In the current issue of the online Journal of the World Public Health Nutrition Association (of which I am a charter member), Carlos Monteiro, a professor at the University of São Paulo writes, "The big issue is ultra-processing." Because his commentary is so lengthy, I am taking the liberty of extracting pieces from it, not always in the order presented.
The most important factor now, when considering food, nutrition and public health, is not nutrients, and is not foods, so much as what is done to foodstuffs and the nutrients originally contained in them, before they are purchased and consumed. That is to say, the big issue is food processing—or, to be more precise, the nature, extent and purpose of processing, and what happens to food and to us as a result of processing.
Monteiro makes it clear that all foods and drinks are processed to some extent. Fresh apples are washed and, sometimes, waxed. Drinking water is filtered. Instead, he distinguishes three types of processing, depending on their nature, extent, and purpose:
• Type 1: Unprocessed or minimally processed foods that do not change the nutritional properties of the food.
• Type 2: Processed culinary or food industry ingredients such as oils, fats, sugar and sweeteners, flours, starches, and salt. These are depleted of nutrients and provide little beyond calories (except for salt, which has no calories).
• Type 3: Ultra-processed products that combine Type 2 ingredients (and, rarely, traces of Type 1).
The purpose of Type 3 ultra-processing is to create:
durable, accessible, convenient, attractive, ready-to-eat or ready-to-heat products. Such ultra-processed products are formulated to reduce microbial deterioration ('long shelf life'), to be transportable for long distances, to be extremely palatable ('high organoleptic quality') and often to be habit-forming. Typically they are designed to be consumed anywhere—in fast-food establishments, at home in place of domestically prepared and cooked food, and while watching television, at a desk or elsewhere at work, in the street, and while driving.
Monteiro argues: "the rapid rise in consumption of ultra-processed food and drink products, especially since the 1980s, is the main dietary cause of the concurrent rapid rise in obesity and related diseases throughout the world."
As evidence, he notes that ultra-processed products as a group are:
• Much more energy-dense than unprocessed and minimally processed foods and processed culinary ingredients taken together.
• [Contain] oils, solid fats, sugars, salt, flours, starches [that] make them excessive in total fat, saturated or trans-fats, sugar and sodium, and short of micronutrients and other bioactive compounds, and of dietary fiber.
• Relatively or even absolutely cheaper to manufacture, and sometimes—not always—relatively cheaper to buy.
• Often manufactured in increasingly supersized packages and portions at discounted prices with no loss to the manufacturer.
• Available in 'convenience' stores and other outlets often open late or even 24/7, and vended in machines placed in streets, gas stations, hospitals, schools and many other locations.
• The main business of transnational and big national catering chains, whose outlets are also often open until late at night, and whose products are designed to be consumed also in the street, while working or driving, or watching television.