The health impacts of ultra-processed foods explained by a nutritionist

ultra processed foods upfs
The real health impacts of ultra-processed foodsOscar Wong - Getty Images

There is no denying the appeal of ultra-processed foods (UPFs) – ready-to-eat items that undergo multiple stages of industrial processing – not only for their promise of convenience in our ever-busy lives, but also their lower cost in our current economic climate. “Processes and ingredients used to manufacture ultra-processed foods are designed to create ready-to-consume, convenient, hyper-palatable and attractive looking products,” explains registered nutritionist Gabi Zaromskyte, founder of Honestly Nutrition. They are typically made using “low-cost ingredients with a long shelf-life, making them highly profitable”.

It's a classification introduced by the Brazilian nutritionist Carlos Monteiro, who identified “four categories of food processing: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed food substances (UPFs)” and has become increasingly talked about thanks to experts like doctor, academic and TV presenter Chris Van Tulleken – whose 2023 book Ultra-Processed People swiftly became a number one bestseller.

Examples of UPFs include soft drinks, packaged snacks, sugary cereals, frozen meals and fast-food items, Zaromskyte says, with ultra-processed foods typically containing minimal whole foods and myriad other ingredients. “They are commonly composed of high levels of saturated fat, sugars and sodium, as well as ingredients not used in a home kitchen, like high-fructose corn syrup, hydrogenated or interesterified oils, and hydrolysed proteins.” Other ingredients commonly found in UPFs include sweeteners (such as aspartame), flavourings, stabilisers, thickeners, colours, gums and emulsifiers, “all which extend shelf life and increase palatability, but can have all-round negative health effects”. Here, Zaromskyte reveals the risks of overconsumption of UPFs, and the healthier alternatives.

The real impact of UPFs on our health

Numerous studies have linked the consumption of UPFs to adverse health outcomes, explains Zaromskyte. "The French NutriNet-Santé study, with over 100,000 participants, revealed that a 10 per cent increase in UPF consumption was associated with a 12 per cent higher likelihood of developing some sort of cancer, and an 11 per cent higher risk of breast cancer specifically. Meanwhile, three large US cohort studies confirmed the link between UPFs and colorectal cancer. The UK Biobank cohort study, with over 60,000 participants, proved that UPFs increase the incidence of heart disease, as well as death caused by heart disease. Another study published in The American Journal of Clinical Nutrition in 2023 found that higher UPF intake was linked to an increased risk of overall mortality. All this is due to the unnatural, highly modified nature of UPFs." Currently, in the UK, more than half the average diet is said to be made up of UPFs.

The paradox with UPFs, Zaromskyte says, is that they often lack essential nutrients, including fibre, vitamins, and minerals, which are important for maintaining optimal health. "However, the low nutrient density of these foods often leads to overeating, as the body seeks essential nutrients. Research finds this can result in being nutritionally deficient, while overweight."

Additionally, "UPFs are purposefully made to be palatable, making it hard to stop eating them once you start, disrupting your sense of hunger and fullness". It's known that "overconsumption of energy-dense foods can lead to so-called metabolic syndrome, which is a combination of obesity, type II diabetes and high blood pressure".

Moreover, although the area of research around UPFs is still in its infancy, existing evidence suggests that UPFs can have negative effects on gut health, Zaromskyte reveals. "Emulsifiers and artificial sweeteners in UPFs may disrupt the gut microbiota, potentially contributing to gastrointestinal issues, like Crohn’s disease and inflammatory bowel disease." She notes that a small, recent study in women found that UPF consumption was directly related to negative changes in the gut microbiota, influencing leptin resistance. "Leptin is a hormone released from the fat tissue, which regulates satiety and helps maintain healthy weight," she explains. "Lastly, a Spanish population study with 359 participants found that gut microbiota was altered differently in men and women with increased UPF consumption, likely due to the differences in hormonal profiles between the sexes, although the alterations in both sexes were negative."

As Zaromskyte notes, there is significant evidence showing how impactful UPFs can be to health. However, it is also important to note that the health effects of UPFs can vary based on individual factors and overall dietary patterns. Importantly, "what your diet looks like most of the time, rather than occasional treats, can determine the impact it has on your health".

donuts with white and dark chocolate on a white background
Alena Gudz / 500px - Getty Images

UPFs thought to be the worst offenders

Not all UPFs are made equal, and ones high in added sugars and unhealthy fats should be the ones to minimise first, Zaromskyte suggests.

Sugary beverages: "Soft drinks, energy drinks, and fruit juices often contain excessive amounts of added sugars, leading to an increased risk of metabolic diseases."

Processed snacks: "Items like packaged cookies, chips, pastries and sweets are high in unhealthy fats and refined sugars, and are also additives, which can lead to adverse effects on heart health and metabolism."

Fast food: "Burgers, fries, and other fast-food items are usually packed with calories, unhealthy fats, and sodium, promoting obesity and cardiovascular problems."

Sugary cereals: "Breakfast cereals with added sugars provide little nutritional value, leading to blood-sugar spikes and subsequent crashes, contributing to unhealthy eating patterns."

'Healthy' marketed UPFs: "Think certain protein balls and energy bars. Despite being seemingly healthy, many of these such products still fall under ultra-processed foods and are packed with sweeteners or sugars and emulsifiers (not all of them, so do read the labels). Also be mindful of 'diet', 'calorie-free' and 'sugar-free' products, as their composition can hinder the gut microbiome and result in bloating and abdominal discomfort."

Healthy alternatives to UPFs

Zaromskyte feels that shifting away from UPF consumption requires collective actions as well as individual efforts. "Improved food labelling is essential to make it easier for consumers to spot UPFs," she says, while governments need to work with food industry giants "to reformulate their products and reduce all non-beneficial ingredients, while making healthier options more accessible". However, there are some simple ways to minimise UPFs in your diet.

Firstly Zaromskyte suggests replacing packaged snacks with fresh foods, like apples, berries, carrots and cucumbers, for a nutritious and satisfying snack. "Pair them with unsalted nuts, hummus or guacamole to make the snacks more satiating."

When it comes to mealtimes, it's ideal to opt for homemade, "using whole, unprocessed ingredients". Experiment with simple recipes to replace frozen meals or fast-food options, she suggests. "Opt for tinned pulses and frozen vegetables to make cost-conscious stews and soups," and choose wholegrain alternatives like brown rice, buckwheat, quinoa, or wholewheat bread instead of refined grain products like white bread and pastries, she says. "It is overwhelming to learn to cook from scratch, but starting with one recipe per week can quickly add up to a whole new, wholesome menu in a couple of months." If you're looking for inspiration we highly recommend the new cookbook by Ella Mills, Deliciously Ella Healthy Made Simple which shares speedy, plant-based recipes that contain 10 ingredients or fewer.

And when it comes to drinks, "try swapping sugary soft drinks and fruit juices with infused water, herbal teas, or homemade smoothies made from fresh fruits and vegetables," Zaromskyte adds.

Her top tip? "Opt for foods and drinks with short ingredient lists, as well as checking the nutrition label for a total amount of sugar, salt and saturated fat to be sure you are selecting a healthy product." While she's passionate about helping people to be mindful of the better options, "avoid strict restrictions," she says – "as this can negatively impact your relationship with food, which can lead to detrimental mental and physical health consequence".

Reassuringly, Zaromskyte doesn't feel think anything should be avoided at all costs, "as all kinds of food serve a purpose and can have a place in a balanced diet". However, "due to the many downsides of UPFs regarding health, it is best to keep consumption to a minimum and opt for whole foods instead whenever possible".

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