A growing evidence base linking ultra-processed foods with poor health outcomes including heart disease, type 2 diabetes, obesity and cancer has led to a number of countries advising their populations to reduce or avoid them.
But a new position statement from the British Nutrition Foundation (BNF) warns that “blanket messaging” to avoid UPF could have unintended consequences and implications for “health equity”.
The statement comes in the same week that the broadcaster and infectious disease doctor Chris van Tulleken published Ultra-Processed People, described as a “shocking” investigation into the highly processed foods that make up over half of the diet of the average Briton.
Ultra-processed food (UPF) is most commonly defined using the NOVA classification system, and is based on the ‘extent’, ‘purpose’ and ‘nature’ of food processing, within national dietary guidelines. BNF points out that classification systems that categorise foods based on the extent of processing are not universally accepted and that NOVA “has been criticised for being too broad across, and within, categories”. To illustrate the catch-all nature of of the NOVA system, BNF says that “a lower sugar wholegrain breakfast cereal with chicory inulin isolate, a high sugar refined breakfast cereal, a multi-seed sliced wholemeal loaf and a white sliced loaf would all be classified as UPF”.
BNF says that while research has shown consistent associations between high intake of UPF and adverse health conditions, this is largely based on observational studies that cannot demonstrate cause and effect. It is calling for further studies to investigate possible mechanisms by which processing or particular ingredients may cause ill health. It points out that food processing encompasses a broad spectrum of processing techniques which impact factors such as food matrix integrity.
BNF also argues that if it is “implied that expensive artisanal products are superior for health, the health equity of advice to limit intake of UPF in the current back-drop of rising food insecurity and the cost of living crisis is also an important consideration”. It warns that “demonising” all processed foods could “foster feelings of guilt and stigma around food choices, adversely impacting intake of more affordable sources of nutrients”.
In the same week that BNF posted its new position statement, the group – which is partially funded by the for industry – issued a press release highlighting increasing concern from the public about ultra-processed foods. The YouGov survey showed that the top five foods that consumers were mostly likely to think of as ultra-processed were: Ready meals (50%); Vegetarian meat alternatives (41%); Shop bought burgers (32%); Packaged breakfast cereals with added sugar (32%); Shop bought sausages (30%). However, fewer people classified baked beans (9%), low-fat fruit yogurts (10%), ice cream (14%), and sliced bread (19%) as ultra-processed.
In a press release issued alongside the statement, Bridget Benelam, a BNF spokesperson said: “For many of us when we get home after a busy day, foods like baked beans, wholemeal toast, fish fingers or ready-made pasta sauces are an affordable way to get a balanced meal on the table quickly. These may be classed as ultra-processed but can still be part of a healthy diet.”
The baked beans distraction
Some commentators have noted that in making this point baked beans have, one again, been called upon to do the heavy lifting (an appetising photo of beans on toast, garnished with parsley accompanied the BNF press release). On Twitter, the author and food policy specialist, Rob Percival, wrote: “The ‘what about baked beans’ question is employed by Industry to shift focus away from the commercial determinants of ill health, away from the power dynamics of the food system, away from the big picture.”