Defining Ultra-Processed Food

Am I willing to drink dipotassium phosphate in my coffee every morning?

That’s the question I found myself asking recently. NutPods coffee creamer has been a regular resident in my fridge for a couple of years now. The ingredient list is relatively short: 8 ingredients not including water, most of which I stock in my kitchen at home. It’s “Whole30 Approved”, doesn’t have any sugar or artificial sweeteners, and I only add a splash. Harmless, right?

Lately, I’ve been thinking more about ultra-processed foods: how we define them, how they are made, and their purpose in our food system. Mostly I’ve been thinking about whether they are actually food - or not.

Manufactured ingredients in ultra-processed foods are ubiquitous in modern life. We eat them and feed them to our children. It’s hard to go anywhere without someone trying to market us an industrially-produced feat of edible science. Food companies spend billions convincing us that they’re harmless, tasty, and fun. Sometimes they even convince us that they’re GOOD for our health.

But are these relatively new, manufactured ingredients harmless? And if so, what can we do about them?

The Problem with Food Made in a Lab

1. Synthetic food doesn’t align with our biology. The irony is that the age of scientific discovery has not only ushered in synthetic food, but also the knowledge of how our cells work, how we make energy, and how and why chronic inflammation happens. Our bodies expect food grown in nature, within a complex matrix of nutrients. The biggest health problem with eating these ultra-processed food-like substances is that we’re living out of alignment with what our cells expect. The result is:
   • Mitochondrial dysfunction
   • Inflammation
   • The start of a cascade toward disease
2. Food is so much greater than the sum of its parts. A simple spinach leaf contains over 20 different nutrients that we know of - and researchers estimate that there are hundreds of nutritional compounds in spinach we have yet to explore. While our minds do not yet know how a spinach leaf interacts with our biology, our cells do. And they do it beautifully. We can’t replicate that kind of complexity in a lab.
3. For many of these new substances, long-term safety on gut health and chronic disease risk has not been studied. Even if there were a dire need to create food in a lab (maybe on Mars?), these synthetic substances should be THOROUGHLY tested in humans before being added to the food supply, which would be tricky. Who’s willing to volunteer to drink a polysorbate drink for a year to find out if it harms your gut health? Would you do it if you knew that synthetic emulsifiers do harm gut health and promote metabolic disease in mice? Me either.

 Back to My Coffee

A quick online search tells me that the dipotassium phosphate in my coffee creamer is used as an emulsifier to help the ingredients stay mixed. This makes sense since the first two ingredients of my NutPods are water and coconut cream. I’m no food scientist, but I do know that water and oil tend to separate. Emulsifiers are added to food in order to bind the ingredients together and keep them from separating. Eggs and mustard are examples of natural emulsifiers (think mayonnaise and salad dressing). 

Chemical emulsifiers, like dipotassium phosphate, are new substances and some animal model studies suggest that they also emulsify our gut lining, causing leaky gut. The integrity of our gut lining is fundamental to our health, making these synthetic emulsifiers concerning. 

Some of our food additives have been evaluated for cancer risk and birth defect risks (nope - not all of them; that’s a topic for another day). However, we aren’t very good at testing these substances for their long-term chronic disease impacts. We don’t know if they harm our gut lining. And since there are over 10,000 food additives in use today in the U.S. (that’s not a typo), this kind of long-term in-depth testing is not likely to ever happen.

Every time we purchase a “food” with a manufactured ingredient, we’re volunteering to be a test subject to observe the long-term impact of ingesting synthetic food-like substances.

“There are inherent dangers in consuming complex mixtures of novel molecules as a source of calories.”

- Chris van Tulleken in “Ultra-Processed People: Why We Can't Stop Eating Food That Isn't Food”

Back to My Coffee

1. We know that UPF causes weight gain.

   In 2019, Kevin Hall, a researcher set out to answer the question of weight and ultra-processed foods at the National Institutes for Health (NIH) in the first randomized, controlled study of ultra-processed foods. The results were astounding.
   

   A group of 20 participants stayed in the facility for the entire month, allowing researchers to precisely control food quantity and quality and to keep activity stable in each group. Using the NOVA food classification system (described below), participants either ate a whole-food diet or a diet of ultra-processed foods for two weeks, then switched to the other diet. The foods offered to the participants were matched for calories, sugar, salt, and fat, and the participants were allowed to eat as much or as little as they wanted.

   Intriguing, right? So what happened?

   During the 2-week UPF diet, participants ate about 500 more calories per day. They gained an average of two pounds and ate more quickly. During the unprocessed food phase, participants LOST 2 pounds in just two weeks, while eating freely from the unprocessed food. This is stunning.

   I see this all the time.

   I clearly remember a middle-aged couple that I coached about two years ago. The husband had been working with Dr. Hartman for less than 3 months. They had both switched to eating a minimally processed, paleo-like diet. Even though they hadn’t cut back on how much they ate (or so they thought), they avoided refined grains (usually UPF) and other processed foods while eating more vegetables and meat - and they also cooked at home more often.

   The results they experienced surprised and confused them a bit. The husband lost 20 pounds, and the wife 17, noticed their brain fog lifting and were feeling much more energetic. I clearly remember them asking me why I thought these changes had made such a difference. They wondered if they were allergic to something they were eating or if I thought it was such a strange outcome in such a short period of time.

   I told them, “No, it’s not you. It’s the food.” Between the eat less/exercise more diet mentality and ubiquitous food marketing, we have trouble believing that the quality of our food can make such a huge impact on our health.

2. UPF is Linked to Chronic Disease.

   I won’t belabor this point as Dr. Hartman has talked about this on the blog before. He’s stated here that 80% of chronic disease is linked to eating processed food.

   A recent umbrella review from the British Medical Journal linked higher ultra-processed food intake to 32 different health issues.

   No one reading this will be surprised that eating a steady diet of the interior of the grocery store (or fast food restaurants) results in higher rates of disease. However, you MIGHT be surprised at how researchers define ultra-processed foods and what makes the cut.

What IS an Ultra-Processed Food Anyway?

Using the NOVA classification system to define UPF

The NOVA classification is a system developed by researchers at the University of São Paulo in Brazil. It categorizes foods based on the extent and purpose of processing. The purpose of the classification is to help consumers and health professionals understand the impact of food processing on health.

The NOVA system is a helpful framework to cut through the marketing claims that permeate the food industry. A company may claim that its product is healthful for this or that reason, but a quick look at the ingredient list while asking ourselves a few simple questions can cut through the noise to determine the level of processing of the substance we’re about to put into our bodies.

Here are the four main categories of the NOVA classification:

1. Class 1: Unprocessed or Minimally Processed Foods

Foods closest to the way they are found in nature, have undergone minimal processing to preserve them or make them suitable for storage and consumption.

• • Examples: Fresh fruits and vegetables, whole intact grains, legumes, nuts, seeds, fresh meat and fish, eggs, and milk.

2. Class 2: Processed Culinary Ingredients

Items derived from Class 1 foods, used in the kitchen to prepare, season, and cook other foods. These are ingredients that you may cook with and are likely found in your pantry but that you wouldn’t typically eat alone.

• • Examples: Natural oils, butter, sugar, salt, honey, and vinegar

3. Class 3: Processed Foods

Foods that have been modified by adding salt, sugar, oil, or other Class 2 foods to make them more palatable or to extend their shelf life. These foods are made with ingredients from Class 1 and 2.

• • Examples: Canned vegetables and beans, cheeses, freshly made bread (made with a few simple ingredients), smoked meats, pickles, and canned fish

4. Ultra-Processed Foods

Here are the key parts of this definition:

1. 1. Includes ingredients not commonly used in culinary preparations (not in Class I-III above). Hint these are not FOODS at all. These ingredients include flavors (natural or artificial), colors, emulsifiers, preservatives, sweeteners, and other additives.
   2. Often includes more than five ingredients.
   3. Are designed to be convenient, attractive, and highly palatable.

• • Examples: Sugary drinks, packaged snacks, instant noodles, frozen ready meals, breakfast cereals, processed meats (like hot dogs and sausages), and fast food

Perhaps Fernanda Rauber, a researcher from the University of San Paolo in Brazil, who studies the effects of ultra-processed foods said it best: 

 “It’s not food; it’s an industrially-produced edible substance.”

The bottom line: There are foods that are harmful to our health, and the good news is that we can all easily identify them. 

Two simple questions to ask to determine whether a food is ultra-processed:

The NOVA system has received some criticism that its classification is too complicated for the average person to use effectively. Our food system IS complicated these days and there is a need to be precise when using the classification system in epidemiology. 

We, as consumers, can use a simple test, based on their criteria:

1. 1. Looking at the ingredients list, does the item contain ingredients you wouldn’t stock in your pantry or purchase at the grocery store?
   2. Is this item designed to encourage overconsumption? In other words, is it difficult to only eat one serving?

If the answer to either of these questions is yes, then it is likely an ultra-processed food.

What Can You Do to Reduce Your UPF Intake?

With ultra-processed, heavily marketed foods at our every turn, what can we do to eat in a way that supports our biology?

1. 1. Just say no to food marketing (especially health claims).
      There are so many health claims on packaging and in food advertising these days. Ignoring these and focusing on the quality of the food in the ingredient list is key to cutting through the marketing noise.
      
      
   2. Shop the outside of your grocery store or your local farmer’s market.
      
      Focusing on clean vegetables, fruit, meat, beans, nuts, and seeds for most of your food is a great way to organize your shopping for optimal health.
   3. Check out Real Food Diaries!
      If you haven’t seen it yet be sure to watch Dr. Hartman’s free course, Real Food Diaries. In this informative video course, Dr. Hartman shares how eating real food can accelerate your health and help eliminate chronic illnesses. Included in that course is Rebekah Hartman’s video tour of Costco, in which she shows exactly how she reads labels and what she looks for when shopping for her family.
   4. Cook at Home
      Preparing your own food is the only way to truly take control of what’s in it. Cooking is the ultimate expression of self-care for your health and a host of other reasons. Check out my last post on Cooking as Self-Care on the blog.
      
      
   5. Read food labels and ask yourself those questions above.
      If the ingredient list contains items that you wouldn’t want to stock in your pantry, then it’s ultra-processed food. Further, it’s wise to question whether “clean” packaged food will contribute to your health if you know that it’s designed to drive overconsumption and it will be difficult to eat just one serving.
   6. Try the Bobby Approved app
      Looking for a fun way to check out some of the ingredients on your food labels? This app allows you to scan an item to see whether “Bobby” gives it a thumbs up or a thumbs down. I like that it gives some information on ingredients that are not “Bobby approved”. Note that being “Bobby Approved” doesn’t necessarily mean that a food is not UPF, but Bobby has pretty high standards and I think it’s a great tool.

A Better Understanding of Ultra-Processed Food

So, what am I going to do about my coffee? I usually make my own almond milk or use canned coconut milk, but lately, I've been busier and used it as an excuse to take shortcuts. That's why I have a coach to help me think through these small shifts and set goals. I'm not saying I'll never eat anything with an emulsifier again. But today, I'm happy with my decision to take the time to make some almond milk. Every tiny step is a win.

Understanding ultra-processed foods helps us make healthier food choices. The NOVA classification has helped us to distinguish between minimally processed and heavily altered foods. By checking ingredient lists and avoiding heavily marketed products, we can choose options that support our health. Prioritizing whole, natural foods is key. The closer your food is to its natural state, the better it is for your well-being.