Ultra-processed foods are everywhere. Over the last few decades, its availability and accessibility have increased explosively and intentionally, first in high-income countries and then in others.
In the United States, and also in the United Kingdom, around 60% of caloric intake already comes from ultra-processed products. In Brazil, over the last ten years, the consumption of ultra-processed foods has increased by an average of 5.5%.
Other data from the study, published by the Public Health Magazine of the University of São Paulo (USP), carried out by the Center for Epidemiological Research in Nutrition and Health (Nupens/USP) also responsible for the Food Guide for the Brazilian Population, shows that around 20 % of the calories consumed by Brazilians come from ultra-processed foods.
Messages about these products also proliferate. In many press reports, they are identified as the main responsible for the increase in obesity or type 2 diabetes. There is also no shortage of influencers who advocate abandoning consumption. But what are ultra-processed foods? And what is the scientific evidence about its effect on health?
That are?
Sweets, soft drinks, cookies, nuggets, pre-cooked dishes, dairy desserts, among others. All are products made predominantly (or entirely) from industrial ingredients and containing little (or no) natural food. Therefore, they tend to have high caloric density (due to their amount of sugars and fats) and low nutritional quality (very little amount of proteins or micronutrients). That is, they provide almost nothing except packaged calories.
The term ultra-processed was used, for the first time, by Carlos Monteiro in 2009. Currently, and in the absence of a legal standard that establishes a specific definition, the most accepted (at least in the field of public health) is that of Monteiro himself and collaborators . They define ultra-processed products as “industrial formulations produced from substances obtained from food or synthesized from other organic sources”. And they continue: “They typically contain little or no intact food, are prepared to be consumed or heated, and are high in fat, salt or sugars and little dietary fiber, protein, various micronutrients and other bioactive compounds.”
In short, ultra-processed foods are edible industrial preparations made from substances derived from other foods. These products are improved to be attractive to the palate and very convenient, as they can be consumed at any time and place.
Added to this is its enormous profitability. Ultra-processed products have a long shelf life and very low production costs. In fact, the production of ultra-processed foods (e.g. sugary drinks) has become one of the most profitable and fastest-growing business activities. These products are cheaper than fresh or processed foods and are advertised through misleading messages (“rich in vitamins”) and accompanied by claims that seek to mask possible harm, to direct consumer demand.
What is its effect on health?
Thanks to traceability and food safety systems, it is very difficult for foods, whether ultra-processed or not, to cause immediate harm to health. Except for some low-quality fats and sugars, which cause direct harm but remain unregulated due to industry interference.
The scientific data on the harmful effects of ultra-processed foods is clear. There are hundreds of studies that have observed an association between the consumption of these products and a higher risk of obesity, diabetes, hypertension, cardiovascular diseases and also premature death. An editorial, recently published by Miguel Ángel Royo-Bordonada and Maira Bes-Rastrollo in Gaceta Sanitaria, summarizes this evidence.
In addition to these effects, a recent study, carried out with almost 200,000 adults in the United Kingdom, concluded that ultra-processed foods also increase mortality from certain types of cancer, especially ovarian cancer in women. And this is not the first. Last year, research carried out in the United States linked ultra-processed foods to colorectal cancer. Adding to this growing evidence are findings about mental health. A longitudinal study, with a decade of follow-up, associated the consumption of ultra-processed foods with cognitive deterioration in more than 10,000 adults in Brazil. Furthermore, in 2022, researchers from the Federal University of São Paulo (Unifesp), USP, Fiocruz and the University of Santiago de Chile carried out a survey (published in the American Journal of Preventive Medicine) where it was estimated that ultra-processed foods can cause the premature death of 57 thousand people per year, even exceeding the number of homicide victims in the country (the data was based on the year 2019 where, according to the Atlas of Violence, the country recorded 45.5 thousand homicides ).
Regarding the mechanism of action, there are several hypotheses. On the one hand, the damage may be related to the aforementioned low nutritional quality of the most common ingredients in these products: free sugars, refined flours, unhealthy fats or salt. In turn, the consumption of ultra-processed foods can replace others with better nutritional quality, such as fresh or less processed foods. There are studies that suggest additional hypotheses, related to changes in satiety signals, imbalances in the diversity and composition of the intestinal microbiota, or the pro-inflammatory and pro-oxidant effects of ultra-processed foods.
Once its effects have been observed, and its plausibility at a biological level has been explained, it remains to implement fiscal measures (taxes on sugary drinks) and regulatory measures (limit the exposure, especially of children and adolescents, to this type of products) that counteract the spread of these products.
