by Marion Nestle

Currently browsing posts about: Ultraprocessed

Jul 10 2023

Nordic Nutrition Recommendations: influenced by industry?

A reader who wishes to remain anonymous sent me an account of the development of the new Nordic Nutrition Recommendations, pointing out what they do not contain: a recommendation to reduce ultra-processed foods [Note: this is an updated and slightly corrected version of what was first posted on July 9].

Indeed, on pages 253-255 (this is a long report), you will find this statement:

The backstory here is one of effective food industry lobbying.

The Nordic Nutrition Recommendations do not say:  reduce consumption of ultra-processed foods.

The story begins with two authors who were asked to sum up the health effects of ultra-processed foods, and to advise the committee writing the recommendations.  They did so.  Their initial background paper concluded with these recommendations:

(1) Limit the consumption of ultra-processed foods.

(2) Choose less processed form of foods within each food group when possible.

(3) Cook at home and choose freshly prepared foods when eating out.

The committee revised the background paper.  It omitted the three recommendations but concluded:

Recommendations to limit ultra-processed foods, and choose foods of lower processing level, when possible, may enhance and support several of the existing FBDGs [food-based dietary guidelines] and help individuals select more healthful foods that align with the overall NNR2022 [last years Nordic Nutrition Recommendations] guidelines within each food category. For example, such advice would support choosing plain, unsweetened yoghurt instead of flavored, sweet yoghurt; choosing oatmeal or muesli based on grains, nuts, and dried fruits over sweetened, refined breakfast cereals; and choosing chicken breast/thighs over chicken nuggets.

The revised document was opened for public comment and a hearing.  A great many representatives of food companies objected to saying anything negative about ultra-processed foods.  This Excel spreadsheet lists the 60 people who commented and their main objections.

After the hearing, the committee preparing the recommendations wrote a draft report based on the comments.  The section on ultra-processed foods is on pages 152-153.  It begins:

There is currently no consensus on classification of processing of foods, including UPFs. The dominating UPF classification (NOVA classification group 4) contains a variety of unhealthy foods, but also a number of foods with beneficial health effects.

It also says:

Health effects. Regular intake of UPF encourages over-eating and intake of foods in the UPF category of the NOVA classification has been suggested associated with increased risk of obesity, cardiovascular disease, type 2 diabetes, cancer, depression, and premature mortality …However, no qSRs [qualified systematic reviews] support these suggestions.

These negative views of the UPF concept differ from the views of the background document (however politely stated) and clearly were influenced by the overwhelmingly negative views of food industry representatives.

The draft report also was opened for public comment.  These comments also are listed in an Excel document. Some favor the changes benefiting the food industry; others—but many fewer—object to them (these last are summarized in yet another document).

The final Nordic Nutrition Recommendations are somewhat of a compromise between public health and food industry views, but generally favor the food industry position.  The new Nordic Nutrition Recommendations are less critical of the UPF concept, but do not say “reduce consumption of ultra-processed foods.”

The NOVA food classification system, which first defined ultra-processed foods, was published by Carlos Monteiro, a professor of public health at the University of São Paulo, and his colleagues in 2009.*  About the Nordic recommendations, my informant writes:

I have come to realize that this is not at all about evidence. It’s about power, and who gets to define what’s important in nutrition science. “The establishment” refuses to accept that someone from Brazil, a country they regard as inferior, should be allowed to tell them they have been wrong in their nutritionism-approach. They claim NOVA is based on ideology, not science….And now this is getting in the way of public health.

My take-home lesson:  The food industry came out in force on this issue and greatly overwhelmed the few comments of public health advocates.  The message here seems clear: public support for reduction of ultra-processed food needs to be widespread, clear, and forceful.

*Definition of ultra-processed foods

  • Industrially produced
  • Bearing no evident relationship to the foods from which they were derived
  • Formulated to be irresistably delicious (if not addictive)
  • Usually containing color, flavor, and texture additives
  • Often high in salt, sugar, and fat (but these are culinary ingredients that do not in themselves make foods ultra-processed)
  • Cannot be made in home kitchens (because they are industrially produced and contain ingredients unavailable to home cooks)

Addition

An additional document was sent to me after this post and the response from nutritionists involved in the NNR, which I posted the following week.  It is from the authors of the background document expressing their concerns about the changes made.

Jun 9 2023

Weekend Reading: Ultraprocessed People!

This absolutely superb—informative, eminently readable, compelling—book makes the strongest possible case for the benefits of not eating ultra-processed foods.

These, you may recall, are produced by industrial means, loaded with unfamiliar and questionable food additives, unable to be made in home kitchens, and designed deliberately to be irresistibly delicious, if not addictive, so as to make profits for food companies.

They also encourage people to eat more than they realize, and are consistently associated with poor health.

Van Tulleken is a British physician, scientist, and television star with his twin brother Xand.

Although I am thoroughly familiar with just about everything in this book having written extensively about these topics myself, I still found it to be a great read.

Van Tulleken tells stories really well.  I was hooked on page 30 with the description of Lyra, his 3-year-old daughter’s first encounter with a breakfast cereal aimed at kids.  He had decided to do a Morgan Spurlock  (Super Size Me!) experiment on himself and eat mainly ultra-processed foods for as long as he could stand it.  He began with a breakfast of Coco Pops cereal.

I had assumed that, having never tried Coco Pops, she [Lyra] wouldn’t have any interest in them.  But Kellogg’s had got her hooked before she’d had a mouthful.  She knew that here was a product designed with a three-year-old in mind.  Again, I told her no, so she collapsed on the floor crying and screaming with rage…My lingering doubts [about this cereal] were irrelevant ….Lyra had crawled out from under the table, filled her bowl and started to eat great fistfuls of dry Coco Pops, wide-eyed and ecstatic.  Defeated, I poured out the milk, and read the ingredients…Lyra put her ear to the bowl and shut her eyes, entranced. She then began to eat again.

And eat.  And eat.  As I watched her, it seemed she wasn’t fully in control…Lyra had hardly taken a breath.  I normally have to do a little cajoling at mealtimes, but the first bowl of Coco Pops had simply disappeared.  When I tried to suggest that one bowl was enough, the idea was immediately dismissed.  It felt like advising a smoker to stick to one cigarette.  Her eating wasn’t just mindless: it was trancelike.

This is just what ultra-processed foods are supposed to do.

Van Tulleken calls for government policies to be made without food company involvement, and for policies to restrict the marketing of such foods.

Yes!

The book is published today by Norton. I thought it was a great read.

May 31 2023

The pushback on ultra-processed foods

Ultra-processed foods—defined operationally as industrially produced foods formulated to be irresistably delicious that can’t be made in home kitchens (because you don’t have the machinery or the ingredients—are by now well established to be associated with weight gain and weight-related chronic diseases.

Evidence now suggests the association is causal.  Ultra-processed diets induce people to eat more calories without realizing it.

Alas for food companies.  Ultra-processed products are among their most profitable.

The British Nutrition Foundation to the rescue!

  • It has issued a position statement on ultra-processed foods.   It complains that:
  • The classification system omits foods the Foundation considers healthy.
  • It implies that expensive artisanal products are superior for health (advice to reduce UPF raises questions of equity).
  • The research is largely observational.
  • The food environment is a key driver of poor health.
  • Making products that are not ultra-processed may have unintended consequences.
  • Demonizing ultra-processed foods could foster feelings of guilt and stigma.
  • Messages to avoid UPF might discourage industry from reformulation.
  • Food processing plays a releant role in food system sustainability and food security.

When I read things like this, I have the usual question: Who paid for this?

The British Nutrition Foundation says:

BNF’s funding comes from: membership subscriptions; donations and project grants from food producers and manufacturers, retailers and food service companies; contracts with government departments; conferences, publications and training; overseas projects; funding from grant providing bodies, trusts and other charities.

If it lists its corporate sponsors, I can’t find it.

But PowerBase says:

The British Nutrition Foundation (BNF) is the key food industry front group in the UK. The BNF promotes itself as a source of impartial information, but it does not always make its links with industry clear.

The BNF is hard at work on behalf of food companies who wish the entire UPF concept would just disappear.  See, for example, “How do we differentiate not demonise –Is there a role for healthier processed foods in an age of food insecurity? Proceedings of a roundtable event” published in the Nutrition Bulletin.  The themes that emerged from the conference:

  • problems with the use of definitions for UPF,
  • the lack of causal evidence and defined mechanisms linking processing per se with poor health outcomes,
  • advice that may result in consumer confusion.
  • misalignment of UPF foods with dietary guidelines
  • unintended consequences for vulnerable groups

Comment: 

OK, the food industry is fighting back.  I think it’s a losing battle.  The UPF concept has so much evidence backing up its usefulness.  But I will say one thing about the point about unintended consequences.   It’s OK for rich people to avoid UPF but OK for poor people to eat them?  I think the food industry is in trouble on this one.  It has gotten away with pushing junk food for way too long.  The British Nutrition Foundation would be much more crredible if it put public health first.

 

May 3 2023

The 2025-2030 Dietary Guidelines: an update

Personally, I can’t believe we are going through this again since the result will certainly not differ much from previous versions, except in details (see my previous post on this).
But here we are, so let’s get to it.

ODPHP must be in charge this round (leadership passes back and forth between ODPHP and USDA’s nutrition policy office).  It says:

You can get involved by:

  • Attending virtual meetings: View the recording of the first meeting held in February 2023, and register to view the livestream of the second meeting on May 10th on DietaryGuidelines.gov.
  • Providing public comments: Comments may be submitted online.
  • Subscribing to email updates: Stay informed on each step of the process by registering for updates.

More details on the Dietary Guidelines development process can be found at DietaryGuidelines.gov.

What to expect?

  • Investigative reports on conflicts of interest among members of the Dietary Guidelines Advisory Committee (members must report conflicted interests but the agencies do not make the reports public)
  • Nothing about sustainability (Off the table; the agencies said there will be a separate report on that.  When?)
  • Nothing about meat (Off the table)
  • Debates about the significance of ultra-processed foods (but only with respect to heart disease)
  • Other issues, surely

My prediction: after an enormous amount of work, the guidelines will say, as they mostly do:

  • Balance calorie intake with expenditure
  • Eat more plant foods (foods)
  • Don’t eat too much salt, sugar, saturated fat (nutrients)
  • And, if we are lucky, minimize or avoid ultra-processed foods

Stay tuned.

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For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

Jan 9 2023

Industry funded study of the week: ultra-processed foods are OK, really

Jim Krieger of Healthy Food America sent me this Food Navigator article titled “Can ultra-processed packaged food play a role in healthy, sustainable diets of the future.”

Uh oh.  Another attack on the concept of ultra-processed foods.  These, you will recall, are strongly associated in observational studies with poor health outcome, and one clinical trial demonstrates them to cause people to eat more calories.

The makers of highly processed foods are understandably worried that the word will get out and people will stop eating them.

Clif Bar to the rescue.

It sponsored a small session to establish guidelines for making highly processed foods healthier: “Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods

The publication emphasizes flaws in the concept of “ultra-processed,” an approach it says

lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health.

Acknowledgments: “Staff at Clif Bar & Company developed the meeting agenda, synthesized all prework inputs, participated as observers in the workshop, and assisted in the gathering of the materials used to prepare this manuscript.”

Here is an ingredient list for an oatmeal raisin walnut Clif Bar:

ORGANIC ROLLED OATS, ORGANIC BROWN RICE SYRUP, SOY RICE CRISPS (SOY PROTEIN ISOLATE, RICE FLOUR, BARLEY MALT EXTRACT), ORGANIC ROASTED SOYBEANS, ORGANIC TAPIOCA SYRUP, ORGANIC CANE SYRUP, ORGANIC RAISINS, CHICORY FIBER, ORGANIC SOY FLOUR, WALNUTS, SUNFLOWER AND/OR SOYBEAN OIL, NATURAL FLAVORS, SALT, ORGANIC CINNAMON, MIXED TOCOPHEROLS (ANTIOXIDANT).

My definition of ultra-processed is that you can’t make it in your home kitchen because the ingredients are industrially produced and not available in supermarkets.  By this definition, the soy rice crisps are ultra-processed and maybe chicory fiber, but that’s about it.

The Clif people must be worried that they will be viewed in the same category as seriously ultra-processed snack foods.

Let’s give them and their parent company, Mondelez, credit for full disclosure.

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For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

Nov 30 2022

Food marketing exposed !

TODAY: @Stphn_Lacey will moderate at 1:00 p.m. ET. Register HERE.

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The Global Health Advocacy Incubator (GHAI) has just released this report.

The report documents how marketing of unhealthy food and beverages is linked to complex political, social, historical, cultural and economic forces that make it a key driver of unhealthy food environments:

  • Ultra-processed food and beverage product (UPP) marketers…saturate the marketplace with junk products through tactics that are aggressive, insidious and everywhere.
  • Consumers are ambushed with food marketing through the sponsorship of their favorite sports teams, the hidden product placements in their children’s educational shows and the free products that they receive at events.
  • The dangers are even more apparent when UPPs target children and adolescents who lack the developmental maturity to distinguish advertisements from entertaining or educational content.
  • The UPP industry is notorious for failing to take responsibility for its participation in creating an unhealthier planet.
  • The industry instead places blame solely on the individual or the guardian of the child.
  • UPP corporations exploit consumers through deception and undue influence, and also gain privileged spaces in policymaking tables.
  • UPP marketing threatens public health by decreasing state action to regulate food environments.

More evidence for the need to regulate ultra-processed foods and beverages (see my paper on this precise point).

Let’s get to it !

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For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

Oct 31 2022

Happy Halloween! [But see correction]

Trick or Treat?  You can’t make this stuff up.  CORRECTION: No you can’t.  It’s a fake.  Busted.

On the brighter side…

Happy Halloween!

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For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

 

 

Jul 6 2022

Canada’s new front-of-pack food label

Canada has joined the ranks of countries with front-of-package food labels alerting customers to products high in salt, sugar, and saturated fat.

I learned about this in a press release from Kate Comeau, Communications Advisor, Mission, Canada | Heart & Stroke

The official announcement from Health Canada is here. 

It comes with an explanatory Infographic.

I think the warning labels used in some Latin American countries work better, but this is a big step forward and is likely to cover the great majority of ultra-processed foods—and those are the ones that are best avoided.

Congratulations to Canadians who pushed for this.  Progress!