Processed Foods and Health

Man reading the labels to compare two jarred products while standing in a supermarket aisle

Processed foods are generally thought to be inferior to unprocessed foods. They may bring to mind a packaged food item containing many ingredients, perhaps even artificial colors, flavors, or other chemical additives. Often referred to as convenience or pre-prepared foods, processed foods are suggested to be a contributor to the obesity epidemic and rising prevalence of chronic diseases like heart disease and diabetes. However, the definition of a processed food varies widely depending on the source:

  • The U.S. Department of Agriculture (USDA) defines a processed food as one that has undergone any changes to its natural state—that is, any raw agricultural commodity subjected to washing, cleaning, milling, cutting, chopping, heating, pasteurizing, blanching, cooking, canning, freezing, drying, dehydrating, mixing, packaging, or other procedures that alter the food from its natural state. The food may include the addition of other ingredients such as preservatives, flavors, nutrients and other food additives or substances approved for use in food products, such as salt, sugars, and fats.
  • The Institute of Food Technologists includes additional processing terms like storing, filtering, fermenting, extracting, concentrating, microwaving, and packaging. [1]

According to these standards, virtually all foods sold in the supermarket would be classified as “processed” to some degree. Because food begins to deteriorate and lose nutrients as soon as it is harvested, even the apples in the produce aisle undergo four or more processing steps before being sold to the consumer. That’s why in practice, it’s helpful to differentiate between the various degrees of food processing.

Types of food processing

A popular system to classify processed foods was introduced in 2009, called the NOVA classification. It lists four categories detailing the degree to which a food is processed: [2,3]

Potassium foods including bananas, almonds, dried fruit, beans, avocado, cantaloupe, salmon, spinach

Unprocessed or minimally processed foods

Unprocessed foods include the natural edible food parts of plants and animals. Minimally processed foods have been slightly altered for the main purpose of preservation but which does not substantially change the nutritional content of the food. Examples include cleaning and removing inedible or unwanted parts, grinding, refrigeration, pasteurization, fermentation, freezing, and vacuum-packaging. This allows the food to be stored for a greater amount of time and remain safe to eat. Many fresh fruits, vegetables, whole grains, nuts, meats, and milk fall into this category.

Processed culinary ingredients

Food ingredients derived from a minimally processed food by pressing, refining, grinding, or milling. They are typically not eaten on their own but used to prepare minimally processed foods. Examples include oils from plants, seeds, and nuts, or flour and pastas formed from whole grains.

Processed foods

Foods from either of the two previous groups that have added salt, sugar, or fats. Some canned fruits and vegetables, some cheeses, freshly made bread, and canned fish are examples. These foods usually are made from at least 2-3 ingredients and can be readily eaten without further preparation.
a plate of soda, chips, fried chicken, grilled cheese, hamburgers, french fries

Ultra-processed foods

Also commonly referred to as “highly processed foods,” these are foods from the prior group that go beyond the incorporation of salt, sweeteners, or fat to include artificial colors and flavors and preservatives that promote shelf stability, preserve texture, and increase palatability. Several processing steps using multiple ingredients comprise the ultra-processed food. It is speculated that these foods are designed to specifically increase cravings so that people will overeat them and purchase more. They are typically ready-to-eat with minimal additional preparation. Not all but some of these foods tend to be low in fiber and nutrients. Examples are sugary drinks, cookies, some crackers, chips, and breakfast cereals, some frozen dinners, and luncheon meats. These foods may partially if not completely replace minimally processed foods in some people’s diets. One study using data from the U.S. National Health and Nutrition Examination Survey found that ultra-processed foods comprised about 60% of total calories in the U.S. diet. [4] An association has been suggested between the increasing sales of ultra-processed foods and the rise in obesity. [3]

The NOVA system is recognized by the World Health Organization, Food and Agriculture Organization, and the Pan American Health Organization, but not currently in the U.S. by the Food and Drug Administration or USDA. NOVA has been criticized for being too general in its classification of certain foods, causing confusion. For example, yogurt may fall into more than one category: plain yogurt is minimally processed, but fruited yogurt with added sweeteners could be labeled either processed or ultra-processed depending on how much sweetener and other chemical additives are incorporated. NOVA also does not provide comprehensive lists of specific foods in each category, so the consumer is left to guess where each may fall.

Is processed food unhealthy?

There’s no doubt that at least some processed foods are found in most people’s kitchens. They can be time-savers when preparing meals, and some processed and fortified foods provide important nutrients that may not otherwise be obtained in a busy household or one that has a limited food budget. From a nutritional standpoint, processed and even ultra-processed foods can provide key nutrients. Some nutrients like protein are naturally retained throughout processing, and others like B vitamins and iron may be added back if they are lost during processing. Fruits and vegetables that are quickly frozen after harvesting can retain the majority of vitamin C.

Throughout history, foods fortified with specific nutrients have prevented deficiencies and their related health problems in certain populations. Examples include infant cereals fortified with iron and B vitamins to prevent anemia, milk fortified with vitamin D to prevent rickets, wheat flour fortified with folic acid to prevent birth defects, and iodine added to salt to prevent goiter.

Processing by certain methods like pasteurization, cooking, and drying can destroy or inhibit the growth of harmful bacteria. Additives such as emulsifiers preserve the texture of foods, such as preventing peanut butter from separating into solid and liquid parts. Other functions of processing include delaying the spoilage of food; preserving desirable sensory qualities of food (flavor, texture, aroma, appearance); and increasing convenience in preparing a complete meal.

But food processing also has drawbacks. Depending on the degree of processing, many nutrients can be destroyed or removed. Peeling outer layers of fruits, vegetables, and whole grains may remove plant nutrients (phytochemicals) and fiber. Heating or drying foods can destroy certain vitamins and minerals. Although food manufacturers can add back some of the nutrients lost, it is impossible to recreate the food in its original form.

If you are deciding whether or not to include a highly processed food in your diet, it may be useful to evaluate its nutritional content and long-term effect on health. An ultra-processed food that contains an unevenly high ratio of calories to nutrients may be considered unhealthy. For example, research supports an association between a high intake of sugar-sweetened beverages and an increased risk of obesity, diabetes, and heart disease. But some processed foods that contain beneficial nutrients, such as olive oil or rolled oats, have been linked with lower rates of these chronic diseases.

comparing two labels on cans of food

Decoding the ingredients list on a food label

Being aware of specific ingredients in a food is a good general practice for everyone but may be especially useful for those with food allergies or intolerances, diabetes, or digestive diseases. In many cases, the longer the ingredients list, the more highly processed a food is. However, an ingredient that is not recognizable or has a long chemical name is not necessarily unhealthful. When scanning the Ingredients listing on a food package, consider the following:
  • The ingredients are listed in order of quantity by weight. This means that the food ingredient that weighs the most will be listed first, and the ingredient that weighs the least is listed last. [5]
  • Some ingredients like sugar and salt may be listed by other names. For example, alternative terms for sugar are corn syrup, high-fructose corn syrup, honey, agave nectar, cane sugar, evaporated cane juice, coconut sugar, dextrose, malt syrup, molasses, or turbinado sugar. Other terms for sodium include monosodium glutamate or disodium phosphate.
  • If the food is highly processed, it may contain several food additives such as artificial colors, flavors, or preservatives. Their ingredient names may be less familiar. Some preservatives promote safety of the food by preventing growth of mold and bacteria. Others help prevent spoilage or “off” flavors from developing. Examples that you may see on the label include:
    • Preservatives—ascorbic acid, sodium benzoate, potassium sorbate, tocopherols
    • Emulsifiers that prevent separation of liquids and solids—soy lecithin, monoglycerides
    • Thickeners to add texture—xanthan gum, pectin, carrageenan, guar gum
    • Colors—artificial FD&C Yellow No. 6 or natural beta-carotene to add yellow hues
  • Fortified foods contain vitamins and minerals that are added after processing. Either these nutrients were lost during processing, or they were added because they are lacking in the average diet. Examples include B vitamins (riboflavin, niacin, niacinamide, folate or folic acid), beta carotene, iron (ferrous sulfate), vitamin C (ascorbic acid), Vitamin D, or amino acids to boost protein content (L-tryptophan, L-lysine, L-leucine, L-methionine).

Ingredients used widely in the production of highly/ultra-processed foods such as saturated fats, added sugar, and sodium have become markers of poor diet quality due to their effect on heart disease, obesity, and high blood pressure. [6,7] It is estimated that ultra-processed foods contribute about 90% of the total calories obtained from added sugars. [4] 

The bottom line

Food processing is a spectrum that ranges from basic technologies like freezing or milling, to the incorporation of additives that promote shelf stability or increase palatability. As a general rule, emphasizing unprocessed or minimally processed foods in the daily diet is optimal. That said, the use of processed foods is the choice of the consumer, and there are pros and cons that come with each type. The Nutrition Facts Label and ingredients list can be useful tools in deciding when to include a processed food in the diet. There is evidence showing an association with certain types of food processing and poor health outcomes (especially highly- or ultra-processed foods). This association applies mainly to ultra-processed foods that contain added sugars, excess sodium, and unhealthful fats.

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