Experts believe UPF classification misleads consumers

CHICAGO — With ultra-processed foods (UPFs) in the spotlight, it may be an important time to revisit how such foods are classified.

Speakers at a Feb. 19 webinar hosted by the Institute of Food Technologists (IFT) identified several problems facing the research surrounding and categorization of UPFs. Presently, UPFs make up one of four categories under the Nova classification system introduced in 2009 by Brazilian epidemiologist Carlos Monteiro. The Nova system delineates between four groups: unprocessed or minimally processed foods, processed culinary ingredients, processed foods and lastly UPFs, which includes foods such as soft drinks, ready-to-eat meals, pre-packaged bread, cookies, ice cream, sugary drinks, hamburgers, nuggets and more.

Matthew Teegarden, PhD, regulatory affairs manager for Abbott Nutrition, explained how the current Nova UPF classification can create confusion when the entire food group is conflated with being unhealthy.

“If we look back at the Nova categories, there’s some interesting nuances here that are kind of really contrary to current dietary recommendations,” Teegarden said. “For instance, ground beef that is 75% lean versus ground beef that is 97% lean would both be grouped into group one. Similarly, olive oil, lard and butter would be grouped into group two, tuna and canned beans will be grouped into group three, and white bread and whole wheat bread that are mass produced would be grouped into group four.

“The issue here is that we know that these are not nutritionally equivalent, so by recommending that people eat across these categories, you’re not necessarily providing precise nutrient recommendations based off of our decades of evidence.”

Problems with the Nova system also may arise from how the same or similar foods can end up in different categories based on minor formulation and processing choices by the manufacturer.

“So, if beans are just canned in water and a little bit of salt, that would be group three,” Teegarden said. “But if they have EDTA (ethylenediaminetetraacetic acid) added for color retention, that would be seen as a cosmetic additive and they would be group four, even though they’re virtually the same product. Similarly, if it’s plain yogurt, that would actually be a group one food. But if it’s yogurt with a flavor added, that would be a group four food.”

Teegarden said simply using Nova categories to determine the nutritional value of foods may lead to poorer dietary choices, citing an example of a consumer baking a cake from scratch versus using a storebought cake mix. The former would be considered a group three item, while the latter would be a group four item.

“To me, the take home message for consumers and for people trying to eat a healthy diet shouldn’t necessarily be, ‘Well, if you’re going to eat cake, make one from home,’” he said. “I think the issue, or the recommendation, should be to eat less cake.”

Susanne Gjedsted Bügel, PhD, head of section Nutrition and Health at the Department of Nutrition, Exercise and Sports at the University of Copenhagen, reinforced the idea, explaining how diets based on Nova classifications may lead to unhealthier outcomes.

“The Nova classification is broad,” Bügel said. “There are a lot of different foods where at least some of them are healthier than expected if you only talk about processing, but also the global classification for (each) class does not include some of the foods that we actually consider unhealthy. So, if we’re only using this, we might actually choose to be more unhealthy.”

Additional issues may arise surrounding food waste and the ethics of labeling certain lifesaving foods as UPFs, Bügel said.

“(In) many of these breads there are additives, as preservatives are being used that also decrease the food waste, because otherwise our bread would actually deteriorate very fast,” she said. “I also think, it's both a moral and ethical problem that foods that are used as food aids, as baby formulation, etc. (are placed) among ultra-processed foods as they are actually lifesaving.”