Ultra-Processed Foods (Part 1)

**Michael Greger** (0:00)
Doesn't it seem like when it comes to nutrition there are more opinions than facts to go around? Every day we hear new theories about diets and supplements and the best foods to eat. Well, my role is to take the mystery out of good nutrition and look at the science. Welcome to the Nutrition Facts Podcast. I'm your host, Dr. Michael Greger.
Ideally we should try to center our diets around healthy, unprocessed plant foods, but in today's world most of what fills the grocery carts isn't just processed, but ultra-processed, which is good for shelf life, but not necessarily our life. Let's take a closer look.
Modern nutrition science began about a century ago in the context of nutrient deficiency diseases. Editorials in the Journal of the American Medical Association had titles like Sugar as Food. Heralding sugar is one of the cheapest sources of calories. For six cents, you could buy 3,000 calories. But the nutrient deficiency era gave way to the dietary excess era. No longer were we dying of nutrient deficiency diseases like scurvy, as much as we were dying from nutrient excess diseases like obesity and heart disease. So nutrition scientists became more about avoiding too many calories, too much sugar, too much sodium, while still focused on nutrients. This allowed food companies to get away with whipping out fiber-fortified fruit loops. But food, not nutrients, is the fundamental unit of nutrition. And to its credit, the field of nutrition started moving towards a more holistic view. First-generation dietary guidelines emphasized individual nutrients, then moved to second-generation food-based dietary guidelines, which largely converged on encouraging diets rich in vegetables, fruits, legumes, beans, split peas, tuna peas, lentils, whole grains, and nuts. But an area of emerging importance is the degree of food processing. National nutrition guidelines first told us to cut down on saturated fat, alcohol, cholesterol, salt, and sugar. Then they started actually naming names, suggesting citizens might want to cut down on cake, for example. So, from nutrients to foods, and more recently countries recommending limiting processed foods. This was the bombshell that really started the momentum commentary in the journal Public Health Nutrition in 2009 by Carlos Monteiro, nutrition professor at the University of São Paulo.
Maybe the issue with nutrition and health is not so much the food nor the nutrients as much as the level of processing. For example, food-based dietary guidelines might tell us to eat more vegetable soup. Great, but there is vegetable soup, then there is vegetable soup. Maybe we could talk about cleaning out your fridge vegetable soup. Health-haloed organic quinoa and kale soup with a heart-stopping 1200 mg of sodium per can. How about a vegetable soup that has more salt than it has vegetables? Or a vegetable-flavored soup that contains more artificial flavors and MSG than it has vegetables?
Just like there's breakfast cereal and then there's breakfast cereal. Professor Monteiro and colleagues proposed the NOVA food classification system. NOVA is not an acronym. It means new in Portuguese, as in a new way to classify foods, based on the level of processing. NOVA classifies all foods and food products into four groups. Group 1 foods are unprocessed or minimally processed, like fresh, dried, frozen, or cooked plants or animal parts, with nothing bad added, like salt or sugar.
Group 2 foods are the salt, sugar, and fats used in cooking, and group 3 includes traditionally processed foods, like when you add group 2 ingredients to group 1 foods. But what really put NOVA on the map is group 4, its concept of ultra-processed foods. These are industrial formulations of several ingredients, which, besides salt, sugar, oils, and fats, include food substances not used in culinary preparations, like added flavors, colors, artificial sweeteners, emulsifiers, other additives used to imitate real foods, like a frosted grape pop tart that has more grapes on the front of the box than inside it, with less grapes than salt, but may artificially taste like grapes and look like grapes because of one, two, three, four, five different food dyes. Simply put, ultra-processed foods are foods that can't be made in home kitchens because they have been chemically or physically transformed using industrial processes. They typically contain little to no whole foods, are ready to consume, are heat up, and are fatty, salty, or sugary, and depleted in dietary fiber and other nutrients, like all the sweet, fatty, or salty snacks like potato chips, ice cream, soda, candy, french fries, burgers, hot dogs, chicken nuggets, fish sticks, basically almost everything in a box or a bag. Why not just call them packaged foods? Well, they were thinking about it, but were afraid consumers might look at a bag of apples or something and get confused. Before the NOVA classification system was introduced, the issue of food processing was largely ignored or minimized in education and outreach as well as in public health policy. But, NOVA exploded onto the stage, resulting in a super NOVA in the world of nutrition.