Strawberry yogurt, potato chips, fortified water, soda, frozen meals, cookies, infant formula and sliced wheat bread.
What do these products have in common? According to a public health movement that’s sweeping the globe, they are all “ultra-processed.”[i] Some public health nutrition advocates are using this terminology to judge a food or beverage’s impact on health – arguing that it’s the processing aids and methods (versus nutrient composition) contributing to obesity and disease. What exactly makes a food “ultra-processed?” It’s complicated – certain processes or ingredients that can’t be found in your grandmother’s kitchen intended to enhance the palatability and acceptability of foods (like carbonation or added whey protein, for example) land many common and even nutritious foods in this category, making it difficult to determine what foods meet this definition.[i]
We’ll tell you everything you need to know about this emerging trend, from the new policy realities it’s creating to why the food and beverage sector may need to rethink its approach to product reformulation, innovation and corporate social responsibility efforts.[i],[ii]
How Did We Get Here?
The notion of ultra-processed foods originated in Brazil in 2009, when Dr. Carlos Monteiro, Professor of Nutrition and Public Health at the University of Sao Paulo, Brazil, created the NOVA system.[iii] NOVA defines ultra-processed foods as “cheap industrial sources of energy and nutrients, plus additives, using a series of processes.”[i] Five years later, Brazil’s dietary guidelines adopted this idea, encouraging Brazilians to “avoid ultra-processed foods.”[iv] Since then, other countries like Uruguay, Canada and France have followed Brazil’s lead, with more to come. [v],[vi],[vii],[viii] Dietary guidelines recommendations like these lead to restrictions around ultra-processed foods and beverages through front-of-package warning labels, marketing restrictions and other policies.1, [ix],[x]
The science supporting recommendations to limit processed food consumption is still evolving and controversial. Studies in Brazil, Spain, New Zealand and the UK, largely observational in nature, have found associations between ultra-processed foods and obesity, metabolic syndrome, hypertension and cardiovascular disease.[i] Very recently, the first randomized controlled trial on the subject was published by the U.S. National Institutes of Health (NIH)—it too found these foods may cause weight gain.[xi],[xii] Critics, however, have pointed out significant limitations in these studies, including small sample sizes, the inability to distinguish the effect of high caloric content versus that from processing, inconsistent definitions of processing and not controlling for affordability. Some contend the focus on processing is flawed because it fails to acknowledge the role processed foods can play to promote health and provide affordable, accessible and practical options.[xiii],[xiv]
5 Potential Impacts on the Global Food & Beverage Marketplace
Bottom Line: While controversial, efforts to denigrate ultra-processed foods are gaining steam and changing the global public health landscape through communications and policy actions. The food and beverage sector should keep close watch on global developments and develop nutrition affairs strategies to productively contribute to the dialogue.
[i]Monteiro CA, et a. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr. 2018; 21: 5-17. doi: 10.1017/S1368980017000234.
[ii] Recent guidance from Santé publique France included advice to minimize consumption of “ultra-processed foods.” (Santé publique France présente les nouvelles recommendations sur l’alimentation, l’activité physique et la sédentarité. Santé publique France. 2019. Accessed at: https://www.santepubliquefrance.fr/Accueil-Presse/Tous-les-communiques/Sante-publique-France-presente-les-nouvelles-recommandations-sur-l-alimentation-l-activite-physique-et-la-sedentarite.)
[iii] Monteiro CA, et al. A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica. 2010; 26(11):2039-2049. doi: 10.1590/S0102-311X2010001100005.
[iv] Dietary Guidelines for the Brazilian Population. 2015. Accessed at: http://bvsms.saude.gov.br/bvs/publicacoes/dietary_guidelines_brazilian_population.pdf
[v] The new Canada Food Guide includes recommendations to limit intake of “highly processed” foods and beverages. (Canada’s food guide. Government of Canada. 2019. Accessed at: https://food-guide.canada.ca/en/.)
[vi] Recent guidance from Santé publique France included advice to minimize consumption of “ultra-processed foods.” (Santé publique France présente les nouvelles recommendations sur l’alimentation, l’activité physique et la sédentarité. Santé publique France. 2019. Accessed at: https://www.santepubliquefrance.fr/Accueil-Presse/Tous-les-communiques/Sante-publique-France-presente-les-nouvelles-recommandations-sur-l-alimentation-l-activite-physique-et-la-sedentarite.)
[vii] Food-based dietary guidelines for the population of Uruguay. 2016. Access at: http://www.fao.org/nutrition/education/food-based-dietary-guidelines/regions/countries/uruguay/en/
[viii] Pan-American Health Organization Nutrient Profile Model. 2016. Accessed at: https://www.paho.org/hq/index.php?option=com_content&view=article&id=11662:paho-nutrient-profile-model&Itemid=41739&lang=en
[ix] Decree no. 272/2018. Uruguay Ministry of Health. 2018. Accessed at: https://medios.presidencia.gub.uy/legal/2018/decretos/08/cons_min_705.pdf.
[x] Allemandi L, et al. Food advertising on Argentinean television: are ultra-processed foods in the lead? Public Health Nutr. 2018; 21:238-246. doi: 10.1017/S1368980017001446.
[xii] Researchers found the consumption of “ultra-processed” foods causes increased calorie intake and weight gain. (Hall KD, et al. Ultra-processed diets cause excess calorie intake and weight gain: An inpatient randomized controlled trial of ad libitum food intake. Cell Metab. 2019. doi: 10.1016/j.cmet.2019.05.008.)
[xiii] Gibney MJ. Ultra-processed foods: Definitions and policy issues. Curr Dev Nutr. 2018; 3(2). doi: 10.1093/cdn/nzy077
[xiv] Miller Jones J. Food processing: criteria for dietary guidance and public health? Proc Nutr Soc. 2019; 78(1): 4-18. doi: 10.1017/S0029665118002513.
[xv] U.S. Department of Health and Human Services. Food and Drug Administration. Code of Federal Regulations Title 21. 2018. Accessed at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=101.65.
[xvi] U.S. Department of Health and Human Services. Food and Drug Administration. Use of the term “healthy” in the labeling of human food products: Guidance for industry. 2016. Accessed at: https://www.fda.gov/media/100520/download.
[xvii] This survey was designed by FoodMinds Strategic Insights and fielded by SMS Research Advisors, a division of Padilla, in 2019.
[xviii] Federal University of Paraná warning label proposal to Anvisa. 2017. Accessed at: https://idec.org.br/noticia/idec-apresenta-novo-modelo-de-rotulagem-nutricional-anvisa
[xix] Access to Nutrition Index. Global index 2018. 2018. Accessed at: https://www.accesstonutrition.org/sites/gl18.atnindex.org/files/resources/atni_report_global_index_2018.pdf.