Summary of ultra-processed foods and reformulation
- Ultra-processed foods linked to chronic illness regardless of nutrient reformulation
- Reducing sugar, fat and salt often increases harmful additive consumption
- Disrupted food structure and soft textures affects nutrient absorption
- Fortification adds nutrients but promotes misleading health claims and higher intake
- Lancet series urges policy to target UPFs beyond nutrient-based regulations
Industry responses to UPF criticism often put forward reformulation, rather than tackling the underlying ultra-processing, as the answer.
As historically, many of the health risks associated with UPFs have been linked to problem nutrients like salt, added sugar and saturated fats, reducing these ingredients would reduce harms, the argument goes.
But according to the new series on UPFs recently published in the Lancet, limiting these problem nutrients via reformulation is not enough, as it does not address the total impacts of ultra-processed foods.
Why reformulating UPFs isn’t enough
UPFs are often reformulated so that they are under regulatory limits on sugar, fat and salt introduced by policy markers.
This may address part of the harm linked to UPFs, but many facets of processed foods remain.
For example, the disruption of the food matrix is thought to make them them more easily digestible, which can affect the extent to which the body absorbs nutrients. The soft textures of many UPFs have a similar effect.
The series suggests that reformulation is often used as a means of “health-washing” UPF products, in order to hide their negative impacts behind their nutrient content.
Government policy should not only focus on nutrients, according to the series, but on UPFs as well; targeting common UPF ingredients, such as additives, either alone or in conjunction with nutritional profiles.
Reformulation often means replacement by additives
It’s not only that reformulation doesn’t, in itself, counter all negative effects from UPFs, the series’ authors attest. It’s also the case that reducing certain ingredients often lead to their replacement with others, which could also have detrimental effects.
For example, sugar reduction efforts in Chile were accompanied by a 15% increase in the consumption of non-nutritive sweeteners in children. Sweeteners have in the past been linked to higher degrees of mortality, and when used in soft drinks, can match sugar in their links to liver disease.
Evidence found on health outcomes suggests that reformulation is not enough to remove the link between chronic illness and UPFs. “When you adjust for reformulation, the health outcomes remain the same”, says Chris van Tulleken, one of the authors.
Fortification is good, but not the answer
Reformulation has two sides. One is taking out ingredients linked to harm, the other is adding beneficial ingredients.
Many products that are considered UPFs are fortified with nutritious ingredients, such as protein and fibre.
The Nova classification, which is used to define whether or not a food is ultra-processed, is not against fortification per se, explains Philip Baker, one of the authors of the study. The process of fortification is not inherently harmful.
Yet fortification is often used as the justification for health claims which in themselves can distract from the potential harms a UPF product has.
If health claims from fortification are used to encourage increased consumption of a food that is still ultra-processed, they may lead to more harm than good.
“Part of the marketing of UPFs is to have claims,” says Carlos Monteiro, developer of the Nova Classification and one of the series’ authors. “And when you have a food that has claims, it’s very likely it’s ultra-processed.”
