Experts assess evidence for and against incorporating ultra-processed foods into dietary guidelines

Dietary recommendations form the basis of nutritional advice and regulations worldwide. Although there is strong scientific consensus around most of the existing guidelines, one question has recently sparked debate: should consumers be warned to avoid ultra-processed foods?

Two articles published today in Jhe American Journal of Clinical Nutrition (AJCN) describe the arguments for and against using the concept of ultra-processed foods to help inform dietary guidelines beyond conventional food classification systems. The authors, Carlos A. Monteiro, MD, PhD, of the University of São Paulo in São Paulo, Brazil, and Arne Astrup, MD, PhD, of the Novo Nordisk Foundation in Hellerup, Denmark, will discuss the issue during a live virtual debate June 14 during NUTRITION 2022 LIVE ONLINE.

The debate centers on NOVA, a system developed by Monteiro and his colleagues that classifies foods according to their degree of industrial processing, ranging from unprocessed or minimally processed to ultra-processed. NOVA defines ultra-processed foods as those made using sequences of processes that extract substances from foods and modify them with chemicals or additives to formulate the final product. Ultra-processed foods are generally designed to be cheap, palatable, and convenient; examples include soft drinks and candies, packaged snacks and pastries, ready-to-heat products, and reconstituted meat products or plant-based alternatives.

Studies have linked the consumption of ultra-processed foods -; which are often high in salt, sugar and fat -; with weight gain and increased risk of chronic disease, even after adjusting for the amount of salt, sugar and fat in the diet. Although the mechanisms behind these associations are not fully understood, Monteiro argues that the existing evidence is sufficient to justify discouraging the consumption of ultra-processed foods in dietary recommendations and government policies.

“The negative dietary effects of ultra-processed foods have now been demonstrated by numerous nationally representative studies,” Monteiro wrote in his position paper. “[Guidelines] should emphasize the preference for unprocessed or minimally processed foods and freshly prepared meals and make explicit the need to avoid ultra-processed foods.

In a counter-argument, Astrup argues that classifying foods according to their processing methods does not significantly improve existing systems and could lead to unintended consequences. For example, there are both nutritional and environmental benefits to a greater emphasis on plant-based foods, but many healthy plant-based meat and dairy alternatives are considered ultra-healthy. transformed. Astrup also argues that unhealthy foods like fries, burgers and pizza would be considered ultra-processed if purchased from a fast-food restaurant, but minimally processed if prepared at home with similar ingredients.

Obviously, there are many aspects of food processing that can affect health outcomes, but these need not be confused with the notion of ultra-processing, as the major determinants of chronic disease risk are already taken into account by existing nutrient profiling systems. The NOVA classification adds little to existing nutrient profiling systems; characterizes many healthy, nutrient-dense foods as unhealthy; and is counterproductive to solving major global challenges to food production.”

Arne Astrup, MD, PhD, Novo Nordisk Foundation in Hellerup, Denmark

The papers are part of Great Debates in Nutrition, a series created and edited by David S. Ludwig, MD, PhD, to advance the mission of the American Society for Nutrition (ASN) to facilitate productive discourse on controversies in nutritional science.

“Scholarly debate is a hallmark of the scientific process,” said AJCN Managing Editor Christopher P. Duggan, MD. “We established Great Debates in Nutrition as a forum for timely and collegial discourse on current topics in nutrition that have direct relevance to clinical care and public health. By facilitating a rational review of evidence, this venue can help reduce polarization and politicization while advancing the field. »

Monteiro and Astrup will debate the topic from 2-3:30 p.m. on Tuesday, June 14 as part of NUTRITION 2022 LIVE ONLINE (presentation details; register for a press pass). Susan B. Roberts, PhD, of Tufts University will serve as commentator for the session. Following the debate, the authors will produce consensus statements on the topic, which will be published in AJCN.


American Society of Nutrition

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