The food supply has changed dramatically over the past 50 years.  While some of these changes have been positive (e.g., improvements to food safety and food security), others have not.  An example of the latter is the widespread availability of ultra-processed food1. What are ultra-processed foods? How has children’s intake of these products changed? What is their impact on health? This month’s blog will answer these and other questions.

What are ultra-processed foods?

The extent to which a food or beverage is processed can be viewed on a continuum.  The term “ultra-processed foods” refers to those foods and beverages that are the result of the highest level of processing and have been defined as:

“Ready-to eat or ready-to-heat commercially-prepared formulations with refined ingredients that contain additives and little to no whole foods”2.

How are ultra-processed foods different from other processed foods?

Ultra-processed foods and beverages are not simply modified by processing, but rather formulated with additives to heighten their appeal and durability. They typically have high amounts of added sugars, saturated fat, sodium, and refined starch, and provide little fiber, protein, vitamins and minerals2.

The NOVA food classification was developed to help differentiate processed foods3. As noted below, foods and beverages are assigned to one of four groups according to extent and purpose of processing. This classification system wasn’t meant for consumers but rather to facilitate research about food processing and health.

What is the impact of ultra-processed foods and beverages on health?

There is strong evidence that ultra-processed food intake is associated with poor health outcomes in both children and adults. Studies indicate that diets high in ultra-processed food/beverages compared to minimally processed or unprocessed options increased a child’s risk of obesity, high blood pressure, cancer, type 2 diabetes, and cardiovascular disease4. Furthermore, frequent consumption of these products has the potential to reduce overall dietary quality and increase the risk of malnutrition among children and adolescents.

In addition, multiple studies in school-aged children have shown that ultra-processed foods reduced cognitive and academic performance, scores in verbal ability and increased mathematical difficulties5.

These findings are particularly important since children’s intake of ultra-processed foods and beverages has significantly increased during the past decade at all income levels2.

What are the implications for your practice?

Curbing the intake of ultra-processed foods and beverages is challenging since they are highly palatable, widely available, heavily marketed and convenient. A reasonable goal for most households may be to reduce rather than eliminate these products all together.  To help your families, consider incorporating these strategies:

  1. Promote the use of tools and information available in MyPlate, including recipes and shopping tips for busy families6.
  2. Support community efforts to enhance the availability and affordability of whole foods such as fruits, vegetables, whole grains, lean meats and dairy products in local markets.
  3. Refer parents to a registered dietitian nutritionist (RDN) to provide more extensive education on the benefits of unprocessed/minimally processed foods for their children, and ways to make this shift successful.
GROUP 1 GROUP 2 GROUP 3 GROUP 4
Unprocessed/
minimally processed
Processed culinary ingredients Processed
Foods
Ultra-processed
Foods
Foods altered or altered by processes such as removing inedible parts:
Drying, grinding, cooking, pasteurization, freezing. No additional substances are added.Examples: fresh or frozen fruits/vegetables, packaged grains, flours, nuts, plain pasta, pasteurized milk, chilled/frozen meat
Substances obtained from Group 1 foods, created by pressing, centrifuging, refining, extracting, and mining to create products for food preparation and seasoning.

Examples: butter, vegetable oils, other fats, sugar, molasses, honey and salt

Products made by adding edible substances to Groups 1 and 2 foods using preservation methods. Such as canning, fermentation, and bottling. Processing aims to increase stability and durability of Group 1 foods and make them more enjoyable.

Examples: canned vegetables in brine, freshly made breads or cheese, cured meats

Formulations of low-cost substances derived from Group 1 foods with little to no whole foods. Always contain edible substances not used in home kitchens. Processing involves multiple steps and additives (flavors, colors, emulsifiers).

Examples: packaged snacks, cookies/biscuits, instant soups/noodles, ready-to-eat/heat meals, candy, soft drinks, sugar-sweetened beverages

References

  1. Baker P, Machado P, Santos T, et al. Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers. Obes Rev. 2020;21(12):e13126. doi:10.1111/OBR.13126 
  2. Wang L, Martínez Steele E, Du M, et al. Trends in Consumption of Ultraprocessed Foods Among US Youths Aged 2-19 Years, 1999-2018. JAMA. 2021;326(6):519-530. doi:10.1001/JAMA.2021.10238 
  3. The NOVA Food Classification System. Accessed December 28, 2023. http://tinyurl.com/BRdietary
  4. Elizabeth L, Machado P, Zinöcker M, Baker P, Lawrence M. Ultra-Processed Foods and Health Outcomes: A Narrative Review. Nutr 2020, Vol 12, Page 1955. 2020;12(7):1955. doi:10.3390/NU12071955
  5. Liu S, Mo C, Lei L, et al. Association of ultraprocessed foods consumption and cognitive function among children aged 4-7 years: a cross-sectional data analysis. Front Nutr. 2023;10. doi:10.3389/FNUT.2023.1272126
  6. MyPlate | U.S. Department of Agriculture. Accessed January 16, 2024. https://www.myplate.gov/

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