Ultra-processed foods: what they are and how to identify them

Abstract

The present commentary contains a clear and simple guide designed to identify ultra-processed foods. It responds to the growing interest in ultra-processed foods among policy makers, academic researchers, health professionals, journalists and consumers concerned to devise policies, investigate dietary patterns, advise people, prepare media coverage, and when buying food and checking labels in shops or at home. Ultra-processed foods are defined within the NOVA classification system, which groups foods according to the extent and purpose of industrial processing. Processes enabling the manufacture of ultra-processed foods include the fractioning of whole foods into substances, chemical modifications of these substances, assembly of unmodified and modified food substances, frequent use of cosmetic additives and sophisticated packaging. Processes and ingredients used to manufacture ultra-processed foods are designed to create highly profitable (low-cost ingredients, long shelf-life, emphatic branding), convenient (ready-to-consume), hyper-palatable products liable to displace all other NOVA food groups, notably unprocessed or minimally processed foods. A practical way to identify an ultra-processed product is to check to see if its list of ingredients contains at least one item characteristic of the NOVA ultra-processed food group, which is to say, either food substances never or rarely used in kitchens (such as high-fructose corn syrup, hydrogenated or interesterified oils, and hydrolysed proteins), or classes of additives designed to make the final product palatable or more appealing (such as flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners, and anti-foaming, bulking, carbonating, foaming, gelling and glazing agents).

Development and evaluation of food environment audit instrument: AUDITNOVA

“…We designed the NOVA-based food environment audit instrument named AUDITNOVA in stages that involved systematic meetings of the research group; detailed analysis of Brazilian and international audit instruments and detailed analysis of the NOVA food classification proposed by Monteiro et al [17][18][19] . The processing of food identified by NOVA involves physical, biological and chemical processes applied after food is separated from nature and before it is eaten or prepared as dishes and meals.…”

“…• group 4: ultra-processed foods. Formulations made mainly or entirely from food-derived substances and additives, with little or no food from group 1 [17][18][19] .…”

“…None of the audit instruments already validated for the Brazilian context 17,18 assess food availability and advertising according to the DGBP recommendations. Martins et al 15 , validating the Brazilian food environment audit instrument based on the adaptation of the study by Glanz et al 14 , approximate the food groups recommended by the DGBP, but explore only three indicators (availability, price, and quality) and disregard the latest version of the NOVA food classification, which divides them into four groups: in natura/minimally processed, culinary ingredients, processed foods, and ultra-processed foods [17][18][19] . Brazilian instruments lack indicators that dialogue with national recommendations.…”

Ultra-processed food and adverse health outcomes

“…. other cosmetic additives.”3 These foods include savoury snacks, reconstituted meat products, preprepared frozen dishes, and soft drinks.…”

“…In the 10 years since Brazilian researchers coined the term ultra-processed foods,4 there has been a growing body of evidence associating consumption of such foods with poor diet quality, increased cardiovascular risk factors (eg, dyslipidaemia, hypertension), and adverse health outcomes such as obesity and metabolic syndrome 3…”