Ultra-Processed Foods: Balancing Risks and Benefits

There’s a common debate in the nutrition community regarding the place of ultra-processed foods (UPFs) in the Western diet. On one side, there is growing evidence that UPFs are linked with chronic disease and health issues and thus should be avoided as much as possible. The other side’s take is that UPFs are an opportunity for the addition of important nutrients and may be a necessary vehicle for reducing micronutrient deficiency. But perhaps there is a middle ground. Let’s take a look at the facts to help you decide where you stand.

Understanding UPFs: A Complex Category

First, a quick recap to set the debate stage. UPFs are foods that have undergone significant modification from their original form through manufacturing methods, including the addition of ingredients and additives. This is done to make a product more palatable and attractive or have a longer shelf-life. Common examples of UPFs include sodas, ice cream, certain baked goods, frozen meals, and more. Higher intakes of these foods are linked with issues like overweight and obesity, chronic disease, and even mental health disorders. Most of the research connecting UPFs with health concerns is correlative, not causative, meaning the exact mechanisms by which UPFs affect our health are unknown. This leaves room for proponents of UPFs to state their case.

Fortified UPFs: A Nutritional Boost?

A fortified food is any food that has had nutrients added to it during processing. This helps to replace nutrients lost during processing or add additional nutrients not already present. Commonly added nutrients include folate, vitamin D, iron, B vitamins, iron, and iodine. Here are some examples of foods that you may see fortified:

• Yogurts: vitamin D
• Milk alternatives: vitamin D, calcium
• Breakfast cereal: riboflavin, niacin, folic acid, pantothenic acid, iron, calcium
• Fruit juice: calcium, vitamin D, vitamin C
• Frozen pizza: niacin, folic acid, riboflavin
• Bouillon cube: iodine, iron
• Bagels: iron, B vitamins, folic acid

Historically, foods have been fortified to address public health concerns. For example, folic acid has been added to grain products to help reduce the risk of folate deficiency, known to cause spina bifida. Since this was introduced in the 1990s, spina bifida rates have decreased by approximately 28%. Improvements such as this to public health are the backbone of the argument that UPFs are necessary.

This argument is especially true in food deserts. In a food desert, the amount of affordable, high-quality, and fresh foods available is disproportionate to the number of people living in that area. As a result, individuals may choose to purchase more affordable foods with a longer shelf life to get the majority of their nutrients. Often, these options are UPFs. By fortifying UPFs with additional nutrients, the hope is that these individuals will experience fewer micronutrient deficiencies.

A Balanced Approach: Incorporating Both Whole Foods and Fortified UPFs

Knowing this begs the question, is the above argument more harmful than helpful? As mentioned previously, UPFs are linked with an increased risk of certain chronic diseases and health concerns. So, you win some, you lose some. One key component of this argument we haven’t addressed is the middle ground.

It’s important to remember that a whole foods diet consisting of primarily limited or unprocessed foods effectively prevents macronutrient and micronutrient deficiencies and is linked with lower rates of chronic disease. Prioritizing these choices is ideal. However, for individuals with limited access to these whole foods, choosing UPFs fortified with additional nutrients may be a good option.

Even if you have access to all the fresh and unprocessed foods in the world, for most people it is impractical to suggest that the diet be completely free of UPFs due to the convenience factor and the value of enjoyment. So, instead of having an “either-or” mindset, perhaps we adopt a more flexible approach. I prefer the mentality of prioritizing whole foods daily and keeping the majority of my kitchen stocked with these foods. Then, when I’m in a time pinch or have a specific craving, I feel okay knowing that my indulgence in more processed food will not wreak havoc on my overall diet and lifestyle.

My personal opinion is just that: the personal opinion of both a health professional and a foodie who wants to ensure a high-quality diet that consists of both healthful options and tasty treats for herself. Wherever you stand on the debate stage, educating yourself on your options can help you make the most empowered choice for your health and lifestyle. That’s a process worth exploring. 

1. _{Centers for Disease Control and Prevention. (2024, May 15). Data and statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/spina-bifida/data/index.html} 
2. _{Juul, F., Vaidean, G., & Parekh, N. (2021). Ultra-processed Foods and Cardiovascular Diseases: Potential Mechanisms of Action. Advances in nutrition (Bethesda, Md.), 12(5), 1673–1680. https://doi.org/10.1093/advances/nmab049} 
3. _{NCI Dictionary of Cancer terms. Comprehensive Cancer Information - NCI. (n.d.). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/fortified-food}