Wednesday 5 January 2022

What is 'ultra-processed food'?

In 'public health', the name of the game is to interfere with people's lives without having your own choices meddled with. This is straightforward with smoking since the philosopher kings of the nanny state don't smoke. Alcohol is more tricky since most of them drink, but minimum pricing - which was introduced in Ireland yesterday - offers the perfect way to penalise ordinary people while leaving fine wine and craft beer unaffected. 

The war on food poses the trickiest problem since its pretext - obesity - is the result of over-consumption and physical inactivity rather than the consumption of any specific type of food. 'Junk food' is too narrow since most people interpret it to mean 'fast food' from a handful of restaurant chains. And so, in the absence of an obvious dietary culprit, the 'public health' lobby is shifting towards a crusade against 'ultra-processed food'. 
Most people don't know what this means, but it sounds bad if you have an instinctive objection to industry and modernity. Perhaps it evokes thoughts of 'chemicals' and 'E numbers'. Certainly, it sounds like the opposite of the 'natural', 'organic' and 'home made' food so beloved of those who think they are superior to other people. It is, however, a classic 'public health' bait and switch. Just as people didn't realise that a ban on 'junk food' advertising would result in adverts for cheese and butter being banned, people won't realise what a war on ultra-processed food means for them until it is too late.

In a deranged op-ed in BMJ Global Health, some of Mike Bloomberg's minions from Vital Strategies call for tobacco-style regulation of 'ultra-processed food', starting with warning labels.

Simply put, ultra-processed foods are foods that can’t be made in your home kitchen because they have been chemically or physically transformed using industrial processes. They are recognisable on the supermarket shelf as packaged foods that are ready-to-eat, contain more than five ingredients and have a long shelf-life. The industrial processing, as well as the cocktail of additives, flavours, emulsifiers and colours they contain to give flavour and texture, make the final product hyper-palatable or more appealing and potentially addictive, which in turn leads to poor dietary patterns.
With more than half the total calories consumed in high-income countries coming from ultra-processed foods and rapid increases in low- and middle-income countries, these products are exposing billions of people to a higher risk of type 2 diabetes, heart disease, stroke, depression and death.

Scary stuff, eh? Alas, they don't give any examples of ultra-processed foods so let us instead turn to a recently published study about them....

Baked goods, including cakes, pastries, industrial breads, and soft drinks ranked among the top contributors to sales of UPFDs [ultra-processed food and drinks]

According to the the British Heart Foundation, ultra-processed foods include...

Ice cream, ham, sausages, crisps, mass-produced bread, breakfast cereals, biscuits, carbonated drinks, fruit-flavoured yogurts, instant soups, and some alcoholic drinks including whisky, gin, and rum.

I'm not sure how hard liquor made the cut, but I suppose if you're going be a fun sponge you might as well go all the way.
The Soil Association adds confectionery, margarine, milk drinks, ‘instant’ sauces, pies, pasta and pizza dishes, poultry and fish nuggets, burgers, hot dogs, noodles, desserts, infant formulas, follow-on milks and 'other baby products' to the list.

It's hardly surprising that high-income countries get more than half their calories from products on such an extensive list. A humble ham sandwich with margarine consists entirely of 'ultra-processed food' (unless you bake the bread yourself in which case it becomes magically healthier). If there is to be a war on ultra-processed food, you will have to be a very unusual person not to be affected.

You might have noticed that a lot of the foods on these lists do not fit the definition given by Bloomberg's people. A lot of them, such as pastries, don't have a long shelf life. Most of them can be made 'in your home kitchen' if you can be bothered. They don't need to be 'chemically or physically transformed using industrial processes'. For the most part, 'processing' simply means 'cooking', ie. combining ingredients and heating them up. Chicken nuggets can be made at home, as Jamie Oliver famously demonstrated. They may or may not have more salt in them than the 'industrial' versions, just as a home cooked cake may or may not have more sugar in it than a shop-bought cake. That's up to you, but the idea that home-cooked food is inherently healthier has no basis in fact.

As for having 'more than five ingredients', what kind of ludicrous, arbitrary threshold is that??

None of this has any scientific standing whatsoever. The only thing these products have in common is that they are mostly sold in shops by businesses. Nevertheless, the authors claim that the foods listed above 'are not real foods'. Indeed, their article is titled '"Warning: ultra-processed" - A call for warnings on foods that aren't really foods'. 

It's high time that consumers had the opportunity to see ultra-processed foods for what they are: foods that are not real foods, containing nutrients but not real nutrition, pervasively marketed by supranational companies offering choices that are not real choices.

This is juvenile stuff and insofar as it makes any sense, it is garbage. The authors do, however, admit that when people are told what kind of foods are 'ultra-processed', they say that they rather like them.

We found evidence that while people are not familiar with the term ‘ultra-processed products,’ they recognise the group of products as harmful. That said, these products are also associated with positive emotions, which might be the result of decades of persuasive marketing by the food industry.

Of course. That's why people like eating sausages, bread and cakes. Persuasive marketing! What else could it be?

For instance, a considerable number of people associate the products with satisfying cravings, being tasty and bringing joy. 

This is totally unacceptable, naturally, and the authors see an urgent need to crack down on it.

If we are to stave off the devastation to our food system and our health, governments with the support of the global public health community need to urgently implement effective strategies that lead to decreasing consumption of these unhealthy products and enable healthier choices. 

One such strategy would be to establish the image of ultra-processed foods—those glossily packaged, alluringly marketed, ready-to-eat, convenient and tasty products—as the vector for obesity and a risk factor for serious diseases alongside tobacco, alcohol and other unhealthy commodities. It’s time to invest in establishing the negative brand identity that ultra- processed foods and beverages deserve. We could start by taking lessons learnt from tobacco control...

Heavens to Betsy, a slippery slope! Who could have seen that coming?

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