Ajornartorsiutit annersaat puigorsimanerparput?

The debate is raging over what ultra-processed food actually is.

The ultra-processed food contains refined and powdered nutrients and many additives such as emulsifiers, thickeners, sweeteners and preservatives. But what about store-bought wholemeal bread and yoghurt with jam or cooked ham with a preservative? Is it really also harmful to your health?

However, there is another side to ultra-processed food: the purpose of the processing.

Food manufacturers can use additives and processing for many purposes, such as making food safer, reducing food waste, or securing the food supply. But there is also another consideration: Profit.

A significant portion of the food in stores is produced by large – often multinational – food companies that put profit before health, according to an editorial recently published in the British medical journal The Lancet.

Companies want to make food that sells the best. This has driven the development of a very special type of product:

- Foods made from cheap raw materials – such as refined wheat, corn, sugar and oil – with a number of substances added that give them a very attractive taste and consistency, says Simon Dankel, professor at the University of Bergen.

We have been given a targeted development and marketing of increasingly tempting ultra-processed products that will be difficult to stop eating.

Food designed for overeating

These foods are often very easy to chew and digest, because the structure of the original raw materials has been completely broken down. The products typically contain little water and have preservatives added so that they can last a long time during transport and on store shelves.

- It is extremely profitable for the companies, says Simon Dankel.

The problem is that profitability is based on us having to consume more, even if we don't need it.

- Processing has become a means of making money and winning the battle for customers, but contributes to people consuming too much energy and too little of the nutrition the body needs, says Simon Dankel.

The brain has not kept up with the times

Tine Sundfør, who is a clinical nutritionist with a Ph.D. in nutrition, believes that it is a big problem.

"Market capitalism has one goal: to sell more goods and more of the producer's own products. It is an extreme driver of overconsumption," she says.

The food industry is spending huge resources on developing and marketing increasingly irresistible products. And the one who has to resist this is each one of us – with nature against us.

- The brain has not kept up with the times, says Tine Sundfør.

When humans evolved, it was advantageous to find food with a high energy content. Strong biological forces within us make us crave fast carbohydrates, especially when they also contain added fat. And when we eat these foods, the brain gets a big reward in the form of feel-good chemicals.

- It's so easy to communicate with the brain that way and tempt it, says Tine Sundfør.

- So even though seven out of ten of us say we want to eat healthier, we leave the store with unhealthy food.

This is where the great potential for increased sales lies.

"People don't overbuy healthy food. You won't be tempted to take an extra apple," says Tine Sundfør.

Can override the body's regulation

In addition, it is possible that the new food confuses the body's regulatory systems, Simon Dankel believes. The body has complex systems for regulating food intake. Everything from the chewing process, how quickly we swallow, to how the food is digested and absorbed into the body, helps control the brain's perception of hunger and satiety.

- But we are designed to handle whole food, says Simon Dankel.

- With the extent of processing that has reached today, we can override the body's regulatory systems.

In many societies around the world, these ultra-processed industrial foods are now displacing the nutritious items in the traditional diet, such as fruits, vegetables, whole grains, meat, fish and simple dairy products. That was precisely the starting point for the NOVA system, developed by Brazilian researchers. They wanted to investigate what happens to health when industrial foods take over. However, it is not necessarily the best system for identifying problematic industrial foods, according to senior researcher Paula Varela-Tomasco, who herself researches ultra-processed foods at the Norwegian state-owned research institute, Nofima.

Maybe a new system is needed

- Not all ultra-processed products are unhealthy, but most unhealthy products are ultra-processed, writes Paula Varela-Tomasco.

A system that takes into account both the degree of processing and the nutritional content will likely be better able to distinguish between such products, she believes.

- Not all categories of UPF have equally strong associations with health outcomes.

- We need more research to delve into these differences and identify the causes, mechanisms and the most important products – especially in the Norwegian diet, she writes.

But even though much knowledge is lacking, both Simon Dankel and Tine Sundfør believe that we have sufficient research to say that a diet with a lot of ultra-processed food is not good for health.

- Of course, we would prefer to have insight into all the mechanisms, says Simon Dankel.

Studies could, for example, compare how individual products with different degrees of processing affect health, digestion, and how quickly and how much we eat.

But waiting for such certain knowledge is not necessarily an option, Simon Dankel believes.

Research resources for studying nutrition are quite limited, and with the current range of different ingredients, processes, and products, it goes without saying that it would take a very long time to test everything in randomized, controlled trials.

Such studies also do not necessarily provide particularly good answers to the effect of the entire diet, says Simon Dankel.

- You might get studies of individual products that show some very small differences between ultra-processed and minimally processed goods. But if you add up the effects of many ultra-processed products over a long period of time, the effect can be enormous.

The Mediterranean diet is also widespread

Simon Dankel understands that there has been skepticism towards the concept of ultra-processed food.

- An important definition of ultra-processed food is not about nutrients, but about the purpose of the processing. I think that many researchers will not fully accept this because they want to study the details.

At the same time, he does not believe that the ambiguities surrounding categories and definitions of ultra-processed food are in any way unique.

- For example, health authorities advise us to limit red meat, but there is no research on the health effects of game meat or liver pâté, says Simon Dankel.

They like to recommend the Mediterranean diet, even though we don't have a clear definition of what such a diet actually includes and excludes.

Or knowledge of what all the different ingredients in the diet do in the body. Most people still agree that it is the whole that counts and that such a dietary pattern is beneficial for health.

Usman Ahmad Mushtaq, who is State Secretary at the Norwegian Ministry of Health and Care (the Norwegian answer to the Danish Ministry of Health and Elderly, ed.), welcomes more research into ultra-processed food.

- Today we have a society that, for many, seems to promote obesity. There is a need for more knowledge about a systems approach to the challenges, rather than just studying individual factors, he writes.

At the same time, he believes that we must be able to have two thoughts in our heads at once. Not all ultra-processed food is unhealthy.

- The World Health Organization is working to look at the definition of ultra-processed food. We have had meetings with the WHO, and the Danish Health Authority is following this work closely.

More than enough knowledge

- I believe that there is more than enough knowledge to initiate measures, says Simon Dankel.

Both he and Tine Sundfør believe that professionals are in fact far more in agreement than the heated debate might give the impression.

- All of us who work with nutrition should be so professional that we now unite around what we agree on, says Tine Sundfør.

- Namely, we should limit our intake of sweets, snacks, soda and other sweet drinks, store-bought cakes and biscuits, and processed meat products such as sausages, burgers and bacon.

- All of these foods are already recommended by the dietary guidelines for us to cut back on, so the focus should be on following the dietary guidelines, says Tine Sundfør.

The two researchers believe that it is high time to act.

- Food directly affects our health, and therefore there should be strict regulations for those who produce it, concludes Simon Dankel.