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The revolt against ultra-processed foods

By Paula Goodyer

There’s no mistaking the message on some packaged foods sold in Chile:  a black logo shaped like a ‘stop’ sign tells shoppers when products are high in sugar, saturated fat, sodium or kilojoules.  

But Chiles’s crackdown on junk food doesn’t stop there.

“Foods carrying these labels aren’t allowed to be advertised to children or sold in schools,” says Dr Priscila Machado, a research fellow at Deakin University’s Institute for Physical Activity and Nutrition (IPAN).  

Peru has similar warning labels, Mexico’s parliament recently voted to adopt them, while in Brazil a proposal to require warning labels on products high in sugar, sodium and saturated fat is up for public comment.

Why Latin America leads the charge

“These countries have a traditional food culture with a food supply less dominated by ultra-processed foods compared to countries like the USA and Australia. They can see the levels of obesity and chronic disease in these countries and want to avoid them. Traffic lights or stars can sometimes be confusing but there’s nothing confusing about a clear black sign that says a product is high in sugar,”  says Dr Machado who’s on the  team led by Professor Carlos Monteiro of the University of Sao Paulo that coined the term ‘ultra-processed food’. It also developed NOVA, a new classification system ranking foods according to their level of processing rather than nutrient content.

How NOVA classifies foods:

Group 1 Unprocessed  foods and minimally processed foods - whole foods including plants, meat, fish, eggs, milk and whole foods extracted directly from nature or minimally processed by methods such as drying, crushing, grinding roasting,  pasteurising freezing and vacuum packaging.

Group 2 Processed culinary ingredients - ingredients like oils, butter, lard, sugar, vinegar and salt that are rarely eaten alone but used to season/cook other foods. May contain additives used as preservatives (e.g. oils with added antioxidants; salt with added anti-humectants).

Group 3 Processed foods - canned/bottled vegetables preserved in brine, whole fruit preserved in syrup, tinned fish preserved in oil; some processed animal foods e.g. ham and other processed meats; smoked fish; most fresh breads and simple cheeses.

Group 4 Ultra-processed foods (UPFs) - soft drinks, sweet/ salty/ fatty packaged snacks, confectionery, mass produced breads/baked goods, cake mix, margarine and other spreads; sweetened breakfast cereals; fruit yoghurt; pre-prepared meat, cheese, pasta and pizza dishes; poultry or fish ‘nuggets’; sausages, burgers, instant soups, instant noodles and sauces; packaged desserts, energy bars, baby formula, meal replacements. Manufacturing these foods involves several steps - e.g. fractioning whole foods into substances like fats, protein, starch and fibre; sometimes submitting them to hydrolysis or hydrogenation or other chemical modification. Other processes may include extrusion and pre-frying. Colours, flavours, emulsifiers and other additives are often added to make products palatable or hyper-palatable. 

“What sets UPFs apart from other foods is the extent and purpose of processing,” Dr Machado explains. “Food processing isn’t new but techniques like fermentation or pasteurisation, for example, don’t change the food matrix and are beneficial. UPFs have a higher level of processing that changes the food and often stimulates overconsumption.”

How UPFs undermine diet quality and health

Using NOVA, she’s published studies analysing Australia’s National Nutrition and Physical Activity Survey (2011-2012) this year, finding that UPFs contribute to over 40 per cent of Australians’ daily energy intake and drive excessive free sugar intake among all age groups.

“There’s consistent evidence from other studies using NOVA, showing that when UPFs displace other foods it increases the risk of obesity and other diet-related non-communicable diseases, “she adds.   

That’s not the only concern.

“There’s emerging evidence that some emulsifiers and artificial sweeteners may disrupt the gut microbiome. It’s also how processing itself alters food in ways that can compromise health. Trans fats formed by hydrogenation is a well-known example but there’s also the impact of heating on the formation of advanced glycation end products and acrylamide which may contribute to health problems too,” she says. 

A fresh approach to informing nutrition policy

NOVA has its critics - some argue the UPF category includes products like breakfast cereal that are useful sources of nutrients for some people. But Priscila Machado believes NOVA makes it easier to see the big picture of our modern food supply and gauge its impact on health.  

She’s now working with IPAN’s Food Policy and Public Health Group to create a new framework to help policy-makers use the most appropriate evidence to tackle contemporary nutrition and food security problems.

 “The framework will guide evidence synthesis and translation for policies based on a holistic view of nutrition science that goes beyond the narrow focus of nutrients,” she says.

“We face unprecedented pandemics of obesity and chronic disease, and problems with our environment. We need to promote healthy, sustainable diets to help deal with them. But existing food and nutrition policies with their emphasis on nutrients - food reformulation, nutrient-based food labelling and current dietary guidelines, for example - are insufficient to tackle the complexity of these problems because they don’t consider important aspects such as the role of food processing.”

To find out more, see Ultra-processed foods, diet quality, and health using the NOVA classification system, a report from the Food and Agriculture Organisation to which Dr Machado contributed.

Dr Machado’s presentation on ultra-processed food for Education in Nutrition will be freely available from the website on January 17, 2020. Register here