Processed and Ultra-Processed Foods: Reading Beyond the Headlines

Written by Andrew Akhaphong, MS, RD, LD, Mackenthun’s Registered Dietitian

Updated April 16, 2024

Processed and ultra-processed foods are common headliners in terms of health-related topics. Concerns for consuming processed foods include heart disease, cancer, type-2 diabetes, and obesity.

A sample size of 105,159 participants ages 18-years and older in Europe were observed over the course of 5-years for their consumption of ultra-processed foods. Over the course of the study, it was found that 1409 participants (13%) developed heart disease (ie. high cholesterol, high blood pressure, heart attack history, stroke history, etc.). The associated foods included ultra-processed fats, sauces, and meats.These findings were measured using a tool called a 24-hour food recall and were collected over the course of 5 days per week for the 5-year study.(1)

An additional study examined 19,899 participants ages 20 to 91-years in Europe over the course of December 1999 and February 2014. Every two years their consumption of ultra-processed foods were measured using a 136-item food frequency questionnaire. During this study 335 participants (15.8%) have passed. Persons who consumed at minimum 4 servings or more of ultra-processed foods daily had a 62% increased risk for mortality. “For each additional serving of ultra-processed food, mortality increased by 18%”.(2)

At this time of this article being written, we currently can find only studies around ultra-processed foods and not processed foods itself. As we examine additional outlets communicating the topic of processed and ultra-processed foods they have only examined the negative impacts on health and the environment. Because of this seldom do processed and ultra-processed foods have an opportunity to be examined further on its applications for health and the environment in a more “positive light”. For the purpose of this article, there is lack of evidence on the benefits of ultra-processed foods and we will focus on examining only processed foods.

What Are Processed and Ultra-Processed Foods?

Processed foods is defined as the “alteration of foods from the state in which they are harvested or raised to better preserve them and feed consumers”.(3) Additionally the National Health Service of the United Kingdom states processed foods are “not just microwaveable and ready-to-eat meals”. Processed foods include foods that are altered in any way during preparation for distribution, storage, and consumption including -(4)

Freezing
Canning
Cooking
Drying

Not all processed foods are unhealthy, but once additional ingredients are added including salt, sugar, and fat then this terminology is different. Many people often use processed foods and ultra-processed foods interchangeably, but they do describe different things.

The definition of ultra-processed foods has been revised over the years. The most recent definition as of 2017 by the NOVA Food Classification for ultra-processed foods identifies this category as industrial formulations typically with 5 or more ingredients including -(5)

Salt
Sugar
Oils and fats
Food substances not typically used in culinary preparations (hydrolyzed proteins, modified starches, hydrogenated or interesterified oils, food additives)

The Purpose of Food Processing

The image above outlines different stages in how food becomes “processed food”.(6)

According to anthropologists, processed foods have been present since prehistoric times. As technology improved for agriculture and animal husbandry it was important to find means to preserve food and reduce loss due to spoilage and survival during times of famine.(6) Most processing of food was done at home but as large scale food production grew, the demand for food industries to take over increased.(6)

Fortifying Nutrients – In the United States and most countries the process of nutrient fortification was initiated to correct nutritional deficiencies in populations.(7) Goiter is a medical condition in which a person experiences an abnormal enlargement, inflammation, and dysfunction of the thyroid gland. In 1907 it was found by Davine Marine that iodine supplementation improved thyroid health; however, many scientists did not believe him.(8) Eventually in 1924 the United States declared it mandatory to add iodine to table salt. A review found in secondary-education enrolled girls there was a decrease of 28-million confirmed cases of goiter in the 1920s to 25-million confirmed cases in the 1940s. Today, it is estimated goiter affects 2.2-million people worldwide with the United States ranking the lowest of confirmed goiter cases annually.(9,10)

Foods often fortified with nutrients to reduce nutritional deficiencies include

Orange juice and apple juice
Cow’s milk
Cold cereals
Bread
and eggs

With the rise in interest and consumption of non-dairy milk alternatives such as soy non-dairy beverage or almond non-dairy beverage there has been an increase in children with stunted growth and low Vitamin D and calcium levels. Non-dairy milk is not required to be fortified with nutrients, but due to these concerns many brands are opting to now fortify their beverages.

Food Insecurity – environmental disasters, climate change, impacts of soil and water quality inadequate community infrastructure, and poor pest control are factors that may contribute to persons having low access to food and nutrient-dense foods.(6) Improving crop resistance to pests and drought, providing advances in canning, pickling, and dehydrating allows for more persons to have a source of food that is safe and shelf stable.

Lycopene is a nutrient found in high concentrations in tomatoes, more specifically in the skin of tomatoes. Studies supporting lycopene may reduce the risk of cancers, heart disease, and reduce risk for osteoporosis.(11) Multiple studies have found the average absorption of lycopene from tomato skin is 0.2%; one tomato provides on average 8.0 milligrams of lycopene.(12) Deficiency in lycopene includes increases in cholesterol, poor eyesight, enlarged prostate gland, and irregular heart rates.(13) There is no set recommendation for lycopene, but many studies report an average of 21 milligrams per day is necessary.(14) Multiple studies also show the processing of tomatoes (ie. canning, stewing, pickling) increases absorbable lycopene by 82% as processed tomatoes have lower concentrations of tomato cells.(15)

Foodborne Illness – The United States Centers for Disease Control and Prevention reports 3,000 people pass due to foodborne illness annually.(16) Additionally an average of 110 cases of botulism is reported annually.(17) Botulism is a toxin that attacks the nervous system leading to difficulty breathing, muscle paralysis, and eventually mortality.(18) Food processing by means of canning or pickling reduces the botulism rate from 50% to 8% when done well.(19)

To Recap

Think about processed foods differently, but be aware that ultra-processed food consumption may increase our risks for developing chronic health conditions.

References

Srour B, Fezue LK, Allè B, Méjean C, Andrianasolo RM, et. al. Ultra-processed food intake and risk of cardiovascular disease: a prospective cohort study (NutriNet-Santé). BMJ. 2019;365:I1451. doi: https://doi.org/10.1136/bmj.l1451
Rico-Campá A, Martínez-González M, Alvarez-Alvarez I, de Deus Mendonça R, de la Fuente-Arrillaga C, Gómez-Donoso C. Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ. 2019;365:I1949. doi: https://doi.org/10.1136/bmj.l1949
Floros JD, Newsome R, Fisher W, Barbosa-Canovas GV, Chen H, et. al. Feeding the world today and tomorrow: the importance of food science and technology. An IFT scientific review. Compr Rev Food Sci Food Saf. 2010;9(5):572-599. https://doi.org/10.1111/j.1541-4337.2010.00127.x
National Health Services of the United Kingdom. Eating processed foods. Updated June 12, 2023. Accessed April 16, 2024. https://www.nhs.uk/live-well/eat-well/how-to-eat-a-balanced-diet/what-are-processed-foods/
Gibney MJ. Ultra-processed foods: definitions and policy issues. Cur Dev Nutr, 2019;3(2):nzy077. https://doi.org/10.1093/cdn/nzy077
Weaver CM, Dwyer J, Fulgoni III VL, Leveille GA, MacDonald RS, et. al. Processed foods: contributions to nutrition. Am J Clin Nutr. 2014; 99(6):1525-1542. doi: 10.3945/ajcn.114.089284
Committee on the Use of Dietary Reference Intakes in Nutrition Labeling. Dietary reference intakes: guiding principles for nutrition labeling and fortification. Institute of Medicine. 2003. Accessed April 16, 2024. https://www.ncbi.nlm.nih.gov/books/NBK208880/
Connelly KJ, Park JJ, LaFranchi SH. History of the thyroid. Hormone Research in Paediatrics. 2022;95(6):546-556. https://doi.org/10.1159/000526621
Sittler T. Did iodized salt raise the IQ of 50 million Americans by 15 points?. January 7, 2016. Accessed April 16, 2024. https://www.givingwhatwecan.org/blog/are-we-underestimating-benefits-salt-iodization
John Hopkins Medicine. Goiter. n.d. Accessed April 16, 2024. https://www.hopkinsmedicine.org/health/conditions-and-diseases/goite
Petrovich B. What is lycopene?. VeryWellHealth. Updated March 4, 2024. Accessed April 16, 2024. https://www.verywellhealth.com/lycopene-health-benefits-4684446
Arballo J, Amengual J, Erdman Jr JW. Lycopene: a critical review of digestion, absorption, metabolism, and excretion. Antioxidants. 2021;10(3):342. doi: 10.3390/antiox10030342
Welter ML. The effects of lycopene on your health. North Dakota State University. n.d. Accessed April 16, 2024. https://www.ndsu.edu/pubweb/chiwonlee/plsc211/student%20papers/articles04/Melissa%20Welter/mwelter.htm
Petre A. Lycopene: health benefits and top food sources. Healthline. Updated October 3, 2018. Accessed April 16, 2014. https://www.healthline.com/nutrition/lycopene
Fielding JM, Rowley KG, Cooper P, O’Dea K. Increase in plasma lycopene concentration after consumption of tomatoes cooked with olive oil. Asia Pac J Clin Nutr. 2005;14(2):131-6. PMID: 15927929
Centers for Disease Control and Prevention. Estimates of foodborne illness in the United States. Updated November 5, 2018. Accessed April 16, 2024. https://www.cdc.gov/foodborneburden/index.htm
Centers for Disease Control and Prevention. Botulism: epidemiological overview for clinicians. Updated October 6, 2006. Accessed April 16, 2024. https://www.emergency.cdc.gov/agent/botulism/clinicians/epidemiology.asp
Centers for Disease Control and Prevention. About botulism. Updated June 1, 2021. Accessed April 16, 2024. https://www.cdc.gov/botulism/general.html
Clemson University Cooperative Extension. Canning vegetables to prevent botulism. n.d. Accessed April 16, 2024. https://www.clemson.edu/extension/food/canning/canning-tips/07preventing-botulism.html