• Dr. Dawn Harris Sherling

If we are what we eat, our kids are ultra-processed

In 1999, Britney Spears was an uncomplicated pop sensation; our greatest virus fear was a computer glitch called Y2K; and kids were eating a lot of crappy food.


Fast forward to today and it turns out that things have not only spun out of control for Britney and viruses, but kids’ diets have taken a turn for the worse too.


A recent JAMA (Journal of the American Medical Association) article notes that kids’ consumption of a substance called ultra-processed foods has increased significantly in the past 20 years, going from about 61% to 67% or what is now two-thirds of their diet. (Read more here: https://jamanetwork.com/journals/jama/article-abstract/2782866). In the past decade, we have learned that the more ultra-processed food you eat, the higher your risk of obesity, heart disease, cancer, and gastrointestinal maladies. The problem is, these so-called foods are getting harder and harder to avoid. I use the term “food” loosely because a hallmark of ultra-processed foods is that they do not consist of what our grandparents would have identified as culinary ingredients.


The reason these substances are hard to avoid is that they’ve been manufactured and marketed to look like real, actual food, but perhaps a bit cheaper and flashier. Take pizza, for example. My husband likes to make pizza. It’s a lot of work and exclusively a weekend project. He makes a dough from scratch. Ingredients: wheat flour, water, yeast, salt. He makes his sauce from scratch too. Ingredients: tomatoes, salt, pepper, a little bit of sugar, garlic, basil, oregano. The cheese he buys. Ingredients: milk, cultures, salt. Compare that to the ingredients of a frozen supermarket pizza (which may not be any better than the take-out pizza you get from your local chain).




I’m not arguing that my husband’s pizza is health food. It isn’t. It's a processed food. It’s not a banana or an apple or kale for that matter, but it’s still recognizable as food to our bodies. The stuff that we are all now consuming, and our kids are consuming at an alarming rate, isn’t. That’s why in 2009, a new nutrition classification system, called NOVA, deemed ultra-processed foods its own category. NOVA groups foods into four categories.


  • Category 1 is made up of foods that are unprocessed or minimally processed. Unprocessed foods are eaten as nature gives them to you—an apple, banana, or kale. If you take the kale and bake it into chips, you’ve processed it, but minimally (it’s still basically kale).

  • Category 2 is made up of what are called processed culinary ingredients like oil or salt. Nature does not give us oil or salt. We have to make them from basic starting points (pressing olives in the case of oil and grinding whatever it is that salt comes from—rocks? The sea?). They should be used sparingly to enhance the flavor of Category 1 foods.

  • Category 3 foods are processed foods. It generally is how we have historically preserved food to last a bit longer. Bread and pasta are processed. Real cheese and yogurt are processed. The ingredients used to make them have to go through a few steps to get to their final stage, but they are essentially still wheat or milk.

  • Which brings us to Category 4—the ultra-processed foods. NOVA says these are made up of substances that are of “rare” or “no culinary use” or are “additives whose function is to make the final product sellable, palatable and often hyper-palatable. Food substances of no or rare culinary use, employed in the manufacture of ultra-processed foods, include varieties of sugars (fructose, high-fructose corn syrup, ‘fruit juice concentrates’, invert sugar, maltodextrin, dextrose, lactose), modified oils (hydrogenated or interesterified oils) and sources of protein (hydrolysed proteins, soya protein isolate, gluten, casein, whey protein, and ‘mechanically separated meat’). Classes of additives used only in the manufacture of ultra-processed foods, are flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, artificial sweeteners, thickeners, and foaming, anti-foaming, bulking, carbonating, gelling and glazing agents.” (Read more here: http://www.fao.org/3/ca5644en/ca5644en.pdf)


Category 4 "foods" have been linked to a host of diet-related diseases including obesity, diabetes, fatty liver disease, inflammatory bowel disease, and irritable bowel disease. And, they are everywhere.


It’s not just that the ultra-processed foods are being eaten in fast food restaurants. They are in more expensive restaurants too. They are in our school cafeterias and in our homes, though the JAMA article notes that the more we eat at home, the less ultra-processed foods we tend to eat.


And yet, there’s room for hope. According to the study, in the past 20 years, there was a notable DECREASE in the consumption of sugary beverages by kids. This is probably due to numerous campaigns to steer kids away from sodas. The increase in the ultra-processed foods seems to be coming from more heat-and-eat meals and packaged breads and pastries that we are all probably eating (because, for the most part, kids can’t buy their own food).


Forty years ago, a tremendous number of Americans smoked. Twenty years ago, we were drinking more soda. Now, it’s time to cut out the ultra-processed foods. If we can free Britney and figure out how to start counting years beginning with the number “2”, we can also stop eating the foods that are destroying our health.

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