More than 50% of all the calories we’re now eating in countries like the US and the UK are ultra-processed foods (UPFs), and their regular consumption has been tied to lots of different health problems, especially in the gut. So today, I want to provide you with a clear definition of what a UPF is, tell you about the problems they create in your digestive tract, and give you some practical tips for how to avoid them without going hungry.
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On today’s show: you know that feeling when you’re eating certain foods, and you just can’t stop? That bag of chips or pint of ice cream that says 4 servings but feels like one. And even after you eat the whole bag or pint you still don’t feel satisfied. I’m talking about ultra-processed foods, UPFs. Edible food-like substances also known as “junk food” that are engineered to make you want to keep eating. But UPFs aren’t confined to just junk food anymore – they make up a lot of the foods that you probably think of as health foods, and they do way more than just make you want to keep eating. More than 50% of all the calories we’re now eating in countries like the US and the UK are UPFs, and their regular consumption has been tied to lots and lots of different health problems, especially in the gut. So today, I want to provide you with a clear definition of what a UPF is, tell you about the problems they create in your digestive tract, and give you some practical tips for how to avoid them without going hungry. And I want to give a shout out here to Chris van Tulleken’s book “Ultra-Processed People”. Detailed must-know information about what these foods are doing to your body and your brain and how in addition to making you sick, they are also increasing your risk of dying prematurely.
We’re going to start off with a little bit of background on the Nova classification of foods, which is where the term “ultra processed food” comes from. The Nova classification comes from the work of Dr Carlos Monteiro from Brazil. His early research in the late 1970s focused on malnutrition, but in the mid-1990s, Monteiro observed a major shift in the health landscape of Brazil. There was a huge rise in obesity rates amongst one group in particular – lower socioeconomic populations. Poor people who had previously been at risk for malnutrition were now suffering from obesity. This shift led Monteiro to focus on dietary patterns instead of just individual nutrients and he identified two distinct eating patterns in Brazil: one was rooted in traditional foods like rice and beans that people were preparing at home, and the other was characterized by the consumption of highly processed ready to eat products. The Nova framework identifies four food groups, based on ingredients as well as the type of industrial food processing used to make the product, which paints a much more accurate and comprehensive picture of the health of the food as opposed to just focusing on the ingredients alone. After all, we can make car tires from corn but based on the industrial processes used to make car tires, we would not consider them a healthy food group. When we come back, the definition of an ultra-processed food and the 4 groups in the Nova classification.
So what exactly is an ultra-processed food? UPFs are industrially formulated products that contain synthetic ingredients and minimal or no whole food. The processing methods used to make UPFs make them easy for your digestive tract to absorb, which can lead to a spike in your glucose levels, and that’s why they’re a risk factor for developing diabetes. They are usually calorie-dense, high in sugar, salt, fat, and additives, and low in protein, fiber, and micronutrients. Examples of UPFs include soft drinks, pre-packaged meals, frozen pizza or waffles, processed meat products, and packaged snacks like chips. I’m going to go through groups 1, 2 and 3 of the Nova classification and then we’ll circle back to group 4, which is the ultra-processed foods.
Group 1: Unprocessed or minimally processed foods
Unprocessed foods are the edible parts of plants & animals. Minimally processed foods are foods that are modified through industrial methods like crushing, drying, pasteurization, fermentation, freezing, and other preservation techniques that maintain the food’s integrity without introducing salt, sugar, oils, fats, or other ingredients. There are no additives in this group. Examples: fresh or frozen fruits and vegetables, grains, legumes, fresh meat, eggs, milk, plain yogurt.
Group 2: Processed culinary ingredients
These are ingredients that are derived from group 1 foods or from nature by additional processing like refining, grinding, milling, and drying. These ingredients are mostly used in seasoning meals that are homemade and prepared from scratch. They usually don’t have additives, but some products in group 2 may have added vitamins or minerals, like iodized salt that has iodine in it. Examples: oils produced through crushing seeds, nuts, or fruit, like olive oil, salt, sugar, vinegar, honey, agave, butter. These are all ingredients that I have in my kitchen and use to prepare meals.
Group 3: Processed foods
Processed foods are basically a combination of group 1 and group 2. So they’re processed culinary ingredients (group 2) like salt or sugar plus unprocessed or minimally processed (group 1) foods. The processing that we’re talking about here includes baking, boiling, canning, bottling, and fermentation. Additives are usually present in these foods to enhance shelf life or improve the taste. Examples: cheese, canned vegetables, salted nuts, fruits in syrup, and dried or canned fish.
Group 4: Ultra-processed foods
OK, so now we get to the heart of the matter. Industrially manufactured food products with multiple ingredients including sugar, oils, fats and salt (usually in higher amounts than in group 3 processed foods) and food substances that are not normally used in cooking like high-fructose corn syrup, hydrogenated oils, modified starches and protein isolates. These are ingredients that you would never have in your kitchen or pantry. Another defining feature of ultra processed foods is that Group 1 foods (those unprocessed or minimally processed foods) are either completely absent or present in very small amounts in the formulation. And when I say formulation you probably think of a chemistry experiment, which is exactly what you should be thinking of when you think of these foods. A chemistry experiment – on you!
So how do you formulate these ultra processed edible food-like substances? These products are made via industrial techniques like extrusion where you push material through a hole to create a specific shape, to make things like pasta and breakfast cereal and puffed snacks. Molding is another industrial manufacturing technique that uses heat and pressure to shape material into a specific form using a rigid mold. But it’s not the shape of these foods that’s the problem, it’s the excessive amount of additives: flavors, colorants, non-sugar sweeteners and emulsifiers whose function is to make the final product palatable or even hyperpalatable – meaning the product is so appealing that you literally can’t stop eating it. And that is precisely the goal. UPFs are made with specific combinations of fat, sugar, sodium, and carbohydrates that trigger your brain’s reward system and makes them very hard to resist. They are a huge contributor to the obesity crisis. Our genes certainly have not changed in the last few decades to explain the skyrocketing rates of obesity, and most people aren’t gorging on massive servings of unprocessed food. What they’re doing is they are consuming more and more of these energy rich, nutrient poor foods. And gaining a lot of weight as a result of that. When we come back: what else do UPFs do to your body, besides make you gain weight?
Let me be really clear about the goal of UPFs: this entire process is designed to create highly profitable, long shelf-life, convenient, hyperpalatable alternatives to freshly prepared dishes and meals. UPFs are different from group 3 processed foods not just because of how they’re made, but because of what they contain: substances of no nutritional value like high-fructose corn syrup, maltodextrin, modified starches, hydrogenated oils, protein isolate, and additives with cosmetic functions like flavor enhancers, colors, emulsifiers, thickeners and anti-foaming agents. Nothing about these foods is nourishing. In fact, they are anti-nourishing.
The reality is that most of our diet is now ultra processed. And that includes a lot of foods that are marketed as health foods like flavored yogurt and granola bars and plant based milks and gluten free products and protein bars and collagen powders. I was at a health and wellness conference recently and the products they had in the goodie bags when you registered were all ultra processed foods protein bars and chips and other edible food like things that I would never recommend eating. But this is what is being pushed by health influencers out there as actually good for you. I have been a gastroenterologist for almost 30 years, and I can tell you with certainty that this crap will mess up your gut.
Ultra-processed foods (UPFs) have a number of negative effects on the gut. Emulsifiers, sweeteners, colors, and microparticles in these products have a profound impact on your gut microbiome and your intestinal lining. The nutritional composition: low in fiber and high in fat and sugar plus all the synthetic additives can create chronic intestinal inflammation. UPFs can change the composition of your gut bacteria, leading to decreased diversity and a state of dysbiosis – microbial imbalance, which is associated with a wide range of conditions, including autoimmune diseases, obesity, allergies, and even some types of cancer. Emulsifiers and thickeners commonly used in UPFs like lecithin, xanthan gum, tapioca starch, and carrageenan can damage your gut lining, leading to an increase in intestinal permeability known as “leaky gut”. This can increase your risk of food allergies, chronic inflammation and autoimmune disease – especially if you have a genetic predisposition. UPFs are associated with gut diseases like inflammatory bowel disease, colorectal cancer, and irritable bowel syndrome. They may not be the only cause, but they are definitely a contributing factor. GI symptoms like gas, bloating, cramps, diarrhea, or constipation are common in people consuming a lot of UPFs. And of course, weight gain because your digestive tract does not signal fullness after eating them.
If we look at a map of the world we see this rising incidence of autoimmune diseases like inflammatory bowel disease (IBD) and rheumatoid arthritis, and lupus, and diabetes in parts of the world that are becoming more Westernized, like sub-Saharan Africa, the Caribbean, countries in South America. This increase coincides with the increase in UPF consumption over the last few decades. So it’s not just an increase in obesity in these parts of the world like Dr Monteiro saw in Brazil, it’s also an increase in chronic diseases. A recently published study in a quarter million people looked at the link between UPFs and IBD. They found that higher UPF intake was associated with an increased risk of IBD, especially ultra-processed breads and breakfast foods; frozen or shelf-stable ready-to-eat meals; and sauces, cheeses and spreads. The reality is that none of us should be eating UPF’s on a regular basis, but if you have an autoimmune disease, not just a gut based autoimmune disease like Crohn’s or ulcerative colitis, but any autoimmune disease, you need to avoid these foods as much as possible.
In my medical practice we have a success rate of 79% in helping patients with inflammatory bowel disease get off steroids and biologics and other immunosuppressive drugs using diet and lifestyle techniques. And the #1 dietary technique that we use is to eliminate these foods from our patients diet. We also ramp up the amounts of fresh fruits and vegetables that people are eating, but the number one strategy is to get rid of the UPF’s in the diet. I remember one of my G.I. colleagues asking me: “does that really make a difference?” And I said to him: “are you asking me if what you put in your G.I. tract affects what’s going on there? Are you kidding me!”
The most important thing if you are struggling with any kind of GI issue – especially an autoimmune disease – is to eliminate these foods from your diet. Is that easy to do? No, but it is absolutely essential to stop the ongoing damage to your gut microbiome, your gut lining, and heal intestinal inflammation. No amount of supplements or probiotics is going to heal your gut if you are not also paying attention to the things that are damaging it.
I want to leave you with three important takeaways about ultra processed foods:
1. You must read the ingredients on the package – ignore the health claims and the nutrition facts. That is all marketing. If the ingredient list contains substances that you do not normally have in your kitchen or pantry or that you don’t recognize as an actual food, do not eat it. If the ingredients sound like they belong in a chemistry lab – that’s because they do! Artificial flavor, glycerin, citric acid, potassium sorbate, red 40, soy lecithin, mineral oil. Those are just some of the ingredients in Twizzlers – a partial list. Not to pick on Twizzlers. These are common ingredients in many if not most of the foods that we are consuming on a daily basis, and particularly what our young people are consuming.
2. If you don’t feel like reading the ingredient list, here is another idea: purchase foods that don’t have an ingredient list or just have one ingredient listed: apples, a bag of rice, a piece of fish, dried beans. When you look at the food, think, did this food make a stop in the factory to get to me? Corn on the cob yes, corn chips no. Rice yes, Rice Krispies no. Oats yes, oat milk no. Farm yes. Factory no.
3. We live in the real world, and it is almost impossible to never eat an ultra-processed food, but you want to make sure that these foods are not making up more than 10% of your diet. And that’s particularly important if you have an underlying chronic disease.
So that’s it for this episode of the Gutbliss podcast on ultra-processed foods and the Nova classification.
