Wikipedia

Ultra-processed food

An ultra-processed food (UPF) is an industrially formulated edible substance derived from natural food or synthesized from other organic compounds.[1][2] The resulting products are designed to be highly profitable, convenient, and hyperpalatable, often through food additives such as preservatives, colourings, and flavourings.[3] UPFs have often undergone processes such as moulding/extruding, hydrogenation or frying.[4]

Bowl of Froot Loops cereal, an ultra-processed cereal
Aisle of ultra-processed foods in an American supermarket

Ultra-processed foods first became ubiquitous in the 1980s,[5] though the term "ultra-processed food" gained prominence from a 2009 paper by Brazilian researchers as part of the Nova classification system.[6] In the Nova system, UPFs include most bread and other massed-produced baked goods, frozen pizza, instant noodles, flavored yogurt, fruit and milk drinks, “diet” products, baby food, and most of what is considered junk food.[7][8] The Nova definition considers ingredients, processing, and how products are marketed;[9] nutritional content is not evaluated.[10] As of 2024, research into the effects of UPFs is rapidly evolving.[11][4]

Since the 1990s, UPF sales have been increasing or remained high in most countries. In the limited available national data, as of 2023, consumption is highest in the United States (58% of daily calories) and United Kingdom (57%), and ranges widely, with Chile, France, Mexico and Spain among the countries in the 25-35% range, and Colombia, Italy, and Taiwan among those at or below 20%.[4]

Epidemiological data suggest that consumption of ultra-processed foods is associated with non-communicable diseases and obesity.[12] A 2024 meta analysis published in The BMJ, identified 32 studies that associated UPF with negative health outcomes, though the specific mechanism of the effects was not clear.[11]

Some authors have criticised the concept of "ultra-processed foods" as poorly defined, and the Nova classification system as too focused on the type rather than the amount of food consumed.[13] Other authors, mostly in the field of nutrition, have been critical of the lack of attributed mechanisms for the health effects, focusing on how the current research evidence does not provide specific explanations for how ultra-processed food affects body systems.[14]

Definitions

edit

Concerns about food processing have existed since at least the Industrial Revolution.[15] The origin of ultra-processed food is more recent: Michael Pollan's influential book The Omnivore's Dilemma (2006) referred to highly processed industrial food as 'edible food-like substances'.[16] Carlos Augusto Monteiro cited Pollan as an influence in coining the term 'ultra-processed food' in a 2009 commentary.[9] Some sources have described UPF as "predigested food".[17][18][19][20]

Monteiro's team developed the Nova classification for grouping unprocessed and processed foods beginning in 2010, whose definition of ultra-processing became the most widely accepted, refined through successive publications.[7] The identification of ultra-processed foods, as well as the category itself, is a subject of debate among nutrition and public health scientists, and other definitions have been proposed.[21]

A survey of systems for classifying levels of food processing in 2021 identified four 'defining themes':

  • Extent of change (from natural state)
  • Nature of change (properties, ingredients added)
  • Place of processing (where/by whom)
  • Purpose of processing (why, essential/cosmetic)[22]

Monteiro's 2009 commentary

edit

Carlos Monteiro, working with a team of researchers at the University of São Paulo, first published the concept of ultra-processed foods:

Ultra-processed foods are basically confections of group 2 ingredients [substances extracted from whole foods], typically combined with sophisticated use of additives, to make them edible, palatable, and habit-forming. They have no real resemblance to group 1 foods [minimally processed foods], although they may be shaped, labelled and marketed so as to seem wholesome and 'fresh'. Unlike the ingredients included in group 2, ultra-processed foods are typically not consumed with or as part of minimally processed foods, dishes and meals. On the contrary, they are designed to be ready-to-eat (sometimes with addition of liquid such as milk) or ready-to-heat, and are often consumed alone or in combination (such as savoury snacks with soft drinks, bread with burgers).[9]

This definition is as much social as one based on specific ingredients, which makes the understanding of ultra-processed foods highly intuitive, even among untrained consumers.[23][24] A letter responding to Monteiro's 2009 commentary suggested that the definition 'lacks precision', since it lacks the measurable definitions of traditional food science.[25] Because of this, researchers disagree whether the definition can form a valid basis for scientific control.[13] Researchers have developed a quantitative definition for hyperpalatable food, but not for ultra-processed food.[26]

Nova classification

edit
Main article: Nova classification
 
Label for Nova group 4, 'ultra-processed foods'

Monteiro's team subsequently presented ultra-processed foods as a group in the Nova food classification system.[6] The system focuses on food processing rather than foods types or nutrients. Nova categorizes foods into four groups:[3] unprocessed or minimally processed foods, processed ingredients, processed foods, and ultra-processed foods.

Nova is an open classification that refines its definitions gradually through scientific publications rather than through a central advisory board.[7] The most recent overview of Nova defines ultra-processed food as:

Industrially manufactured food products made up of several ingredients (formulations) including sugar, oils, fats and salt (generally in combination and in higher amounts than in processed foods) and food substances of no or rare culinary use (such as high-fructose corn syrup, hydrogenated oils, modified starches and protein isolates). Group 1 [un- or minimally processed] foods are absent or represent a small proportion of the ingredients in the formulation. Processes enabling the manufacture of ultra-processed foods include industrial techniques such as extrusion, moulding and pre-frying; application of additives including those whose function is to make the final product palatable or hyperpalatable such as flavours, colourants, non-sugar sweeteners and emulsifiers; and sophisticated packaging, usually with synthetic materials. Processes and ingredients here are designed to create highly profitable (low-cost ingredients, long shelf-life, emphatic branding), convenient (ready-to-(h)eat or to drink), tasteful alternatives to all other Nova food groups and to freshly prepared dishes and meals.

Ultra-processed foods are further defined as measurably distinguishable from processed foods by ingredients "of no culinary use (varieties of sugars such as fructose, high-fructose corn syrup, 'fruit juice concentrates', invert sugar, maltodextrin, dextrose and lactose; modified starches; modified oils such as hydrogenated or interesterified oils; and protein sources such as hydrolysed proteins, soya protein isolate, gluten, casein, whey protein and 'mechanically separated meat') or of additives with cosmetic functions (flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners and anti-foaming, bulking, carbonating, foaming, gelling and glazing agents) in their list of ingredients."[27]

The Nova definition of ultra-processed food does not comment on the nutritional content of food and is not intended to be used for nutrient profiling.[10]

International Agency for Research on Cancer (IARC)

edit

The International Agency for Research on Cancer, an intergovernmental agency that forms part of the World Health Organization, classifies foods by their degree of processing. This system breaks food into 'non-processed', 'moderately processed', and 'highly processed' food.[28][clarification needed] The system does not take into account the nature or purpose of changes.[29]

Siga Index

edit

The Siga Index is a classification system for processed foods developed in France.[5] It is based on the degree of processing and the nutritional quality of foods, using a holistic and reductionist approach.[30]

The Siga Index assigns a score from 1 to 100 to each food product, where higher scores indicate higher nutritional quality and lower processing. The Siga Index also defines ultra-processed foods (UPFs) as those with a score below 40, which are considered to have low nutritional value and high levels of additives, preservatives, and artificial ingredients.[31]

International Food Information Council (IFIC)

edit

The International Food Information Council defines five levels of food processing: minimally processed, foods processed for preservation, mixtures of combined ingredients, ready-to-eat processed foods, and prepared foods/meals.[32][33]

NUPENS

edit

The Center for Epidemiological Research in Nutrition and Health at the University of São Paulo has proposed a variant on the Nova classification consisting of: unprocessed, minimally, or moderately processed foods; processed foods; and ultra-processed foods.[34]

Economics

edit

The high amount of processing lends ultra-processed food to be subject to different economic constraints compared to natural food.

Profitability

edit
 
Nestlé is one of the world's major distributors of ultra-processed food, with a presence in 188 countries.

Ultra-processed foods often use less expensive ingredients, allowing ultra-processed food to be priced lower.[35] Furthermore, ultra-processed foods are more consistently available in stores.[36][37] Global production networks of multinational food companies creating ultra-processed food are supported by high brand awareness, aggressive globalization tactics, and the purchasing of local companies selling similar products.[38]

Companies selling ultra-processed food frequently target youth consumers and middle income countries.[36][39] Many of these companies use big data to choose which consumers to market to.[40] Furthermore, the ultra-processed food industry uses indirect and direct lobbying in large countries to influence local food policy.[41][42]

Affordability for consumers

edit
 
Ultra-processed food as a percentage of household purchases in some European countries, as of 2018

They often have an extended shelf life, an important consideration for lower income consumers without reliable access to refrigeration. Among other reasons for the popularity of ultra-processed foods are the inexpensive cost of their main ingredients. The price of ultra-processed food fluctuated less than unprocessed food over a twelve-year period.[35]

Health effects

edit

The effect of ultra-processed foods on health has mainly been investigated using nutritional epidemiology and so far there has been no randomized controlled trial to investigate the effect of these foods on any health outcome other than weight gain. These studies have shown an overall increased risk for disease,[12][43] although studies separating different types of ultra-processed food have found adverse effects mainly for only some sub-groups such as soft drinks.[44] Overall, there is an association between certain poor health outcomes – including poor cardiometabolic and mental health, and reduced life expectancy – and consumption of UPF.[11] One study proposed that food addiction may also be associated with consumption of ultra-processed foods.[45]

One possible explanation for the adverse effect on health are the high amounts of sugar, fat and salt in these foods, although that does not apply to all ultra-processed foods. Other potential explanations are the presence of contaminants, certain food additives, and the high heat treatment of these foods.[46] There is currently however no scientific consensus.[47]

The publicizing of these findings has sparked debate over the categoric demonization of ultra-processed foods, with some critics calling for a more balanced view, and others arguing that promoting UPFs could undermine public health communication about their risks.[10][48][49][50][51] Jessica Wilson, a registered dietitian in California, challenged the negative stereotypes with an experiment where she consumed 80% ultra-processed food for a month. Contrary to expectations, Wilson reported she felt less hungry, experienced less fatigue, and was more physically active. She highlighted that UPFs are a significant part of the diet for many low-income families due to their affordability and convenience, and said that the public deserves more nuanced discussions rather than just "scary stories" about them. Her stance is partly driven by the view that fearmongering around UPFs overlooks socioeconomic factors like access to healthier alternatives.[52]

Environmental impact

edit

Beyond health implications, the production of ultra-processed foods also has significant environmental impacts.[53] These foods require extensive processing and packaging, resulting in higher energy consumption and waste production compared to minimally processed foods. Moreover, the globalized supply chains for the ingredients of ultra-processed foods contribute to greenhouse gas emissions.[54]

Regulation and policy

edit

Given the health and environmental impacts of ultra-processed foods, there have been calls for better regulation and policy surrounding these products. These measures face significant challenges, including industry opposition and the global nature of food supply chains. Future policy efforts may require a combination of regulation, education, and incentives to promote healthier, more sustainable food choices.

Four Latin American countries—Brazil,[55] Uruguay,[56] Peru,[57] and Ecuador[58]—have so far published national official dietary guidelines that recommend avoiding ultra-processed foods. Chile requires warning labels on some ultra-processed foods and taxes sugar-sweetened beverages.[59] A report on obesity published by the World Bank in 2020 mentions ultra-processed foods as a potential contributor.[60]

In 2022, the Scientific Advisory Committee on Nutrition (SACN) reviewed scientific literature to consider whether the British government should adopt a position on ultra-processed food and recommended further research, scheduling a review on its position for June 2024.[47]

Criticism

edit

Following the publication of the Nova classification, some researchers questioned whether food processing should itself be considered a factor in nutrient intake, especially in a prominent 2017 criticism written by researchers, one of which was funded by Nestlé and the Kerry Group.[61] UPFs are imprecisely defined and it is unclear how any adverse effects on health may come about.[62]

In 2022, Carlos Monteiro and Arne Astrup argued for and against the Nova classification in a series of three articles written in the style of an Oxford debate. Monteiro's 'yes' argument states that the effects of ultra-processed food are demonstrated by representative dietary surveys and long-term cohort studies; that consuming ultra-processed food is associated with negative health outcomes; and that the associations are supported by discussions of specific mechanisms.[63] Astrup's 'no' argument states that the Nova definition of ultra-processed foods is ambiguous and inherently leads to misclassification of foods; that evidence is lacking for effects that are not already accounted for by known factors such as nutrient composition; that existing evidence is limited to observational studies rather than being supported by randomized controlled trials; and that some ultra-processing techniques are valuable in achieving the transition to sustainable food production.[64] The two researchers nonetheless agreed that food processing significantly affects diet quality and health outcomes; that most types of food processing are harmless or beneficial, with a minority being harmful; that some characteristics of food processing are useful for food classification systems; and that further study is required to understand the effect of food processing on human health.[65]

A number of studies show that although UPFs in general are associated with higher health risks, there exists a large heterogenity among UPF subgroups. For example, although bread and cereals are classfied as UPFs, a large 2023 study published in The Lancet finds them inversely associated with cancer and cardiometabolic diseases in the European population.[66] The study found that animal-based products and artificially and sugar-sweetened beverages are most strongly associated with diseases among UPFs.[67] Robinson and Johnstone (2024) cite a similar study conducted in the US population. They argue that there should be a balanced approach in approaching UPFs: consumers should not be prematurely advised to avoid all UPFs, not just because of physical health concerns, but also because of social costs of the removal of UPFs (unnecessary anxiety and mistrust of science).[68]

See also

edit
 
Scholia has a profile for ultra-processed food (Q48931140).

References

edit
  1. ^ Monteiro C (2010). "The big issue is ultra-processing". World Nutrition. 1 (6): 237–269. ISSN 2041-9775.
  2. ^ Monteiro C (2011). "The big issue is ultra-processing. Why bread, hot dogs – and margarine – are ultra-processed". World Nutrition. 2 (10): 534–549. ISSN 2041-9775.
  3. ^ a b Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, et al. (April 2019). "Ultra-processed foods: what they are and how to identify them". Public Health Nutrition. 22 (5): 936–941. doi:10.1017/S1368980018003762. PMC 10260459. PMID 30744710.
  4. ^ a b c Touvier M, da Costa Louzada ML, Mozaffarian D, Baker P, Juul F, Srour B (October 2023). "Ultra-processed foods and cardiometabolic health: public health policies to reduce consumption cannot wait". BMJ. 383: e075294. doi:10.1136/bmj-2023-075294. PMC 10561017. PMID 37813465.
  5. ^ a b Fardet A (2018). "Characterization of the Degree of Food Processing in Relation With Its Health Potential and Effects". Advances in Food and Nutrition Research. Vol. 85. Elsevier. pp. 79–129. doi:10.1016/bs.afnr.2018.02.002. ISBN 978-0-12-815089-4. PMID 29860978.
  6. ^ a b Monteiro CA, Levy RB, Claro RM, Castro IR, Cannon G (November 2010). "A new classification of foods based on the extent and purpose of their processing". Cadernos de Saude Publica. 26 (11): 2039–2049. doi:10.1590/S0102-311X2010001100005. PMID 21180977.
  7. ^ a b c Gibney MJ (February 2019). "Ultra-Processed Foods: Definitions and Policy Issues". Current Developments in Nutrition. 3 (2): nzy077. doi:10.1093/cdn/nzy077. PMC 6389637. PMID 30820487.
  8. ^ Dixon R (Sep 6, 2023). "Ultra-processed foods: the 19 things everyone needs to know". The Guardian. Retrieved Sep 24, 2024.
  9. ^ a b c Monteiro CA (May 2009). "Nutrition and health. The issue is not food, nor nutrients, so much as processing". Public Health Nutrition. 12 (5): 729–731. doi:10.1017/S1368980009005291. PMID 19366466. S2CID 42136316.
  10. ^ a b c Lockyer S, Spiro A, Berry S, He J, Loth S, Martinez-Inchausti A, et al. (June 2023). "How do we differentiate not demonise - Is there a role for healthier processed foods in an age of food insecurity? Proceedings of a roundtable event". Nutrition Bulletin. 48 (2): 278–295. doi:10.1111/nbu.12617. PMID 37164357. S2CID 258618401.
  11. ^ a b c Lane MM, Gamage E, Du S, Ashtree DN, McGuinness AJ, Gauci S, et al. (February 2024). "Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses". BMJ. 384: e077310. doi:10.1136/bmj-2023-077310. PMC 10899807. PMID 38418082.
  12. ^ a b Pagliai G, Dinu M, Madarena MP, Bonaccio M, Iacoviello L, Sofi F (February 2021). "Consumption of ultra-processed foods and health status: a systematic review and meta-analysis". The British Journal of Nutrition. 125 (3): 308–318. doi:10.1017/S0007114520002688. PMC 7844609. PMID 32792031.
  13. ^ a b Visioli F, Marangoni F, Fogliano V, Del Rio D, Martinez JA, Kuhnle G, et al. (December 2023). "The ultra-processed foods hypothesis: a product processed well beyond the basic ingredients in the package". Nutrition Research Reviews. 36 (2): 340–350. doi:10.1017/S0954422422000117. hdl:11577/3451280. PMID 35730561.
  14. ^ Valicente VM, Peng CH, Pacheco KN, Lin L, Kielb EI, Dawoodani E, et al. (July 2023). "Ultraprocessed Foods and Obesity Risk: A Critical Review of Reported Mechanisms". Advances in Nutrition. 14 (4): 718–738. doi:10.1016/j.advnut.2023.04.006. PMC 10334162. PMID 37080461.
  15. ^ Moubarac JC, Parra DC, Cannon G, Monteiro CA (June 2014). "Food Classification Systems Based on Food Processing: Significance and Implications for Policies and Actions: A Systematic Literature Review and Assessment". Current Obesity Reports. 3 (2): 256–272. doi:10.1007/s13679-014-0092-0. PMID 26626606. S2CID 23606942.
  16. ^ Pollan M (2006). The omnivore's dilemma: A natural history of four meals. New York: Penguin Press. ISBN 978-1-59420-082-3.
  17. ^ LaMotte S (February 1, 2024). "You may be eating predigested food. Here's why". CNN.
  18. ^ O'Connor A, Steckelberg A (June 27, 2023). "Melted, pounded, extruded: Why many ultra-processed foods are unhealthy". Washington Post.
  19. ^ Al-Sibai N (February 3, 2024). "Experts Warn That the Food You're Eating May Have Been "Pre-Digested". Futurism.
  20. ^ Boyce H (February 5, 2024). "You might be eating 'predigested' food. Seriously". Atlanta Journal-Constitution.
  21. ^ Fardet A, Rock E (November 2019). "Ultra-processed foods: A new holistic paradigm?". Trends in Food Science & Technology. 93: 174–184. doi:10.1016/j.tifs.2019.09.016. ISSN 0924-2244. S2CID 203896042.
  22. ^ Sadler CR, Grassby T, Hart K, Raats M, Sokolović M, Timotijevic L (June 2021). "Processed food classification: Conceptualisation and challenges". Trends in Food Science & Technology. 112: 149–162. doi:10.1016/j.tifs.2021.02.059. ISSN 0924-2244. S2CID 233647428.
  23. ^ Hässig A, Hartmann C, Sanchez-Siles L, Siegrist M (August 2023). "Perceived degree of food processing as a cue for perceived healthiness: The NOVA system mirrors consumers' perceptions". Food Quality and Preference. 110: 104944. doi:10.1016/j.foodqual.2023.104944. hdl:20.500.11850/625580. ISSN 0950-3293. S2CID 259941132.
  24. ^ Ares G, Vidal L, Allegue G, Giménez A, Bandeira E, Moratorio X, et al. (October 2016). "Consumers' conceptualization of ultra-processed foods". Appetite. 105: 611–617. doi:10.1016/j.appet.2016.06.028. PMID 27349706. S2CID 3554621.
  25. ^ Darmon N (October 2009). "The good, the bad, and the ultra-processed". Public Health Nutrition. 12 (10): 1967–1968. doi:10.1017/S1368980009991212. PMID 19732488. S2CID 233340283.
  26. ^ Fazzino TL, Rohde K, Sullivan DK (November 2019). "Hyper-Palatable Foods: Development of a Quantitative Definition and Application to the US Food System Database". Obesity. 27 (11): 1761–1768. doi:10.1002/oby.22639. hdl:1808/29721. PMID 31689013. S2CID 207899275.
  27. ^ Martinez-Steele E, Khandpur N, Batis C, Bes-Rastrollo M, Bonaccio M, Cediel G, et al. (June 2023). "Best practices for applying the Nova food classification system". Nature Food. 4 (6): 445–448. doi:10.1038/s43016-023-00779-w. PMID 37264165. S2CID 259024679.
  28. ^ Chajès V, Biessy C, Byrnes G, Deharveng G, Saadatian-Elahi M, Jenab M, et al. (November 2011). "Ecological-level associations between highly processed food intakes and plasma phospholipid elaidic acid concentrations: results from a cross-sectional study within the European prospective investigation into cancer and nutrition (EPIC)". Nutrition and Cancer. 63 (8): 1235–1250. doi:10.1080/01635581.2011.617530. PMID 22043987. S2CID 23413731.
  29. ^ Slimani N, Deharveng G, Southgate DA, Biessy C, Chajès V, van Bakel MM, et al. (November 2009). "Contribution of highly industrially processed foods to the nutrient intakes and patterns of middle-aged populations in the European Prospective Investigation into Cancer and Nutrition study". European Journal of Clinical Nutrition. 63 (Suppl 4): S206–S225. doi:10.1038/ejcn.2009.82. PMID 19888275.
  30. ^ Davidou S, Christodoulou A, Fardet A, Frank K (March 2020). "The holistico-reductionist Siga classification according to the degree of food processing: an evaluation of ultra-processed foods in French supermarkets". Food & Function. 11 (3): 2026–2039. doi:10.1039/C9FO02271F. PMID 32083627. S2CID 211231016.
  31. ^ Fardet A (October 2018). "Vers une classification des aliments selon leur degré de transformation: Approches holistique et/ou réductionniste". Pratiques en Nutrition (in French). 14 (56): 32–36. doi:10.1016/j.pranut.2018.09.008. S2CID 187435561.
  32. ^ Eicher-Miller HA, Fulgoni VL, Keast DR (June 2015). "Energy and Nutrient Intakes from Processed Foods Differ by Sex, Income Status, and Race/Ethnicity of US Adults". Journal of the Academy of Nutrition and Dietetics. 115 (6): 907–18.e6. doi:10.1016/j.jand.2014.11.004. PMID 25578928.
  33. ^ Eicher-Miller HA, Fulgoni VL, Keast DR (November 2012). "Contributions of processed foods to dietary intake in the US from 2003-2008: a report of the Food and Nutrition Science Solutions Joint Task Force of the Academy of Nutrition and Dietetics, American Society for Nutrition, Institute of Food Technologists, and International Food Information Council". The Journal of Nutrition. 142 (11): 2065S–2072S. doi:10.3945/jn.112.164442. PMC 3593301. PMID 22990468.
  34. ^ Louzada ML, Baraldi LG, Steele EM, Martins AP, Canella DS, Moubarac JC, et al. (December 2015). "Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults". Preventive Medicine. 81: 9–15. doi:10.1016/j.ypmed.2015.07.018. PMID 26231112.
  35. ^ a b Gupta S, Hawk T, Aggarwal A, Drewnowski A (2019-05-28). "Characterizing Ultra-Processed Foods by Energy Density, Nutrient Density, and Cost". Frontiers in Nutrition. 6: 70. doi:10.3389/fnut.2019.00070. PMC 6558394. PMID 31231655.
  36. ^ a b Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B (November 2013). "Ultra-processed products are becoming dominant in the global food system". Obesity Reviews. 14 (Suppl 2): 21–28. doi:10.1111/obr.12107. PMID 24102801.
  37. ^ Stuckler D, Nestle M (2012-06-19). "Big food, food systems, and global health". PLOS Medicine. 9 (6): e1001242. doi:10.1371/journal.pmed.1001242. PMC 3378592. PMID 22723746.
  38. ^ Baker P, Machado P, Santos T, Sievert K, Backholer K, Hadjikakou M, et al. (December 2020). "Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers". Obesity Reviews. 21 (12): e13126. doi:10.1111/obr.13126. hdl:11343/276118. PMID 32761763.
  39. ^ Monteiro CA, Cannon G, Moubarac JC, Levy RB, Louzada ML, Jaime PC (January 2018). "The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing". Public Health Nutrition. 21 (1): 5–17. doi:10.1017/S1368980017000234. PMC 10261019. PMID 28322183.
  40. ^ Montgomery K, Chester J, Nixon L, Levy L, Dorfman L (January 2019). "Big Data and the transformation of food and beverage marketing: undermining efforts to reduce obesity?". Critical Public Health. 29 (1): 110–117. doi:10.1080/09581596.2017.1392483. ISSN 0958-1596.
  41. ^ Mialon M, Gaitan Charry DA, Cediel G, Crosbie E, Scagliusi FB, Perez Tamayo EM (June 2021). "'I had never seen so many lobbyists': food industry political practices during the development of a new nutrition front-of-pack labelling system in Colombia". Public Health Nutrition. 24 (9): 2737–2745. doi:10.1017/s1368980020002268. PMC 10195544. PMID 32819452.
  42. ^ Slater S, Lawrence M, Wood B, Serodio P, Baker P (February 2024). "Corporate interest groups and their implications for global food governance: mapping and analysing the global corporate influence network of the transnational ultra-processed food industry". Globalization and Health. 20 (1): 16. doi:10.1186/s12992-024-01020-4. PMC 10882744. PMID 38388413.
  43. ^ Isaksen IM, Dankel SN (June 2023). "Ultra-processed food consumption and cancer risk: A systematic review and meta-analysis". Clinical Nutrition. 42 (6): 919–928. doi:10.1016/j.clnu.2023.03.018. PMID 37087831. S2CID 257872002.
  44. ^ Chen Z, Khandpur N, Desjardins C, Wang L, Monteiro CA, Rossato SL, et al. (July 2023). "Ultra-Processed Food Consumption and Risk of Type 2 Diabetes: Three Large Prospective U.S. Cohort Studies". Diabetes Care. 46 (7): 1335–1344. doi:10.2337/dc22-1993. PMC 10300524. PMID 36854188.
  45. ^ LaFata EM, Gearhardt AN (2022-11-07). "Ultra-Processed Food Addiction: An Epidemic?". Psychotherapy and Psychosomatics. 91 (6): 363–372. doi:10.1159/000527322. PMID 36349805.
  46. ^ Kliemann N, Al Nahas A, Vamos EP, Touvier M, Kesse-Guyot E, Gunter MJ, et al. (July 2022). "Ultra-processed foods and cancer risk: from global food systems to individual exposures and mechanisms". British Journal of Cancer. 127 (1): 14–20. doi:10.1038/s41416-022-01749-y. hdl:10362/153976. PMC 9276654. PMID 35236935.
  47. ^ a b Scientific Advisory Committee on Nutrition (2023-07-11). "SACN statement on processed foods and health". GOV.UK.
  48. ^ Kelly A (December 9, 2019). "Demonising processed food undermines our trust in science". The Conversation. Retrieved Sep 24, 2024.
  49. ^ Schober C (2024-08-29). "Time Magazine Suggests Ultra-Processed Foods Really Aren't That Bad, And The Comments Are Hilarious". Evie Magazine. Retrieved 2024-09-19.
  50. ^ Nichols L (2024-05-20). "Beyond the Headlines: Unpacking the Truth About "Ultra-Processed" Foods and Health". Consumer Brands Association. Retrieved 2024-09-19.
  51. ^ "Here are the surprising results a dietitian got after eating ultra-processed food for a whole month". scoop.upworthy.com. 2024-09-04. Retrieved 2024-09-19.
  52. ^ Ducharme J (2024-08-27). "Why One Dietitian is Speaking Up for "Ultra-Processed" Foods". TIME. Retrieved 2024-09-19.
  53. ^ Leite FH, Khandpur N, Andrade GC, Anastasiou K, Baker P, Lawrence M, et al. (March 2022). "Ultra-processed foods should be central to global food systems dialogue and action on biodiversity". BMJ Global Health. 7 (3): e008269. doi:10.1136/bmjgh-2021-008269. PMC 8895941. PMID 35346976.
  54. ^ Seferidi P, Scrinis G, Huybrechts I, Woods J, Vineis P, Millett C (October 2020). "The neglected environmental impacts of ultra-processed foods". The Lancet. Planetary Health. 4 (10): e437–e438. doi:10.1016/S2542-5196(20)30177-7. hdl:11343/252595. PMID 33038314. S2CID 222280757.
  55. ^ Dietary Guidelines for the Brazilian Population (Report). Brasília: Brazilian Ministry of Health. 2014.
  56. ^ "Guías Alimentarias para la Población Uruguaya". Montevideo: Ministerio de Salud del Uruguay. 2016.
  57. ^ Guías Alimentarias para la Población Peruana (Report). Lima: Ministerio de Salud del Perú. 2018.
  58. ^ Documento Técnico de las Guías Alimentarias Basadas en Alimentos (GABA) del Ecuador. GABA-ECU (Report). Quito: Ministerio de Salud Pública del Ecuador y Organización de las Naciones Unidas para la Alimentación y la Agricultura. 2018.
  59. ^ Colchero MA, Paraje G, Popkin BM (2021-12-02). Vadiveloo MK (ed.). "The impacts on food purchases and tax revenues of a tax based on Chile's nutrient profiling model". PLOS ONE. 16 (12): e0260693. Bibcode:2021PLoSO..1660693C. doi:10.1371/journal.pone.0260693. PMC 8638973. PMID 34855853.
  60. ^ Shekar M, Popkin B (2020-02-13). Shekar M, Popkin B (eds.). Obesity: Health and economic consequences of an impending global challenge. The World Bank. doi:10.1596/978-1-4648-1491-4. hdl:10986/32383. ISBN 978-1-4648-1491-4. S2CID 219141840.
  61. ^ Gibney MJ, Forde CG, Mullally D, Gibney ER (September 2017). "Ultra-processed foods in human health: a critical appraisal". The American Journal of Clinical Nutrition. 106 (3): 717–724. doi:10.3945/ajcn.117.160440. PMID 28793996.
  62. ^ Tobias DK, Hall KD (December 2021). "Eliminate or reformulate ultra-processed foods? Biological mechanisms matter". Cell Metabolism. 33 (12): 2314–2315. doi:10.1016/j.cmet.2021.10.005. PMID 34699743. S2CID 239986991.
  63. ^ Monteiro CA, Astrup A (December 2022). "Does the concept of "ultra-processed foods" help inform dietary guidelines, beyond conventional classification systems? YES". The American Journal of Clinical Nutrition. 116 (6): 1476–1481. doi:10.1093/ajcn/nqac122. PMID 35670127.
  64. ^ Astrup A, Monteiro CA (December 2022). "Does the concept of "ultra-processed foods" help inform dietary guidelines, beyond conventional classification systems? NO". The American Journal of Clinical Nutrition. 116 (6): 1482–1488. doi:10.1093/ajcn/nqac123. PMID 35670128.
  65. ^ Astrup A, Monteiro CA (December 2022). "Does the concept of "ultra-processed foods" help inform dietary guidelines, beyond conventional classification systems? Debate consensus". The American Journal of Clinical Nutrition. 116 (6): 1489–1491. doi:10.1093/ajcn/nqac230. PMID 36253965.
  66. ^ Campbell D (13 November 2023). "Some ultra-processed foods are good for your health, WHO-backed study finds". The Guardian.
  67. ^ Cordova R, Viallon V, Fontvieille E, Peruchet-Noray L, Jansana A, Wagner KH, et al. (December 2023). "Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study". The Lancet Regional Health - Europe. 35: 100771. doi:10.1016/j.lanepe.2023.100771. PMID 38115963.
  68. ^ Robinson E, Johnstone AM (15 October 2024). "Ultraprocessed food (UPF), health, and mechanistic uncertainty: What should we be advising the public to do about UPFs?". PLOS Medicine. 21 (10): e1004439. doi:10.1371/journal.pmed.1004439. PMID 39405438.
Retrieved from "https://en.wikipedia.org/w/index.php?title=Ultra-processed_food&oldid=1254259759"