Have we forgotten the biggest problem?

The waves are high in the debate about 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 yogurt with jam or cooked ham with a preservative? Is it really too harmful to health?

The waves are high in the debate about 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 yogurt with jam or cooked ham with a preservative? Is it really too harmful to health?

However, there is another side to ultra-processed food: Purpose with the processing.

The food producers can use additives and processing for many purposes, for example making food safer, reduce food waste or secure the food supply. But there is also another consideration: Profit.

A not insignificant part of the food in the shops is produced from large – often multinational – food companies, which put profit first health, according to an editorial recently published in the British weekly medical journal The Lancet.

The companies want to make food that sells as well as possible. This has driven the development of a very special type of product:

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

We have had a targeted development and marketing of increasingly tempting ultra-processed products that it must be difficult to stop eating.

Food created for overeating

These food items are often very easy to chew and digest, because the structure of the original raw materials is completely broken down. The products typically contain little water and have added preservatives so they can last for 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.

- The processing has become a means of making money and win 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. i nutrition, believes that it is a big problem.

- Market capitalism has one goal: to sell more goods and more of the manufacturer's own products. It is an extreme driving force for overconsumption, she says.

The food industry spends large resources on developing and market increasingly irresistible products. And he that shall withstand this, is each one of us – with nature against us.

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

When man evolved, finding food was an advantage with a high energy content. Strong biological forces in us make us want to fast carbohydrates, especially when they also contain added fat. And when we eating this food, the brain gets a big reward in the form of well-being substances.

- It is so easy to communicate with the brain that way 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 will not be tempted to bring an extra apple, says Tine Sundfør.

Can override the body's regulation

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

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

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

In many societies around the world, this is supplanting it ultra-processed industrial foods now the nutritious items in the traditional diet, such as fruit, vegetables, whole grains, meat, fish and simple dairy products. It was precisely the starting point for the NOVA system, developed by Brazilian researchers. They wanted to investigate what happens to health when industrial food takes over. That however, it is not certain that it is the best system to identify problematic industrial food, believes senior researcher Paula Varela-Tomasco, who herself is a researcher in ultra-processed food at the Norwegian, state-owned research institute, Nofima.

Maybe a new system is needed

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

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

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

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

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

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

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

But waiting for such certain knowledge is not necessarily one possibility, says Simon Dankel.

The research resources for researching nutrition are right limited, and with the current scope of different ingredients, processes and products it goes without saying that it will take a very long time to test everything in randomized controlled trials.

Such studies do not necessarily provide particularly good results either answer to the effect of the whole diet, says Simon Dankel.

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

Mediterranean cuisine is also diffused

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

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

At the same time, he does not believe that the ambiguities around categories and definitions of ultra-processed food are by no means unique.

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

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

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

Usman Ahmad Mushtaq, who is state secretary in Norway's Health and Care Ministry (the Norwegian answer to the Danish Ministry of Health and The Ministry of the Elderly, ed.) welcomes more research into ultra-processed food.

- Today we have a society that works for many obesogenic. There is a need for more knowledge about a systems approach to the challenges, rather than only studying single factors, he writes.

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

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

More than enough knowledge

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

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

- All of us who work with nutrition should be like this professionals, that we now gather around what we agree on, says Tine Sundfør.

- Namely that we should limit the intake of sweets, snacks, soft drinks and other sweet drinks, shop-baked cakes and biscuits as well as processed foods meat products such as sausages, burgers and bacon.

- All these foods are already recommended by the dietary guidelines that we cuts down on, so the focus should be on following the dietary advice, says Tine Sundfør.

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

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