Ultra-processed foods: how bad are they for your health? – British Heart Foundation

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Our Senior Dietitian reveals what ultra-processed foods are, how they can affect your health, and simple ways to avoid them.
More than half of the energy (calories) an average person in the UK eats and drinks comes from ultra-processed foods. That’s perhaps not surprising as they can be convenient, appealing, and are heavily marketed to us. But researchers have shown that ultra-processed foods can impact our health. So, what are ultra-processed foods and how can we avoid them?
The term ‘ultra-processed foods’ comes from the NOVA food classification system, which was developed by researchers at the University of São Paulo, Brazil.
The system places food into four categories based on how much they have been processed during their production:
1. Unprocessed or minimally processed foods
This includes produce such as fruit, vegetables, milk, fish, pulses, eggs, nuts and seeds that have no added ingredients and have been little altered from their natural state.
2. Processed ingredients
This includes foods that are added to other foods rather than eaten by themselves, such as salt, sugar and oils.
3. Processed foods
These are foods that are made by combining foods from groups 1 and 2, which are altered in a way that home cooks could do themselves. They include foods such as jam, pickles, tinned fruit and vegetables, homemade breads and cheeses.
4. Ultra-processed foods
Ultra-processed foods typically have five or more ingredients. They tend to include many additives and ingredients that are not typically used in home cooking, such as preservatives, emulsifiers, sweeteners, and artificial colours and flavours. These foods generally have a long shelf life.
Examples of ultra-processed foods include ice cream, ham, sausages, crisps, mass-produced bread, breakfast cereals, biscuits, carbonated drinks, fruit-flavoured yogurts, instant soups, and some alcoholic drinks including whisky, gin, and rum. 
Ultra-processed foods often contain high levels of saturated fat, salt and sugar and when we eat them, we leave less room in our diets for more nutritious foods. It’s also been suggested that the additives in these foods could be responsible for negative health effects.
The actual processing of the food could also make a difference to how our bodies respond to it. Studies have shown, for example, that when foods such as nuts are eaten whole the body absorbs less of the fat than when the nut is ground down and the oils are released. Another new theory is that diets higher in ultra-processed foods could also affect our gut health.
More research is needed to separate these different elements and understand exactly what about ultra-processed foods could be bad for our health: is it one of these elements or is it their combination?
Currently, it’s also hard to know whether it is something within the foods that is the issue or whether eating a diet high in these foods suggests an overall lifestyle that is linked to poorer health. However, given the high salt, sugar, and saturated fat content of most of these foods, cutting down does seem sensible.
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When you think of ultra-processed foods, you might think of chips, sweets, and colourful sugary drinks, but there are some less obvious examples. Everyday items such as breakfast cereals and mass-produced or packaged bread can be considered ultra-processed foods. This is because they often have extra ingredients added during production, such as emulsifiers, sweeteners, and artificial colours and flavours.
One of the criticisms of the NOVA method of categorising foods is that foods like these, which can be part of a healthy diet, sit alongside less nutritious ultra-processed foods. Less nutritious ultra-processed foods can include pre-prepared meals, sausages and nuggets, as well as sweets, biscuits, pastries, buns, cakes and pre-prepared chips.
Plant-based meat and cheese substitutes are also ultra-processed, and so might not be as healthy as they are marketed to be. Despite the problems with lumping different types of food together under the umbrella term ultra-processed, the NOVA system is still widely used in research. While there are pros and cons to using it, it’s helped establish a link between diets high in these foods and worse health.
It might sound like we should go back to eating only foods that are minimally processed, but with restricted time and budget, this isn’t an option for most of us. As we don’t know yet how ultra-processed foods affect our health, it’s also not clear that it’s necessary to completely exclude them.
Instead of trying to completely cut out these foods, think about the balance in your diet. Make sure that there are minimally processed foods in there too – eat fruit and vegetables with your meals and drink water instead of sugary drinks – and try to fit in time over the week for home cooking.
It’s also important to remember that not all ultra-processed foods are equal. When you do include ultra-processed foods in your diet, choose those with more nutritional benefit – wholegrain bread and cereals or baked beans for example, instead of crisps, sweets or pizzas. Get in the habit of reading food labels so you can easily identify and cut back on foods that are high in sugar, salt, or saturated fat.
Eating a lot of processed foods leaves less room for healthier foods like fruit and vegetables, fish, unsaturated oils, pulses and nuts and seeds. So, if you want to change your diet, try to make some swaps, such as:
Let us know how you got on or any tips you might have cutting back on ultra-processed foods. Email your thoughts and any photos for a chance to be featured in the next magazine.
Several studies have shown links between eating higher amounts of ultra-processed foods and the risk of cardiovascular disease and death – and that the more you eat, the greater the risk.
Two studies on ultra-processed foods were published in the British Medical Journal in 2019; one following 105,159 people in France, and another following 19,899 university graduates in Spain.
Both studies collected detailed information about the foods people ate at the start of the study. Participants in the French study also provided information about their diet on other occasions in the next two years. Participants were split into four groups according to their consumption of ultra-processed foods.
In the Spanish study, the group eating the fewest ultra-processed foods ate less than two servings per day, and the group eating the most ate more than four servings per day. People in the group eating the most ultra-processed foods were 62 per cent more likely to have died after an average of 10.4 years than people in the low consumption group.
In the French study, participants were classed according to the percentage of their daily diet that came from ultra-processed foods. This ranged from an average of 7.5 per cent for the lowest consumers to 30.8 per cent for the highest. After an average of 5.2 years, each 10 per cent increase in the intake of ultra-processed foods was linked to a 12 per cent increase in cases of heart and circulatory disease.
Both studies were observational, meaning they can only find associations between factors. They can’t prove that ultra-processed foods were the direct cause of increased heart and circulatory disease and death; it’s possible that other factors could be responsible for the association.
In both studies, the researchers found the same increased risks after taking into consideration other aspects of people’s diets, such as their saturated fat, salt and sugar intake. This suggests the results may not only be down to the higher fat, salt and sugar levels often found in ultra-processed foods.
BHF Senior Dietitian Victoria Taylor said: “It’s important to remember that observational studies like these can only show an association. They cannot tell us what is behind this. The classification of ultra-processed foods used by the researchers is very broad and so there could be a number of reasons why these foods are being linked to increased risk to our health, for example nutritional content, additives in food or other factors in a person’s life. Before we consider making any changes to advice or policy it is important to understand this thoroughly.”
“We already recommend people adopt a Mediterranean-style diet, which includes plenty of minimally or unprocessed foods such as fruit, vegetables, fish, nuts and seeds, beans, lentils and wholegrains. This, along with exercising regularly and not smoking, has been shown to be beneficial for lowering risk of heart and circulatory disease.”
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Updated May 2023
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