Are ultra-processed foods impossible to avoid? - The Global Story podcast, BBC World Service

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Hello, I'm Lucy Hockings. From the BBC  World Service, this is The Global Story.

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Ready meals, chocolate, biscuits, sausages,  fizzy drinks. We know that processed food  

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is bad for us. But recent research shows  that in many countries around the world,  

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the majority of calories most of us consume are  from products known as ultra-processed foods.  

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These foods are being blamed for an increase in  ill health, including heart attacks, strokes,  

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obesity, type 2 diabetes and even anxiety.  So, how harmful are ultra-processed foods  

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for our health? And given how common they  are, is it even possible to avoid them? 

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With me today is BBC health correspondent  Philippa Roxby and Ruth Alexander,  

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a presenter of the BBC programme, The Food  Chain. Good to have you both with us. Hi. Thanks. 

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Hi, Lucy. Hello. 

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Ruth, I think we need to start with the basics  here. What exactly are ultra-processed foods? 

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It's industrially made food that's designed to be  delicious. Often the companies making them have  

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really kind of hacked what it is that we crave in  terms of taste, and they've put those tastes in as  

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additives. And often food that's marketed at you,  I mean, you don't often see adverts for potatoes  

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or eggs. They're not ultra-processed,  of course, but food that's packaged,  

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displayed prominently, particularly to appeal to  children, say, marketed and advertised at you. 

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Ruth, I'm now just mentally running through a  checklist of everything that's in my cupboards,  

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in my fridge and freezer, and I'm a little bit  worried about what you're about to tell us. So  

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I know you've also been going through  your cupboards. What have you found? 

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I mostly cook from scratch, so I didn't think I  would find much, but I found plenty. Wholemeal  

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bread, you know, the sliced package variety  that you find in supermarkets. Nutritionally  

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good for you, but ultra-processed. Fish fingers,  which I think of as a sort of quick but healthy,  

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you know, dinner-time thing. And I thought,  well, that can't be ultra-processed. It's  

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just fish and breadcrumbs, isn't it? It  was ultra-processed. Mayonnaise. I'd had  

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a little bit with my lunch when I was  going around my kitchen checking things. 

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Ultra-processed. Mustard. Ultra-processed.  But the one that probably surprised me most  

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of all was stock cubes. I looked at them and  they are ultra-processed. So that means all  

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those homecooked stews I did, all that cooking  from scratch I did actually was kind of undone. 

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If we start at the beginning of  the day then, what about Philippa,  

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cereal? So many kids start the day with a bowl  of cereal with some whole milk, is that ok? 

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It can be depending on the type of cereal  you choose, there's a lot of cereals that are  

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sweetened so lots of sugar is added to them and  actually you've got some here they look a little  

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bit chocolatey there's definitely added sugar in  there but then there's a lot of cereals that have,  

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are whole grain and have fibre in them and are  good for you so this is the slight issue with  

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the definition of ultra-processed foods is that  you tend to think that everything in your cupboard  

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cannot be eaten but actually there are some that  do contain the good stuff you need, and it's just  

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sorting the good ones out from the bad ones. I mean, I think one of the things with cereal  

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is that they're marketed as being healthy  for you and a really good start to the day,  

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particularly for kids. And this is where  scientists are really concerned, aren't  

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they? Because they say actually the driving force  behind multiple diet-related illnesses can be  

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in something as simple as your breakfast cereal. Yeah, that's right. I mean, there's evidence that  

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the majority of children's diets, particularly in  the Western world, are made up of ultra-processed  

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foods so, everything from the bread they eat  to the cereals to maybe the drinks they have  

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at breakfast. And that's a real worry because  these kids are growing up and what will this do to  

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their health later on. I mean there's lots of  research, growing evidence that ultra-processed  

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foods aren't particularly good for us, but  scientists aren't sure what it is about those  

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foods that's causing the problem. Is it the  way they're made, the way they're processed,  

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or is it the fact that they just contain lots  of sugar and lots of fat, as we can see here? 

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I mean, we've got a table in front of us, full of  ultra-processed foods, and just looking at them,  

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some, you could say, they're high in saturated  fats, salt, sugar, but there's some pretty  

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innocent-looking bread there as well. I guess these are processed to last  

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longer. They're probably, they look like sort  of long-life rolls so you want them to stay  

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ok in your cupboards so you can eat them for say  several days and that's why in the food industry  

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they do process things to preserve them and keep  them for longer, so some reasons why processing  

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is a good thing there are other reasons why  processing might not be such a good thing. 

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Yeah, and I see, Ruth, that scientists have  done a big review, the largest review of  

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some of the evidence to date, and they say  there are 32 harmful health effects from  

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some of these foods that are out there. But  looking at the table of food in front of us,  

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or even thinking about what's in our cupboards,  is there any nutritional value, or is there  

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some hope there with some of these foods, Ruth? Well, that's the thing and as Philippa was saying,  

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it's not known why ultra-processed food might be  causing harm. And it could be that there are some  

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foods that are ultra-processed that are absolutely  fine for you. Like my wholemeal sliced bread,  

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you know, has got sort of lots of goodness  in it. It's got fibre, it's got added  

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vitamins. It's not necessarily that everything  ultra-processed will definitely be bad for you. 

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And also, I mean, there's another category just  down from ultra-processed, which is processed  

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food, and that's not being criticised. But when I  was looking in my cupboards, the dark chocolate,  

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I would like to say as an occasional treat,  actually it's probably quite a frequent treat,  

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if I'm honest. But that wasn't ultra... You and me both, Ruth, I have to say. 

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Keeps you going, doesn't it? It gets you through.  But that was processed, not ultra-processed. Is  

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it good for me in the quantities I eat it? I'm  not so sure. Also, potato crisps another of my  

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weaknesses is another good one to look at  because if they've got added flavour, they  

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tend to be ultra-processed, but the plain salted  varieties are not considered ultra-processed. Are  

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they good for me? Well, they're full of saturated  fat and have high levels of salt. Probably not,  

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actually. So it's not clear-cut, and it's as  Philippa said, it's not clear-cut what it is about  

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the ultra-processing of food that maybe harmful. Ruth you and I share these guilty pleasures,  

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I also love crisps as well as dark chocolate. So  Philippa, I'm standing in the supermarket aisle,  

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I'm looking at the back of a product,  what exactly should I look for? 

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In the ingredients list you're looking for  lots of things with very long unpronounceable  

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names that you would not find anywhere in your  kitchen as ingredients and those are probably,  

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they could be emulsifiers and additives and  flavourings and colourings and they quite often  

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have very long complicated names and that's a  good indication that it's an ultra-processed  

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food. What else? It might have added sugars and  sweeteners or fake sugars and it may say that  

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it's sort of low in sugar or low in fat and make  that sort of claim on the packet and quite often  

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it will come in a package and not look like the  original food, not look like a whole tomato or  

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a whole vegetable. It will be a sauce that comes  in a jar or comes in a tin or comes in a package. 

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Surely the picture is different depending on which  country we're talking about. And I know in 2010 a  

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group of Brazilian scientists said we should be  focusing less on the nutritional content of food  

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and more on the form of processing it undergoes.  And they created this Nova classification,  

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which categorises foods based on how processed  they are. And Ruth, I know you've spoken to one  

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of the scientists who came up with that system,  Professor Jean-Claude Moubarac at the University  

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of Montreal. Did they give you an idea of just  how common UPFs are and how difficult and tricky  

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it is to avoid them? They did. I actually asked  

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for some examples of ultra-processed food and  after about a minute of different foods being  

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listed I realised it would have been much  simpler to ask what isn't ultra-processed  

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actually. So think of packaged snacks, sweets,  biscuits, pastries, cakes, pizzas, cereals,  

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I mean the list just goes on and on and on and  the sales of this type of food, ultra-processed  

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food are actually thought to be increasing  around the world, particularly in middle income  

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countries where the sales are rising and then in  richer countries they're already pretty high. I  

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mean you know yourself if you go to the shops,  actually, you've got the fruit and veg aisle and  

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then beyond that there are just many many shelves  with lots of different packaged goods and if you  

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look at the ingredients on the back, it's often  a long, long list of ingredients. So there is  

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a fair amount of ultra-processed food out there. Philippa, these Brazilian scientists only came up  

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with the term, UPF, back in 2010. That wasn't that  long ago. So how much more is there to find out  

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about the impact that UPFs have on our health? Well, a lot more. It's really a fairly recent  

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term. And there's been an awful lot of research in  the last few years into ultra-processed foods and  

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how they affect our health and why that might  be. And actually, scientists really haven't  

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come up with an answer to that yet. And  so we really don't know whether it's the  

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processing and these added ingredients that  are added into the crisps and the bread and  

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the cereals here. Is that the problem? Or is  it just that we're going back to too much fat,  

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too much sugar, too many calories in our diet. Philippa how much harder is it if you've got a  

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health or dietary issue that means that you have  to have these foods? I know I have a son who has  

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coeliac and a lot of what I go to buy him in the  supermarket seems to have a lot of UPFs in it,  

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and it's because it doesn't necessarily  have the ingredients in it to make the  

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food stick together or to last a long time or  it has a lot of sugar in it to make it taste  

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good. But there aren't many other options. Yeah, that's true. I mean, a lot of people  

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do rely on processed or ultra-processed foods  for their dietary needs. Coeliacs, for example,  

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have to avoid foods that have gluten in them. So if you go to that particular aisle in the  

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supermarket, you're going to find things that  are processed because they need to avoid that  

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ingredient and replace it with something else.  And then there's things like baby formula milk.  

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That would count as ultra-processed under this  classification system. And yet it's something  

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that's used worldwide by mums trying to feed  their babies. And it comes from cow's milk. 

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But it has other things added to make it  healthy for babies. There's also vegan foods,  

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plant-based foods. They would also count  as ultra-processed. And yet they're seen  

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as very healthy alternatives to meat. I spoke to Jean-Claude Moubarac about  

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the issue of, for example, infant formula and  gluten-free foods and said, well, you know,  

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they're ultra-processed under this Nova  classification system, but people rely on  

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those for health reasons. And he agreed and said,  actually, he said, "I view infant formula, for  

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example, as medicine, not as food, but medicine". I'm a working mum, and I'm starting to feel a  

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little bit guilty at the moment about UPFs and  what I'm feeding my family. It's pretty tricky  

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because one of the messages is that we should  be cooking from scratch and cooking at home  

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in our own kitchens with food that we know  where it's come from, but this is all really  

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time-consuming at the end of a long day. Yeah, I mean, it's very difficult,  

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as we discussed, to avoid every single  ultra-processed food. It's extremely difficult,  

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and if you're busy, working parents for example  with young children you don't always feel you  

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have the time to cook from scratch that means  starting off with the vegetables and making the  

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sauce from scratch perhaps and all the different  elements of a meal and that can be time-consuming.  

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And for some people it makes them a little bit  nervous and a bit anxious. And it's much easier,  

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let's face it, to reach for something  that's ready made, ready to go in the oven,  

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ready to go in the microwave. It's quite often  cheaper, too. And in these constrained times when  

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we're all thinking about how much money we've  got in our pockets, that is an easier option. 

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Cost must be a big factor for some people  when they're considering what to eat. 

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I think it is. And also people are time poor as  well, aren't they? Even just stopping to examine  

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the ingredients on the back of packets in the  shop, you know, that's time that you probably  

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don't have. When I discovered the stock I was  using was ultra-processed I thought, 'right,  

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I'll start making my own stock'. Have I  done that? No, I haven't. I haven't got  

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the time. I think, like, as Philippa said... You haven't got the time to go to the butcher  

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and get the chicken carcass and bring it home and  get the vegetables and put it in the pot. I mean,  

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yes, you're right. Just simple stock is  time-consuming. Yeah, that's it. And, you know,  

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when you can go and buy chicken nuggets in the  store for very little money, a big bag, and put  

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it in the freezer, and it's there when you need  it, you know, that's what everyone is up against. 

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So I was in the supermarket recently, and it's  the first time I've noticed this, that people  

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have been standing in aisles with their phones  out and scanning food. What kind of tech is out  

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there to help us identify what's in the food  that we're buying and what UPFs are there? 

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Yes, you can find these apps which will tell  you 'this is ultra-processed' and also like how  

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nutritionally, what the nutritional value  of the food is. I used one in my kitchen. 

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I must say they're sort of like  once you get going on it, you know,  

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I had to make a conscious decision to, 'okay,  close the cupboards, put my phone down,  

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just stop this'. What you do is you scan the  barcodes and it has a traffic light system  

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where you're looking at, you know, green for  nutritionally good, green for not ultra-processed,  

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red if it's ultra-processed. And it just gets you  thinking. But as I say, there's something like  

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really satisfying about scanning a barcode and  then finding out, is this good or is this bad? 

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I was on a family holiday recently and we  got the kids to do all the scanning of the  

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food which they thought was great  fun. Any excuse to use the phone,  

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I don't think they're mind. As long as they've got  the phone in their hands, they're happy. But it  

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is quite a lot of effort to scan a product like  this. And Chile has an interesting example what  

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their government is doing about UPFs. Ruth, tell  us what they did to tackle high obesity rates. 

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Yes, A few years ago, they brought in a system  where they have black labels on packaging,  

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which if it's high in sugar or in fat,  for example. We did speak to people in  

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Chile about how, whether they found those  labels useful, and they said that they did,  

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and they do try to make, to avoid those black  labelled products. And we asked them, you know,  

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would you find it useful to have a label that said  ultra-processed? And they said, yes, they would. 

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If we don't Phillipa get on top of UPFs,  what's going to happen in the long-term? 

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This type of food is so freely available and it's  cheap and it's very moreish and of course lots of  

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people say that it slips down very easily and it  means that you want more very soon afterwards so  

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potentially you eat more of that type of stuff  because it slips down our throats easily. And  

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if children grow up used to eating that way, that  will continue into adulthood. So it's certainly a  

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worry, but I think scientists have still got  a job to do to find out more evidence about  

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whether it's the processing that's to blame or  whether it's the ingredients. And then also we,  

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I suppose we all need to think about, every  country around the world needs to think about  

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how we can help people choose more of the  right kinds of foods and less of the wrong  

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kinds of foods. But it's a big challenge. So any other hot tips, Ruth, about how we  

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can realistically cut down on our UPFs? Probably the thing to do is to start  

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with a small realistic step as well. If  you're listening to this and thinking,  

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you know what, I would like to reduce the amount  of ultra-processed food I'm eating. Perhaps it's  

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just making one meal in the week from scratch.  If you're vegan and you're relying on, you know,  

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plant-based meat substitutes, which are often  ultra-processed, you know, perhaps think about  

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substituting that with lentils and beans  which can bulk out the dish. I mean, like,  

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if you just think about what you're drinking with  a meal, go for water rather than a carbonated,  

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sugary drink, which would be ultra-processed.  That might not be so popular with your children,  

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though, but I'm just saying you could try to do  that. Interestingly, a colleague tried to give  

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up ultra-processed food for a month in January,  and she failed on day one. She went to the pub  

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wanting a non-alcoholic drink, and all the drinks  there were ultra-processed. But I did say to her,  

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you could have chosen water. Tap water? 

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Even sparkling water, but yeah, she just  moved on. She didn't comment on that one. 

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But, you know, like a quick meal that I enjoy  is an omelette sandwich. Problem, I mean,  

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the omelette is not ultra-processed, but I suppose  the problem is the bread I'm using, it probably  

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is ultra-processed. And if you want to find  non-ultra-processed bread, just processed bread,  

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then you're going to have to go to a bakery and  that probably will cost more money and it will go  

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stale quicker but you can put it in your freezer  and make it last longer if you have a freezer. 

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That's true. People tend to think that if you  freeze something, it's a bad thing. And freezing  

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is just another process but actually freezing is  a great way of making something last for longer  

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as Ruth was saying, sliced bread where lots  of people in lots of countries are very fond  

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of sliced bread and the problem with this  classification is you tend to think you can  

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only buy very nice, very expensive, rustic,  whole grain bread. And that's the only thing. 

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Farmer's market bread or bakery bread? Yeah, and we know how that expensive that is.  

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So very difficult for families to make that  choice. And sometimes just buying a sliced  

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brown bread from the supermarket is fine. And then you can freeze it and store it. 

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And also, I mean, something that I often make  when I've got vegetables that are about to  

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go off. I make a soup, just get them all  in there and make a soup. Now, I do put,  

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as we know, an ultra-processed stock cube in  there, but at least it's a pan full of fresh,  

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or just about fresh vegetables otherwise. So, you know. There can be some compromise  

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in there. Yeah,  

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I think so. Well, that's how I'm living anyway. Ruth, it would be lovely if you were here with us,  

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but maybe it's best that you're not, because given  our weakness for crisps. I've got some in the  

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table in front of me. It's going to take every bit  of my willpower not to polish them off. But it's  

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been lovely to have you with us. Thanks so much. Thank you very much. And yeah, I'm pleased to have  

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avoided that bag of crisps. Can we resist, Philippa? 

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No. Definitely not. Thanks so much, Philippa. 

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Thank you. And thank you for watching.  

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