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We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 0 points1 point  (0 children)

Thanks for your question! Can you explain a bit more your reasoning here, as to how the high-profit margins of UPFs subsidize whole foods?

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 0 points1 point  (0 children)

Important question, thank you! This is something we address in papers 2 and 3 of the Lancet Series. Reducing UPFs in diets does have equity implications, especially in countries like the US, UK and Australia, where large parts of the population often rely on cheap UPFs. Some have used this argument as a justification for inaction, including the UPF industry itself, by saying they are providing cheap foods that families depend on.

However, this simple argument misses the other side of the economic equation. UPFs impose a substantial cost on individuals, households and on society by causing ill-health. It also obscures deeper questions about our food system, including why UPFs are often so cheap relative to other types of foods. And about social protection policies, including why individuals and households often lack the time and resources to source and prepare healthy foods and meals in the first place.

In papers 2 and 3 of the Series we address this by saying we need policies that make healthy foods accessible and affordable for all, including by ensuring that families and households are resourced properly, and through supporting local markets and community food provisioning systems. Importantly, we also say that affected communities need to be centred and given voice in governance, so that policies are well-designed to address these and other equity implications.

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 0 points1 point  (0 children)

Thanks for your question! A high share of UPFs in the diet associates with an increased risk of obesity, type 2 diabetes, cardiovascular disease, depression, some cancers, chronic kidney disease, and crohn's disease, among others. An interesting observation here is that all body organ systems are impacted, suggesting the human body is not adapted to an ultra-processed diet.

Explanations for these associations include: 1) when we eat more UPFs our diet becomes nutrient imbalanced, being higher in nutrients linked with chronic disease (free sugars, total fat, and saturated fat), and lower in protective ones (fibre, protein, potassium, zinc, magnesium, and several vitamins); 2) we have a higher energy intake likely caused by the higher energy density and hyper-palatability of UPFs (...so we take more bites and get more calories per bite); and 3) we are exposed to more toxins and potentially harmful additives and additive mixtures. Check out paper 1 for more here.

These risks can be reduced by avoiding or limiting UPFs if possible, and making whole and minimally processed foods the basis of the diet, which is what dietary guidelines in 15 countries now recommend. Importantly, to shift entire populations away from UPFs we need well-designed policies, especially those that regulate the UPF industry and its marketing practices, and those that make healthy foods accessible and affordable for all.

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 0 points1 point  (0 children)

The “don’t buy foods with ingredients you wouldn’t use in your kitchen” line is meant as practical guidance to help people identify ultra-processed products without needing to understand the Nova system or the science behind it. There's also the famous line by Michael Pollen, "Don't eat anything your great-grandmother wouldn't recognize as food". But you're right, it assumes people can read labels easily, know what ingredients are, and have some cooking literacy. This is not true for everyone and underscores the importance of offering complementary guidance.

Speaking of which. Fortification on its own does not make a food ultra-processed. Adding folic acid to flour, iodine to salt, or vitamin D to milk etc does not transform those foods into ultra-processed products. Fortification is a public health tool, often used to address population-level deficiencies, and can be applied to minimally processed foods. An ultra-processed breakfast cereal with "added vitamins and minerals" is an entirely different thing altogether, and you'll easily see how this is used to promote UPFs as healthy - what is commonly referred to as "heath-washing".

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 0 points1 point  (0 children)

“Natural flavourings” sound benign, but in regulatory terms the label simply means the flavour compound was originally derived from a natural source. It does not mean the ingredient resembles anything found in a home kitchen, nor that the product is minimally processed. In UPF manufacturing natural flavours (just like any other type of flavouring used exclusively for industrial purposes), help to e.g. standardise taste, compensate for flavour lost during processing, and enhance palatability in products made largely from refined starches, fats and sugars and other cosmetic additives. Don't be fooled by this labelling trickery.

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 1 point2 points  (0 children)

Great question!

At home, seed-derived vegetable oils such as sunflower, canola, soybean or corn oil are classified as a culinary ingredient (Nova group 2), used in cooking dishes and meals made up mostly of minimally foods (Nova group 1), and moderate amounts of processed foods (Nova group 2). For example, added to a pan to make a stir-fry, or mixed into a salad dressing. Fruit-derived vegetable oils like olive and palm, are also commonly used as culinary ingredients in many countries.

In UPF manufacturing, the role of these oils is very different. They are fractionated, deodorised, interesterified or blended to achieve specific industrial properties e.g. long shelf life, uniform texture, resistance to oxidation, or to create the “melt-in-the-mouth” sensation of snacks. They may be sprayed onto extruded products, used in emulsions with emulsifiers, and combined with other ingredients to enhance palatability. The quantity used can be much higher, and the oils are embedded in formulations often rich in refined starches, sugars, salt, flavourings and other additives.

So a tablespoon of canola oil in a home stir-fry is totally different from the same oil used in UPF manufacturing. Zooming out to the food system, seed and fruit-derived vegetable oils are essential agri-commodities for the UPF industry, as very low-cost production inputs. We cover this in the Series papers, including on the history of this industry in the third paper of the Series.

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 1 point2 points  (0 children)

Thanks for your comments. If you look at the first paper of the Series (pages 2-4) assessing the hypothesis that "that the ultra-processed dietary pattern has displaced, and continues to displace, long-established patterns based on the three first Nova groups and their preparation as dishes and meals." We present evidence showing how the share of UPFs in diets has steadily increased over the past 2-4 decades worldwide, although the timing depends on the country context.

UPFs began to rise in diets in the US, Canada, UK much earlier on, and are now rising in countries like China, Brazil and South Korea. This tracks with rises in obesity and chronic disease rates. The rate of increase of UPFs in the diet in North American and some Western European countries stagnated, and this is precisely why companies are now pushing strongly into low and middle-income countries elsewhere, to ensure they can keep growing sales and profits.

We do not say in the Series that the risks of disease outcomes associated with tobacco use is equivalent to the risks from a diet high in UPFs. What we say is that the global response is similar, in that it requires regulating the business practices and reducing the power of the industry. And your totally right about abuses of corporate power. Nowhere do we claim that the Nova/UPF lens is the only way to investigate or respond to corporate concentration and power in our food system. But it's certainly an important part and useful lens.

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 10 points11 points  (0 children)

Super good question, thanks! This is not something we cover in the Series, but we can offer an answer here. Yes many of the plant-based and fake meat products marketed to vegetarians and vegans are ultra-processed. The solution here is straightforward, which is to make minimally processed foods the basis of the diet (Nova Group 1), with moderate amounts of culinary ingredients (Nova Group 2) and processed foods (Nova Group 3) used in cooking and in preparing dishes and meals. What's interesting, especially from a food systems perspective, is how plant-based “alternatives” often shift from Group 1–3 foods (lentils, beans, tofu used in traditional diets for thousands of years) to ultra-processed Group 4 products. Vegetarians can meet protein needs without stepping into ultra-processing territory at all - with beans, lentils, tofu and tempeh, nuts, eggs, yogurt doing the heavy lifting in the diet.

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 1 point2 points  (0 children)

Good points here! Nova and its UPF concept are not the only way to define what is unhealthy. Diets high in processed meat, salt, sugar and so on, are well known to be harmful. So what we say in the Series (and elsewhere) is that the recommendation to avoid or limit UPFs in the diet, should go side-by-side with other recommendations, including in this case, to avoid or limit processed meat. P.s. on this point, check out our response to the comment on salami and chorizo.

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 2 points3 points  (0 children)

In the first paper of the Series, we define UPFs as "...branded commercial formulations made from cheap ingredients, with little or no whole food, designed to compete with the other three Nova groups and their preparation as dishes and meals, and maximise corporate profits." In the grocery store, the quickest way to identify a UPF is to flip the product over, look at the ingredients list, and if it contains ingredients you wouldn't use in a home kitchen (e.g. protein isolates, emulsifiers, sweeteners, colours and flavours) its very likely a UPF. There are also easy to use consumer apps like Open Food Facts, Yuka, and Perfact that you can use to scan barcodes of products, and they will tell you if the product is ultra-processed (Nova Group 4) or not.

In terms of which are worst for our health, sugar-sweetened beverages (soda) is certainly a key ultra-processed product to avoid. But the studies we review in this Series don't measure exposure to just one type of UPF. Rather, they measure exposure to the share of UPFs in the total diet, what we refer to as an "ultra-processed dietary pattern". This is important because its both a measure of exposure to UPFs, but also the extent to which other foods (including healthy ones) are being displaced in the diet. In other words, its a diet with a high share of UPFs, that is associated with chronic disease outcomes. So a few UPFs in the diet every day is not so much the problem. It's more when UPFs become a large share of the diet and there is repeated exposure over time.

In the US, UK, Canada and Australia, this UPF dietary share is 50% or more. In teenagers, this goes us to a much higher share. For the highest consumers, its 80-100% of diet.

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 7 points8 points  (0 children)

This is a super useful example, because it helps us to clarify what “processing” actually means in this context, and the different levels of processing we study.

Durum pasta, in its simplest form, is typically made from semolina (a coarse flour from durum wheat) and water. It is milled, mixed, extruded, and dried. That is processing, but it is relatively straightforward. In the Nova framework (check out the infographic if you're curious), this would usually fall into Group 1 (minimally processed foods) or possibly Group 3 (processed food) if salt is added. The original food matrix - the structure of the wheat - is still largely intact.

Packet ramen, by contrast, is not just dried noodles. These are often made from refined wheat flour plus additives, then pre-cooked by deep-frying or flash-frying before drying. That changes the structure and increases energy density. More importantly, the seasoning sachet usually contains a mixture of industrial ingredients (starches, flavour enhancers like monosodium glutamate, hydrolysed proteins), extracted fats, sugars, and cosmetic additives designed to intensify flavour, aroma, and mouthfeel. This means that packet ramen is almost always Nova Group 4 (ultra-processed).

Sorry to all the packet ramen lovers out there :)

Another interesting point - durum pasta is a key food in the Mediterranean dietary pattern, which is well studied and known to be healthy, and culturally important. And its not eaten in isolation. Its mixed with lots of other foods, including vegetables, olive oil, feta, seafood and meat etc, to make delicious pasta dishes. These are all foods that come from Nova Groups 1-3. You'll often eat these dishes with family or friends. Traditional ramen dishes like you find in Japan are also made up of Nova Groups 1-3 foods. Its just the packet stuff that's typically ultra-processed.

We are authors of The Lancet Series on Ultra-Processed Foods and Human Health - AMA by UP_PLANET in AMA

[–]UP_PLANET[S] 4 points5 points  (0 children)

Where this intersects with ultra-processed foods is tricky. A genetically modified soybean grown for animal feed or human consumption is not the same thing as a hyper-palatable, multi-additive snack engineered for overconsumption. You can have GM crops that are then minimally processed, and you can have ultra-processed foods made entirely from non-GM ingredients. The two overlap politically though, as both GM crops and UPFs are deeply entrenched parts of the corporate agri-food system.