There has been a lot of recent attention in the medical literature going way beyond the usual definition of a healthy diet based on the typical food groups like carbs, proteins, veggies, and fat and dairy products. It has to do with how our food is processed (or ultra-processed) and not just the contents. The person credited with focusing attention on this important health topic is a Brazilian doctor named Carlos Monteiro, who did dietary and population studies in his country to understand and fight malnutrition. In the mid-1990s, Monteiro started to notice a significant shift in Brazil’s dietary intake that at first seemed to be a paradox. In spite of persistent malnutrition, there was a rise in obesity rates among economically disadvantaged populations, while affluent populations saw declines in weight. He found it was related to two distinct eating patterns in Brazil. The more affluent the population, the more traditional foods like rice and beans they ate, while lower economic groups ate mostly highly processed foods that were cheaper, quicker to prepare, and more readily available. Recent studies discovered the answer to Monteiro’s paradox, linking healthy diets loaded with lots of unprocessed fiber (45gm/day) to weight loss. It turns out that high-fiber diets stimulate the release of a hormone (called peptide tyrosine—PYY) in the GI tract that acts to suppress appetite, resulting in weight loss.
Monteiro used his research findings to develop the “NOVA food classification.” The name is not an acronym that stands for something fancy; it came from the title of his original paper that was written in Portuguese, “Uma nova classificação de alimentos.” Nova classificação obviously means “new classification” in Portuguese. We talked about “meta-analysis“ research in these pages just last month. It’s a way to analyze the scientific and statistical validity of a number of studies and combine the data into meaningful conclusions. A few months ago, the British Medical Journal (BMJ) published a pretty stunning meta-analysis of nutritional research and population health based on dietary intake using the NOVA classification of food processing. The article, titled “Ultra-processed food exposure and adverse health outcomes,” combined data on an incredible 10,000,000 patients studied in 45 statistically valid publications from multiple nations. As you might guess, the conclusion was simple: the more junk food you eat the worse your health. In fancier words, “Greater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiac, common mental disorders, and poor mortality outcomes.” Breaking down their data, statistics show that junk food (ultra-processed) is associated with high risks of mental conditions (depression, anxiety, autism, and sleep disorders), diabetes, obesity, cardiac disease, and early death. Our own CDC has recently published stunning statistics that confirm the Brazilian and BMJ findings on “Autism Spectrum Disorders (ASD)” in our own population that discovered a range of ASD found in 23% of children in Maryland to a high of 45% in California that is linked to diet and socio-economic class!
These conclusions correlate with a worldwide trend in obesity and ultra-processed food consumption that show a clear shift toward an increasingly ultra-processed global diet. “Across high income countries, the share of dietary energy derived from ultra-processed foods ranges from 42% and 58% in Australia and the United States, to as low as 10% and 25% in Italy and South Korea. In low- and middle-income countries such as Colombia and Mexico, for example, these figures range from 16% to 30% of total energy intake, respectively. Over the last few decades, the availability and variety of ultra-processed products has substantially and rapidly increased in countries across diverse economic development levels, but especially in many highly populated low- and middle-income nations.”
Let’s take a look at what ultra-processed foods are and what we can put into our tanks that’s a healthier alternative. Using the Nova food processing classification system, there are four food groups. Group One is the healthiest category and includes unprocessed or minimally processed foods that come directly from plants or animals and don’t undergo any alteration from the natural form. This includes fresh vegetables, fruits, potatoes, nuts, mushrooms, herbs, spices, fresh or chilled meats, poultry, fish, and seafood. Also in this group are fresh or pasteurized milk, yogurt, tea, and eggs. Minimally processed foods are any of these natural foods that have just been cleaned up to remove inedible or indigestible parts and are just as healthy. They can be treated with fractioning, grinding, drying, fermentation, pasteurization, cooling, and freezing, but do not add oils, fats, sugar, salt, or anything else that’s not part of the original food.
Group Two (called processed culinary ingredients) are extracted from natural foods by processes such as pressing, grinding, crushing, pulverizing, and refining. They are used to season and cook food and create varied flavorful meals, including broths and soups, salads, pies, breads, cakes, sweets, and preserves. As long as they are used in moderation in food preparations based on natural or minimally processed foods, oils, fats, salt, and sugar contribute toward tasty diets without rendering them nutritionally unbalanced. Group Three, processed foods, are products manufactured by industry with the use of salt, sugar, oil, or other substances added to natural or minimally processed foods to preserve them or make them more palatable. Most processed foods have two or three of these added ingredients.
The worst category is Group Four, which are those ultra-processed foods found in a broad range of ready-to-eat products like packaged snacks, carbonated soft drinks, energy drinks (check out last month), instant noodles, and ready-made meals. These products are characterized as industrial formulations made up primarily of chemically modified substances and food extracts, along with additives to enhance taste, texture, appearance, and durability, with minimal or no whole foods and grains. Manufacturing techniques include extrusion, molding (heat reshaping), and preprocessing by frying in fat, grease, and heavy oils. Some of the additives in these foods are so well known to be health and even cancer risks that the UK and EU have banned them altogether. A few states here in the US have recently enacted similar restrictions. Supportive data for these legal restrictions was presented this month at the American Society of Clinical Oncology conference that examined factors that have led to a doubling in the rate of colon cancer in young patients (<55), a group previously thought to be at low risk, in just the last 25 years. These data show a link between cancer and high intake of junk food and ultra-processed food in the subjects’ diet. The reason, the study found, was that some ingredients in these foods led to premature aging of intestinal cells that made them less robust and able to fight off and kill tiny cancer cells before they could develop into life-threatening tumors.
It’s hard not to reach the conclusion that our diet is killing us, and all of this brings added information to guide safe, wholesome fuel to put into your tanks and enjoy for better health. Watch your food groups, but also pay extra special attention to how your food is processed. Staying safe in the sky starts right down here at the dinner table. Just like you should always watch the line crew put fuel in your wing tanks to be sure it’s the right grade, watch what you put into your own tank to fuel your body. As always, fly safe!
