Are we ultra-processed students?

What is ultra-processed food and should we be worried?

Jacob Hamilton
21st November 2023
Dr Chris van Tulleken's recently published book, Ultra-Processed People. Image Source: @doctorchrisvt on Instagram

TW: Nutritional information, calories

Earlier this year Dr. Chris van Tulleken waged a war on white bread with his best-selling book Ultra-Processed People. He warns that our diets are dominated by ultra-processed foods and rings the alarm about the associated danger to our health and environment.
But what are ultra-processed foods? Are they really as bad as van Tulleken makes out? Are we ultra-processed students?!

What is ultra-processed food?

The best definition comes from the NOVA classification system developed by Professor Carlos Monteiro and his team – but it’s pretty complex. In summary– “Ultra-processed foods are formulations of ingredients, mostly of exclusive industrial use, typically created by series of industrial techniques and processes.”

Dr. Chris van Tulleken boils it down to– “if it’s wrapped in plastic and has at least one ingredient that you wouldn’t find in your kitchen, it’s ultra-processed food.” You might be thinking at this point– “wrapped in plastic…. with ingredients that aren't in my kitchen, that sounds like most of what I eat!.”

You wouldn’t be alone ­– an analysis of food intake in the UK found that ultra-processed food makes up on average 57% of our diets, and that climbs to 83% for adolescents. The question is – should we be alarmed by that? 

Dr Chris van Tulleken (right) with his twin brother, Dr Xand van Tulleken (left), and the third presenter of TV show Operation Ouch (2012-present), Dr Ronx (center). Image source: @drchris_drxand on Instagram

In the UK, ultra-processed food makes up on average 57% of our diets, and that climbs to 83% for adolescents.

The evidence

There’s a growing body of observational evidence linking ultra-processed food consumption with an increased risk of all-cause mortality and diseases including obesity and cancer.

But there’s a caveat with observational evidence – it’s difficult to distinguish the exact cause of the increased risk and control for other factors. Is it to do with the ‘ultra-processing’? Or is it just down to factors we’re already aware of, such as the high added fat, salt and sugar content of most ultra-processed foods and low amounts of fibre and micronutrients?

Apparently, it’s not that simple! In 2019, researcher Kevin Hall and his colleagues investigated whether individual nutrients are responsible in a landmark study. They found that on average ultra-processed food eaters gained weight and ate about 500 calories per day more than those who ate unprocessed foods.

This was despite the processed and unprocessed meals being matched for calories, sugar, salt, fat and fibre. Participants were allowed to eat as much as they wanted. The ultra-processed food eaters ate more food despite not preferring the pleasantness of the meal. Factors such as texture, palatability and the food matrix likely contributed to the overeating. Also, there are almost definitely contributing factors that we don’t yet fully understand. But is this a good enough reason to demonise all ultra-processed foods? 

The expert consensus

The Eatwell guide recommends keeping added sugars below ~30g a day, saturated fat below 20-30g, salt below 6g per day and getting a daily dose of at least 30g of fibre.

According to the experts – no there isn’t. Just this summer, the Scientific Advisory Committee on Nutrition for the UK government released a statement on processed foods and health. They concluded: “The observed associations … are concerning – however, the limitations in the NOVA classification system, the potential for confounding, and the possibility that the observed adverse associations with ultra-processed food are covered by existing UK dietary recommendations mean that the evidence to date needs to be treated with caution.”

So, until we have better quality evidence, UK healthy eating guidance (The Eatwell Guide) remains the same with no mention of food processing. The Eatwell guide recommends keeping added sugars below ~30g a day, saturated fat below 20-30g, salt below 6g per day and getting a daily dose of at least 30g of fibre. 

My take

Does the current evidence warrant being scared of bread or fearful of cereal? I don’t think it does. I’ve certainly noticed how easy it can be to overeat certain ultra-processed foods and exceed the recommended upper limits for salt, sugar etc. But on the other hand, they’re cheap and convenient, which are important factors for a busy student on a budget.

Additionally, I’d argue that not all ultra-processed foods are unhealthy! Ultimately, I'm not worried about being an 'ultra-processed student' but I will try to eat the less healthy ultra-processed foods in moderation. I do agree that our current food system has detrimental impacts on our health and our planet’s health. So, I certainly don’t veto van Tulleken’s valiant efforts to raise awareness around diet-related disease – but I won’t be binning the baked beans just yet.

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