By Nancy Clark

In today's food culture, we've demonized certain types of foods, such as those with abundant carbs, fat, salt, sugar. The latest demon is ultra-processed foods. You've seen the headlines: Ultra-processed foods linked to heart disease, diabetes, mental disorders and early death, study finds. Eating processed foods tied to shorter life. You should stop eating ultra-processed foods.

Such fear-mongering headlines influence many athletes to steer clear of ultra-processed foods (UPFs). While that is often the nutritionally wisest choice, the words ultra-processed foods get tossed around way too loosely.

Clickbait headlines can fail to offer a balanced overview. Sports drinks, gels, protein bars, as well frozen meals, store-bought bread, and vanilla yogurt (all UPFs) can be helpful additions to a busy (and budget-minded) athlete's food plan. Will these foods really ruin your health?

This article looks beyond the headlines and offers information to help you better understand what UPFs are and what they are not. Nutrition communicator Liz Ward RD shared this UPF information at the Mass. Academy of Nutrition & Dietetics Annual Meeting (March 2024).

Definition: What is an ultra-processed food?

Foods are categorized by the NOVA (not an acronym) system according to how they have been processed. NOVA has four categories—none of which consider a food's nutritional value:

Group 1. Unprocessed or Minimally Processed Foods—fresh & frozen fruits & veggies, plain meat,  oats, coffee, pasta.

Group 2. Processed Culinary Ingredients (also called Oils, Fats, Salt, and Sugar)— includes foods from Group 1, but in a different form. Olive oil (vs. olives), white sugar (vs. sugar cane), maple syrup (vs. sap), butter (vs. cream). Again, no mention of nutritional value.

Group 3. Processed Foods—home-cooked & commercially made food with salt, sugar, oil, plus preservatives to extend the shelf-life in foods from Groups 1 and 2. Examples include many foods thought to be good for us: smoked salmon, canned beans, canned tuna, and fresh cheeses.

Group 4. Ultra-Processed Foods— "industrial formulations" with fat, oil, sugar, starch, flavor enhancers, colors, and food additives. This group includes sports and energy drinks, cookies, baked chips, candy, as well as chocolate milk (excellent for recovery after a hard workout); tofu and salted nuts (protein for vegetarians); and packaged whole-grain bread. Many UPFs are nutrient-rich and positive choices for athletes. Hence, you want to think about nutrient density more than NOVA classifications!

What does the science say about ultra-processed foods?

While click-bait headlines proclaim UPFs are linked to heart disease, diabetes, brain health, and early death, the science is less definitive. Most UPF research looks at what people eat—and may overlook other factors that impact health: stress, economic status, exercise, and lifestyle. Research indicates ultra-processed foods such as breakfast cereal and (sweetened) yogurt can—and do—have health benefits.

To date, only one well-controlled study has compared the impact of two-weeks of eating an UPF diet (80%of calories) to a diet with minimally processed foods but nutritionally similar foods (in terms of carbs, protein, fat, and fiber). The results suggest the subjects ate more calories with the UPFs and gained two pounds during the two-week UPF diet and lost two pounds during the two-week minimally processed food trial.

Does this mean the media can rightfully declare UPFs are fattening? No. Research done under highly controlled conditions differs from athletes' "real life" eating patterns (which could easily have fewer calories from UPFs, given the typical US diet gets 60-67% of calories from UPFs ). Plus, two-weeks is a short trial. (This type of research is difficult to do.)

Is processing the problem— or is something else the culprit?

• Emulsifiers (cellulose gum, polysorbate 80) have been linked to negative changes in rats in the gut microbiome. Stay tuned for human studies.
• PFAs are endocrine disrupting chemicals that resist grease, oil & water. They are in food packaging: shiny wrappers on energy bars, grease-resistant microwave popcorn bags, and paper take-out food containers. As of Feb. 2024, PFAs are no longer allowed in food packaging in the US—but has their metabolic damage already been done?
• Is hyper-palatability the problem? Foods made with sugar and fat are more pleasing than sugar-free and fat-free foods—and even sugar and fat itself. Chocolate, for example, offers an appealing mix of sugar and fat that makes it very easy to overeat...

Food for Thought

Before demonizing all UPFs, we really need to look at the whole picture. We know chronic health issues are linked to eating patterns that lack fiber from fruits, vegetables, whole grains, beans, legumes, nuts. We also know that eating excess calories of salt, added sugars, and certain kinds of fat commonly found in UPFs can harm health. But despite popular belief, it is possible to choose a food plan with 90% UPFs and still consume a quality diet.

Ultimately, your overall dietary pattern—what, when, why, how much you eat—and not just UPFs will impact your health. We need to figure out why some people eat too many "addictive" UPFs such as salty snacks, sweets.  We'd also like NOVA to add a category for nutrient-dense processed foods to help resolve the demonization of all UPFs. Sausages and hot dogs should not be in the same category as tofu and peanut butter!

When making your nutrition game plan, there's little doubt that munching on Group 1 nuts and fruits (instead of pre-wrapped bars), and spending more time cooking homemade foods with fresh, locally grown Group 1 foods will be the ultimate winning diet. But convenience is a key reason people reach for UPFs. Try keeping your pantry stocked with minimally processed foods, so you can just as conveniently assemble a quick meal:

— whole grain bread + all-natural peanut butter + banana + yogurt

— rye crackers + canned tuna + cherry tomatoes + cheese.

As always, you want to eat more of best and less of the rest, keeping balance and moderation in mind.

Nancy Clark MS RD CSSD  counsels both fitness exercisers and competitive athletes in the Boston-area (617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for more information.

Resources:

For a handout on the NOVA Food Classification System with examples of foods in each group: https://ecuphysicians.ecu.edu/wp-content/pv-uploads/sites/78/2021/07/NOVA-Classification-Reference-Sheet.pdf

For more information on hyper-palatable foods: https://www.thinkingnutrition.com.au/food-addiction/?utm_source=substack&utm_medium=email