You start the day with fortified breakfast cereal, fruit yogurt, and fruit juice poured out of a tetrapak; you compliment yourself for having eaten what you thought was a healthy meal. You snack on half a bar of chocolate in the middle of the morning, grab a hamburger with mayonnaise for lunch, have a slice of banana or fruit cake in the evening, and finish the day with a cola, pizza and ice cream. Although you do not realize it, everything that you have eaten is ultraprocessed food, which is slow poison to your body.
Clinical guidelines have now begun to counsel people on what foods to eat and avoid rather than on how much of protein, carbohydrate, and fats the diet must or must not contain. It is easier to understand advice in terms of what is on the plate than in terms of what the biochemistry of the food is.
In this context, a slew of recent studies have found an association between ultraprocessed food consumption and the risk of cardiovascular disease events and mortality. In short, the greater the percentage of ultraprocessed food in the diet, the higher the risk of heart attacks, stroke, and death.
Although these studies were conducted in Spain and France, and published between February and May 2019, their findings are important to India because the urban Indian diet is far unhealthier than that in European countries.
Here is a simplification of the NOVA classification of foods based upon the degree of processing.
Unprocessed foods are those that are eaten fresh, or after processing with minimal addition of salt, sugar, oils, fats, or food additives. If at all the food is processed, it is to extend shelf-life, or to permit freezing or drying, or to otherwise prepare the food for consumption by boiling or pasteurization.
Examples of unprocessed foods are are fresh fruit and vegetables, mushrooms, rice, wheat, maize, and other cereal grains, flours, all kinds of nuts and seeds, milk, curds with no added sweeteners, eggs, meat, fish and other seafood, tea, coffee, fresh fruit or vegetable juice, spices, and herbs.
Minimally processed foods are unprocessed foods to which substances such as salt, sugar, honey, butter, oils, or vinegar have been added.
Processed foods comprise minimally processed foods which have been subjected to smoking, curing, fermentation, or similar processes, and which are packaged and sold. Examples are fruit, vegetables, or fish that are sold in packets, cans, or bottles; all kinds of bread; cheese; and beer and wine.
Ultraprocessed foods are those that are made predominantly or entirely through industrial processing and contain little or no whole foods. Ultraprocessed foods are not found in nature. These foods include ready to eat, drink, or heat items such as breakfast cereals; pies, pizzas, and hamburgers; biscuits, chocolates, candies, cakes, muffins, croissants, doughnuts, and other bakery confectioneries; custard, pudding, and ice cream; mayonnaise and margarine; sweet or savory snacks, including potato chips; sausages and pate; instant soups and noodles; fruit yogurt, sugared milk, milkshakes, fruit drinks that contain added sugar and additives, and carbonated beverages; and distilled alcohols such as whisky, gin, and rum.
What is frightening is that ultraprocessed food has become an important part of everyday life. With the exception of breads which are processed food, all bakery products are ultraprocessed food. All tetrapak, bottled, and canned foods are ultraprocessed food. Almost all desserts are ultraprocessed food.
What is especially frightening is that many of these ultraprocessed foods are considered healthy; breakfast cereal is an example, especially cereals that are marketed with the hype of vitamin and iron fortification. Milkshakes, packaged fruit juices, and fruit yogurt are other examples of unhealthy foods that are thought to be healthy.
Also frightening is the widespread acceptance of ultraprocessed food in the form of biscuits and instant noodles in the home, and pizzas and hamburgers in the workplace.
The relative quantity of ultraprocessed food intake is perhaps more important than the absolute quantity. In this context, 'relative' refers to the calorie content of the ultraprocessed food relative to the total calorie intake per day.
A note is made here that among unprocessed and minimally processed foods, some are less healthy than others. For example, red meats are less healthy than white meats; coconut oil and vanaspati are unhealthier than olive oil.
As a rule of thumb, if the food is something that exists in nature and is eaten as it is or eaten after cooking, it is safer to eat; if it is something that does not exist in nature and is made, packaged, and sold, it can harm health in the long run.
The long run is where we want to be. We don't want to suffer multiple diseases and die well before our time.
(Chittaranjan Andrade is Dean (Basic Sciences) and Professor, Psychopharmacology, at NIMHANS, Bangalore)