More than ever, we worry about the dangers of eating ultra-processed foods (UPFs). Is there a safe level of UPFs to have in your diet? And can an occasional bag of crisps ever be OK? Dietitians share the small swaps that will make big changes to your health.
1. Understand what processed foods actually are
“UPFs have undergone significant modification and processing from their original form,” says Charlie Watson, a Caversham-based NHS dietitian and author of the book Cook Eat Run. “They often contain a large number of ingredients, many of which you may not recognise, including stabilisers, preservatives, artificial colours and flavours.”
“If you were to go into your garden and pick a lettuce, then that’s definitely not going to be processed in any way,” says Priya Tew, a dietitian from Southampton. “But once the lettuce gets washed and put into a bag, it has had some form of processing. And then if we go all the way through to when these things have had lots of added ingredients and have been changed in terms of the way that they have been put together, then that is going to be ultra-processed.”
2. Be aware of the limitations of categorising UPFs
Foods are categorised using the Nova system, explains Tew, which was devised in 2009 in Brazil and has four levels, from completely unprocessed through to ultra-processed, with the top category including high-fibre cereal, fruit yoghurts, chicken nuggets and fizzy drinks. “It’s not really good enough,” she says, “but it is currently the best we’ve got. I don’t think we need to be overly worried about things like plant milks, which are classed as ultra-processed, or shop-bought bread, which is a staple in so many people’s kitchens. It comes down to common sense about not overly relying on convenience foods, but it doesn’t mean we need to cut all of them out.”
3. Try not to worry about avoiding them completely
“Research shows that even those who have the best health outcomes still include some UPFs in their diet,” says Sophie Medlin, a consultant colorectal dietitian at CityDietitians in London. “That is because they are so ubiquitous, and it is really difficult to completely eliminate them from your diet. Nobody is expecting people to be UPF-free. We are just hoping that people will have a bit more awareness of them and reduce their intake.” But, Medlin adds, “it is not something to feel paranoid or excessively worried about. If it is causing people excessive anxiety and affecting their lives, then it is definitely worth seeking help.”
4. That said, UPFs should be eaten in moderation
“People who eat more UPFs have a higher rate of obesity and chronic diseases like heart disease, diabetes and cancer, particularly colon cancer,” says Linia Patel, a dietitian and public health researcher who works between Milan and London. “We know that there is a link between UPFs and poorer health, but we don’t know why. It could be that the additives in ultra-processed foods are having an impact on our gut health for the worse. It could be that processing affects the physical structure of food, making it easier to eat, and as a result these foods can be eaten faster, which leads to overeating. It could be that these foods contain more saturated fat, sugar, salt and less fibre, which means it is probably these foods causing the problem, rather than the processing.”
5. Aim for an 80/20 rule
“It’s not about perfection,” says Nichola Ludlam-Raine, a dietitian from Leeds and author of the book How Not to Eat Ultra-Processed. Ludlam-Raine works with obese patients and says that her philosophy is to focus on what they should be doing more of, rather than restricting them. “I always say moderation, not deprivation.” If you eat well most of the time, she says, you can justify a shop-bought birthday cake. Ludlam-Raine advises an 80/20 rule, as does Adam Cummins, a dietitian from Manchester. “When I’m working with someone,” he says, “80% of their nutrition should be focused on whole foods and then 20% can be focused on foods that they enjoy and feel they wouldn’t be able to go without, such as ice-cream, which are likely to be processed. Reducing them can have a massive impact on health.”
6. Don’t demonise hummus. Or Weetabix
Shop-bought hummus usually contains one preservative, says Ludlam-Raine. “If you see ascorbic acid as a preservative, that does not make the food a UPF – that is vitamin C. Weetabix is a UPF because of the barley malt extract that is added, but it is high in whole grains and there’s only one ingredient that you wouldn’t find in a standard kitchen. I would not class these as UPFs but these foods would come under Nova level 4.”
7. Look for simple swaps
“Have a look through what the common foods are that you’re buying on a weekly basis,” says Tew, “and work out where you can make swaps that aren’t going to cause you lots of stress and days in the kitchen preparing things. Perhaps you have an ultra-processed breakfast cereal, and you swap over to making your own muesli, which is just oats, nuts, seeds and raisins – stick it in a jar, shake it.”
8. Rethink mealtimes
“People live very busy lives,” says Medlin, “and it’s not possible for them to suddenly turn around and start cooking everything from scratch, and eating an entirely wholefood diet. Look at the things that are easy wins. For example, if you are relying on takeaway foods or ready meals in the evening, then think about recipe box delivery options [such as Gousto and HelloFresh], even if it’s just once or twice a week.”
9. Takeaways should be a treat but don’t rule out ready meals
“I am a big advocate of ready meals,” says Cummins. “There is a misconception from the past that they are poor quality, very high in additives and salts and fats. But the ready meal industry has massively improved. For a lot of people it removes the barrier of not having the confidence to cook and it can reduce food wastage. It also helps people on a calorie-controlled diet with portion sizes. It is much better to have ready meals, or pre-prepared meals, than reaching for a takeaway fast food app.”
10. Add an unprocessed side dish
“If you are buying a ready meal,” says Tew, “think about what is going to make the whole meal less ultra-processed overall. Stick some salad on the side or add some frozen vegetables, because quite often ready meals don’t have very much in terms of vegetable content.”
11. Get your head around hunger – and how to manage it
“There are three main types of hunger,” explains Ludlam-Raine. “There is head hunger, which is cravings; heart hunger, which is emotions; and stomach hunger, which is true hunger. You can keep stomach hunger at bay by having regular meals and adequate fluids; heart hunger, by coming up with ‘if-then’ strategies, for example: ‘If I’m feeling angry, I’m going to go for a walk in nature,’ or ‘If I’m feeling lonely, I’m going to phone a friend.’ But your head hunger can be triggered by eye hunger, ear hunger, nose hunger: so smelling, seeing, hearing a crisp packet being opened. If this happens walking past a bakery, just plan to avoid it. Walk a different way.”
Don’t rely on willpower, she says. “Because willpower is like a muscle, and the more you use it throughout the day, the weaker it will become. So that’s why, in the morning you might have resisted those office buns. But then the more you use willpower throughout the day, the more stressed you become, and you’re more likely to have something in the afternoon. Make sure in the office that any treats are not kept in eyesight. Ideally, they’re kept in the kitchen, so they’re there for people if they really want them, but you’re not triggered by eye hunger and you don’t have to rely on willpower.”
12. Ditch the fizzy drinks
“A lot of my patients fuel their day on Coke,” says Ludlam-Raine, “and then they come home from work starving, they haven’t prepped a meal, and might be relying on ready meals or takeaways, which drives more UPF consumption. If we can get them fuelling their day correctly – with regular meals, more wholefoods, more plants – then the Cokes will diminish. If they can swap to Diet Coke, that reduces the sugar intake. But diet fizzy drinks are not a health drink.”
13. Eat like an Italian
While working in Milan, Patel noticed that Italians snack a lot less, perhaps because they eat bigger meals and there is more of a home-cooked “like Mama used to make” food culture. “They have biscotti for breakfast – that would be classified as ultra-processed – and yet they’re still making it work overall. Why? Because the overall dietary pattern is that they’re including wholefoods,” says Patel.
14. Put kids to work in the kitchen
Processed foods are marketed to appeal to children from a young age, so obviously kids would rather have sweets than a piece of fruit. Teach them about the importance of a balanced diet, says Tew, and get them to help with the cooking. “My children have always loved getting messy in the kitchen,” she says, recalling the joy of making energy balls with her son, who couldn’t believe he could choose the flavours that went in them. By baking at the weekend you can add a homemade flapjack to lunchboxes rather than snack packets, says Tew.
A study published this summer highlighted that UK teenagers get about two-thirds of their calories from UPFs, which is a cause for concern, says Patel. “That’s a really important group to focus on because that is when the brain is developing the most. And our brain is one of the hungriest organs that we have: it consumes 20% of our energy every day. So we need to make sure that adolescents are eating in a way that nourishes their brains.”
15. Be organised to avoid UPFs
There is a perception that buying UPFs is cheaper than cooking. “Unfortunately, if you go around the shops, you’ll notice that a lot of the processed foods run deals,” says Cummins. “They are the ones that you can buy in big multipacks. And for people who may be on lower incomes and with children to feed, this can certainly be more appealing than buying wholefoods.”
However, if you plan well you can usually eat better, he says. “I always advise people to come up with a few ideas for the week ahead. Write a shopping list of things that are convenient and cheap. Baked beans are not going to go off and they’ve had a very minimal amount of processing. Same with frozen vegetables and fruits. They last much longer than the fresh versions and are still as nutritious, so you can buy them in bigger packs without them going off and they are cheaper in the long term. You can batch cook, prepare more and freeze meals, instead of throwing away food.”
16. Spend some dough on dough
Most people are unable to make their own bread, but it can be worth buying freshly baked bread, even from a supermarket bakery. “I’m not somebody who has time to bake my own bread,” says Medlin, “so it’s not as though I would ever ask my patients to try to do that, because I just don’t think it’s realistic. But if you are in a position to be able to pop to a local bakery and get some freshly made bread once a week, then that can be a really helpful way of nudging things in the right direction.”
17. Opting for high fibre can outweigh other negatives
Research has shown, says Ludlam-Raine, that the benefits of foods that are high in wholegrain outweigh the additives they contain. “If one of my patients is on a budget and can’t afford UPF-free bread like sourdough, then it is much better for them to have wholegrain bread, because it contributes to their fibre intake for the day.”
18. If in doubt, look at the label
“I recently bought a sandwich on the train, and it had hundreds of ingredients and different additives,” says Ludlam-Raine. “Look at ingredient lists,” agrees Watson. “Limit foods with a large amount of ingredients and many that you wouldn’t find in your home kitchen.”
There are certain things to look out for, says Medlin. “We think that emulsifiers are disrupting the barrier of the gut, which isn’t helpful, particularly if you have inflammatory bowel disease. We also want to be careful of preservatives, because we know that they are killing good bacteria, as well as bad bacteria. And artificial sweeteners, flavourings and colourings are ideally avoided if you can.”
19. Beware of some ‘health food’ products
“There is sometimes a health halo around certain products,” says Ludlam-Raine. “If a doughnut is vegan, people think it’s healthier than the other options, when it’s not.” Medlin adds: “The vegan protein market is full of UPFs. That can be a difficult thing to navigate for people who want to follow a plant-based diet but don’t realise the choices they are making are actually adding a lot of UPFs rather than making their diet healthy.”
20. Don’t let snacks drag you down
Snacking is often where people fall down, says Tew. “You’re out and about, and you need a snack. It’s not so easy to suddenly dash into the kitchen and whip yourself up peanut butter on toast. Think about what you can take with you if you are going to be out for a while.” Medlin agrees that snacks are the ideal first place to make a change. “There are really easy alternatives to processed snack foods: nuts, seed mixes, dried fruit, regular fruit.” But even dietitians are only human: “I mean, sometimes crisps are lovely,” she says.
