That says the American nutritionist Kevin Hall in the renowned trade magazine Cell Metabolism.
In recent decades, nutrition experts have defined a healthy diet based on its nutrient composition: how much salt, protein, sugar or fat does it contain? This led to dietary guidelines and campaigns aimed at reducing fat, salt and sugar. But it didn’t work. People kept getting fatter. A group of researchers from South America developed a different way of looking. This led to the NOVA classification, which focuses on the degree of processing of the original raw materials. The most famous researcher is Carlos Monteiro. Under his leadership, the NOVA ladder was created, which defines raw products as good for people and calls products made from those raw materials increasingly unhealthy the more processed they are. The ultra-processed products puts NOVA under a ban. With this, NOVA is directly targeting the industry that markets many Ultra Processed Foods (UPFs).
UPFs are made from cheap carbohydrates and fats and industrial processes are used with ingredients that can hardly be found in the kitchen of ordinary people. These make the end product tasty, attractive, sustainable and food-safe, but also fattening because people consume too much energy, which they store as fat.
With the help of ingenious marketing tactics (think of child marketing) for which large budgets are available, the total calorie intake in the form of UPFs in many countries now exceeds 50%. In fact, American children now get 67% of their calories from UPFs. Research shows that eating a lot of UPFs at a young age during adolescence and young adulthood results in more overweight and obesity.
However, eliminating UPFs across the board may ultimately not be an appropriate public health goal and may even have unintended harmful consequences
Not with the blunt axe
That is why it stands out for proponents of the NOVA classification: the UPFs must be eradicated, starting with the dietary guidelines. Nutrition researcher Kevin Hall opposes this idea, which he finds too simple. on Cell he writes, “Eliminating UPFs across the board, however, may ultimately not be an appropriate public health goal and may even have unintended harmful consequences.” According to Hall, eliminating or reducing UPFs should involve efforts to replace them with better, affordable, and practical alternatives. Because UPFs also have desirable properties. They make food affordable and microbiologically safe and long-lasting (sustainable) and can be enriched with nutrients. Banning UPFs with the blunt ax “can only exacerbate existing inequalities in food insecurity.”
‘Don’t lump all UPFs with the same brush’
Hall proposes not to lump all UPFs with the same brush. That’s what he calls sugary soft drinks. These are UPFs with little nutritional value but a clear health risk. Anti-soda campaigns are not complicated, have positive results and there are plenty of cheap alternatives. You can drink water just fine.
But the situation is different for ready meals. Thanks to ready meals, American children have been eating a little bit better in recent years. So you shouldn’t just ban those kinds of meals, which are also UPFs. It would be better to capitalize on their usefulness to give public health a nudge in the right direction by applying reformulation. To do that meaningfully, you need to focus nutrition research on the biological mechanisms that cause people to overeat the wrong foods and make them fatter over the years.
Hall knows what he’s talking about, having conducted a much-discussed experiment in 2019 in which people were found to eat (and gain weight) much more from UPFs than from whole foods.
Is it the sensory characteristics of UPFs that make them easier to chew and swallow, so you can eat them faster? Does overconsumption occur because the gut-brain signals cannot signal ‘satiety’ in time in the case of UPFs? Is it the surplus of sugar and fat in combination with the low protein content? Or is it the absence of dietary fiber that upsets the gastrointestinal tract? Or is a combination of the above mechanisms at play? Hall calls for more physiological research to understand how UPFs contribute to current public health problems. This knowledge is crucial for practical and effective interventions at both individual and national levels.
All in all, Hall says, there’s enough evidence against UPFs to recommend that those who can afford it replace UPFs with less processed foods. But banning ‘all’ UPFs as a public health measure goes too far, as it ignores the time, skill, cost, access and effort required to safely prepare a tasty meal without UPFs. Large parts of the world’s population do not have those resources. In addition, eating fresh food as a common practice will greatly increase the unsustainability of the food system through waste.
How should it be? Well, start at the beginning, Hall says. Focus on mechanistic research so you know how the body works. Then you can use this to optimize effective reformulation strategies that actually contribute to improving public health.
Kevin Hall’s article is free to read until December 14.
“Eliminate or reformulate ultra-processed foods? Biological mechanisms matter” is my first publication with @deirdre_tobias and is now online in @Cell_Metabolism and free to access until December 14 https://t.co/8BrfFcNvON
— Kevin Hall (@KevinH_PhD) October 25, 2021
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Kevin Hall: ‘You shouldn’t just ban UPFs’ – Healthy, sustainable, safe and affordable food requires better nutritional research – Foodlog