Ultra-processed foods linked to premature and preventable deaths

Many foods undergo some processing in order not to spoil.

Kimberly Gomer, MS, LDN, registered dietitian and nutrition expert, not involved in the study, explained some of the basics of processed foods at Medical News Today:

“Processing takes a food in its natural state (grown on site) and modifies it by adding salt, sugar, oil and additives such as chemicals, colors, flavors, stabilizers and preservatives. This is why they have an extremely long shelf life, which is attractive to both individuals and industry.

Ultra-processed foods, however, undergo vigorous processing. Here are some examples of ultra-processed foods:

• soda
• sweet or savory packaged snacks like chips or cookies
• energy bars and energy drinks
• instant soups and other ready-to-heat products such as pizza or chicken nuggets

“Most of these foods have a long list of ingredients listed on the food label ingredient list,” Gomer said. “These foods include – but are not limited to – frozen meals, cakes, cookies, fast food, packaged foods and snacks.”

The full health implications of eating ultra-processed foods are still being researched.

Some research indicates that eating processed foods decreases diet quality and increases the risk of health problems like high blood pressure (hypertension), obesity, and heart disease.

The new study looked at the number of deaths in the Brazilian population and their relationship to the consumption of ultra-processed foods.

First, the researchers looked at national food consumption in Brazil from 2017 to 2018. They then looked at this information in light of demographic and mortality data from 2019.

Depending on age demographics, Brazilians got between 13 and 21 percent of their total energy intake from ultra-processed foods. Researchers looked at the 541,160 people aged 30 to 69 who died in 2019.

Their analysis shows that consumption of ultra-processed foods was responsible for 10.5% of all premature deaths in this age group.

The researchers further noted that the consumption of ultra-processed foods was responsible for 21.8% of all preventable deaths from non-communicable diseases.

Study author Eduardo AF Nilson, ScD, researcher at the Center for Epidemiological Research on Nutrition and Health, University of São Paulo, and the Oswaldo Cruz Foundation, Brazil, noted the following highlights from the research for DTM:

“This is the first study that has actually modeled the overall impact of UPF [ultra-processed food] contribution to the deaths of which we are aware. The results are significant first because attributable deaths represent an enormous burden in terms of premature deaths from all causes (57,000 deaths represent 21.8% of premature deaths from preventable non-communicable diseases in Brazil). Moreover, if UPF intake were maintained at the levels we had ten years ago, 21% of attributable deaths could be prevented.

Based on this information, the researchers estimated that reducing energy intake from ultra-processed foods by 10-50% of current amounts could go a long way in reducing these death rates.

“Clinically, the results support a shift in the paradigm of dietary recommendations towards the prevention and treatment of non-communicable diseases and towards the promotion of healthy eating in general,” said Dr. Nilson.

The study adds to a growing body of evidence on the dangers of ultra-processed foods, but it has some limitations that also need to be considered.

First, experts cannot fully determine the number of deaths caused by ultra-processed foods.

The model and analysis had some limitations, such as risk of confounding and inability to account for each factor.

The researchers also recognize that there is a risk of reverse causation. This was also data collected in one country, which means results might be slightly different in other countries, for better or worse.

Eduardo Nilson noted that they could work to apply the data they collected in other regions and other countries:

“We look forward to estimating the impact of UPF in other countries, modeling the impacts of different policies and interventions (dietary advice, UPF taxation, front-of-pack labeling, food advertising, etc.), developing models of specific health outcomes (such as cardiovascular disease, diabetes, obesity), incorporating health economic analyzes into models, and improving models to predict impacts political interventions.

It is unclear how changes in dietary policies and recommendations at national and international levels might affect the health of entire populations.

In the meantime, people can work with their doctors and nutrition specialists to reduce their personal intake of ultra-processed foods, if any.

“Start by reducing (eventually eliminating) sodas, chips, cookies, fried foods, and junk foods,” Gomer says.

“Replacing junk food with whole foods is key. [Sit] mealtimes instead of on-the-go, and spending the time and effort to prepare healthy foods at home. Challenge yourself with small changes. Replace a few unhealthy foods with healthy foods.