Part 2, What is UPF? – Watt?

Guest post by Kip Hansen – January 10, 2025 – 1400 words/5 minutes

What are ultra-processed foods? The UPF literature provides lengthy and confusing definitions, but in almost all cases relies on the original work of Carlos A. Monteiro (and his colleagues Inês Castro, Renata Bertazzi-Levy, Rafael Claro, and Geoffrey Cannon) in 2009 The definition provided is on the topic: “Nutrition and health. The problem is not the food, nor the nutrients, but the processing”.

[Note:  The use of the word “muchas” is in the original, Monteiro is Brazilian.]

I give it here diagrammatically, exactly the same as used in Monteiro 2019a restatement of the original work (link to .docx fileeasier to read):

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The definition has not changed over the years since then, but the actual list of measurements used by researchers in all studies exposure UPF in food frequency questionnaires (FFQ) and 24-hour dietary recalls (24HR) have changed over time, adding another layer of uncertainty to the pooled findings. Not all studies use the same FFQ, and not all decisions about which items in the FFQ/24-hour recall are considered UPF for each study. Lane et al. 2023 [ .pdf ] Including this:

“SACN [UK’s Scientific Advisory Committee on Nutrition] Concerns were expressed on various key points. For example, it emphasizes that existing studies applying the Nova system are mainly epidemiological in nature and may lack adequate consideration of confounding factors or covariates. Criticisms of Nova as a classification system also exist, with evaluators concerned that it may be imprecise and inconsistent. In contrast, recent evaluations have shown that inter-coder construct validity is acceptable and there is strong agreement between coders, and the definitions and examples provided by the Nova system are considered adequate for use by diverse groups from the U.S. More than 70% of the foods reported in the food frequency questionnaire were classified.

Elizabeth et al. The 2020 Supplement provides a chart of UPF project changes since 2009:

Then there's a more popular short definition, provided by Dr. Chris Van Tulleken, an infectious diseases physician at University College London, BBC science presenter and New York Times best-selling author, who offers this simple sentence: “If it's wrapped in plastic and contains at least one ingredient you wouldn't normally find in a home kitchen, then it's an ultra-processed food.”

Supplementary information from Monteiro et al. 2019 NOVA Food Category Chart:

“NOVA Food Categories: Defined by the Degree and Purpose of Food Processing”

Ralph Nader calls UPF “ultra-processed, deadly corporate food.”

We see anti-corporate slogans appearing in the definition of UPF and even in the original article by Monteiro et al. (2019):

“Their convenience (non-perishable, ready-to-eat), super palatability, Multinational Brands and Ownershipand aggressive marketing give ultra-processed foods a huge market advantage over all other NOVA food categories. Marketing strategies used globally include vivid packaging, health claims, special deals with retailers to secure prime shelf space, establishment of franchised food and beverage outlets and campaigns utilizing social, electronic, broadcast and print media (including targeting children and schools), These activities often require large budgets”.

You might be asking yourself, how does ownership of food manufacturers contribute to heart disease? Or diabetes? Or all-cause mortality? How does the “scope and purpose” of the processes used to make food lead to these things? None of the food companies ownership or processing Purpose are the physical components of the food consumed.

You won't be the only one asking this question. Opinion in the field of nutrition is growing in both directions: Support for anti-UPF ideas has grown to include all liberal journals and organizations, including the United Nations World Health Organization and various national health organizations, as they flood the research bandwagon with funding and publishing credits. At the same time, individual nutrition experts also began to speak out Oppose anti-UPF movement In particular, its use of a catch-all definition and its potential to worsen rather than improve human dietary nutrition.

Levine and Ubbink (2023) from the Department of Food Science and Nutrition at the University of Minnesota said:

“The world's daily food supply is and will continue to rely heavily and increasingly on the processing of food and ingredients. As future population growth, climate change, and the need for agricultural practices to become more sustainable, continued innovation in food processing will be critical to ensuring sustainable, A healthy and abundant food supply is vital.

“While many types of processing can have negative impacts, food processing not only produces unhealthy foods but also forms a critical and important part of our food system. Without a more nuanced understanding of the factors that determine the nutritional value (positive or negative) of these foods, the classification of ultra-processed foods undermines public trust in food processing technologies.

FoodDrinkEurope, the European food industry advocacy group, has provided a scientific review of UPF (link is .pdf ), which includes the following key points (there are many):

“Classification is ideologically biased

Categorizing foods based on their presumed “purpose” (including their design, such as being “highly profitable”, “highly attractive” or “convenient”) is subjective and is considered to reflect an ideology about the modern food production system Bias (Forde, 2023b [.pdf]; Vescioli et al., 2022 [.pdf]). There is no evidence that unprofitable, unpalatable, expensive or inconvenient foods are associated with better health outcomes (Forde, 2023b [.pdf])

The classification is too broad and inclusive and there is no scientific evidence

Classifications vary and are based on the degree and nature of changes to the food from its original form, including modification of the food's inherent properties, addition of ingredients, and consideration of the place and purpose of processing. There is no agreement on what constitutes processed foods or different degrees of processing, including the extent to which they should reflect only technical processes and/or include recipes/ingredients. From a food science and technology perspective, if there is no evidence of a correlation between the degree of processing and the nutritional value of the product, these aspects should remain different. Furthermore, these classifications appear to assume that most food processing is harmful to health and are hypothesis-driven rather than derived from strong scientific evidence, i.e. studies using NOVA to support claims made by the NOVA classification itself may represent circular arguments (Sadler et al. People, 2017).

Without scientific evidence of adverse effects of specific ingredients or processing methods, the ultra-processed category may be too broad and inclusive – covering a large proportion of energy (up to 60% in some developed countries) and approximately 10 to 12 different food categories with Broad and diverse nutritional profile (Forde, 2023a [.pdf]2023b [.pdf])”.

European Food and Drink Review [remember, it was produced by a food industry advocacy group] Might be biased against the anti-UPF movement, but it does contain a wealth of literature on the subject as of early 2024, and its summary of the papers listed seems straightforward. Regardless, it nicely summarizes the criticism of the NOVA food classification system in the professional nutrition community.

Best practical answer to this question:

“What exactly are ultra-processed foods?”

It seems to be:

“On the grocery store shelves, in the aisles, just about everything And in your home cupboards and refrigerator.

Such an answer makes us wonder “What do people eat if they don’t eat UPF?”

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Author comments:

This is another ongoing Modern Scientific Controversies (MSC). This means that scientists and experts are taking sides, for or against, and fighting it out in the media and journals. In these controversies, these “wars,” the usual details are often forgotten, papers are written to attack the “other side,” editorials are written in which it is suggested that scientific misconduct is permissible. And, as we have seen in other MSCs, views have hardened and papers have become increasingly skewed towards views that attract more research funding and buy more publication credits. It's become a popular health fad that journals favor “UPF is bad” at the moment, but in the meantime, nutrition experts willing to take the opposite view are making some headway in journals and gaining some favorable space among the general public while the media holds on Contrary views.

The next part of this series will delve deeper into the science of the UPF issue rather than the politics of the food world.

Thank you for reading.

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