. The latter may act to demonise all foods classified as UPF by current definitions, including some affordable nutrient‐dense foods.

The use of food processing terminology in Australian news media: a content analysis

“…Transnational corporations, who stand to lose the most by adoption of the NOVA terminology in public health policy, have been deliberately misusing processing terminology as a means to dispute the evidence and cause confusion, particularly for consumers. For example, some food industry groups have attempted to undermine the increasing evidence base associating UPF with poor health outcomes by referring to group 3 processing and conflating it with ultra-processing techniques ( 35 , 36 ) . Attempts to sow confusion have also been observed among academics with food industry links reporting to the media ( 37 ) .…”

Ultra-processed Food and Obesity: What Is the Evidence?

“…It has been argued that the main determinants of chronic disease risk are captured within existing nutrient profiling models [ 45 ], and current public guidance is sufficient for health [ 46 ]. Indeed, UPFs tend to have higher energy densities and lower nutrient densities than MPFs [ 47 , 48 ], and high-UPF diets are associated with greater intakes of energy, free sugars, fat and saturated fat and lower intakes of fibre, protein and some micronutrients [ 49 ].…”

From dearth to excess: the rise of obesity in an ultra-processed food system

“…The NOVA classification system has been criticized [20][21][22][23][24][25][26][27]. Some critics have argued that the NOVA system is unclearly defined and difficult to implement resulting in substantial discrepancies between different people asked to categorize the same foods according to the NOVA system [28].…”