Recently, I posted the photo at right in my Facebook group. The photo shows a meal I made one night with two slices of frozen pizza next to a gorgeous salad made with lots of fresh veggies and lean protein. I commented that you can have processed food while eating a healthy diet.
Little did I know that the topic of processed food would spark such a lively discussion!
Because several of the women said that they were confused about which foods are considered processed and which were not, I decided to delve into the topic and was surprised to learn many things about processed food that even I, an experienced dietitian, did not know.
First things first: What does "processed food" mean?
Processed foods refer to any food that’s been altered from its original or natural state. This can include food that was cut, washed, heated, pasteurized, canned, cooked, frozen, dried, dehydrated, mixed, or packaged. It also can include food that has added preservatives, nutrients, flavors, salts, sugars, or fats.
Most people believe that processed foods are "bad" and honestly, most processed foods aren't what I would call nutritious. However, there are a lot of processed foods that aren't THAT bad and can fit into an otherwise healthy diet.
What Are the Types of Processed Foods?
To make it easier to know which foods are lightly or heavily processed, the Center for Epidemiological Studies in Health and Nutrition, School of Public Health, University of Sao Paulo, Brazil created the NOVA Food Classification System.
Food processing as identified by NOVA includes "physical, biological and chemical processes that occur after foods are separated from nature, and before they are consumed or used in the preparation of dishes and meals.” (1)
NOVA divides food into the following four groups:
Group one: Unprocessed or minimally processed foods.
Unprocessed or "natural" foods are obtained directly from plants or animals and do not undergo any alteration following their removal from nature.
Minimally processed foods are natural foods that have been submitted for cleaning, removal of inedible or unwanted parts, fractioning, grinding, drying, fermentation, pasteurization, cooling, freezing, or other processes that may subtract part of the food, but which do not add fats, oils sugar, salt or other substances to the original food.
Natural, packaged, cut, chilled or frozen vegetables, fruits, potatoes, and other roots and tubers
nuts, peanuts, and other seeds without salt or sugar
bulk or packaged grains such as brown, white, parboiled and wholegrain rice, corn kernel, or wheat berry
fresh and dried herbs and spices (e.g., oregano, pepper, thyme, cinnamon)
fresh or pasteurized vegetable or fruit juices with no added sugar or other substances
fresh and dried mushrooms and other fungi or algae
grains of wheat, oats and other cereals
fresh and dried herbs and spices
Group Two: Processed culinary ingredients.
This group contains butter, oils, sugar, or salts. These are foods or ingredients that come from nature but are slightly changed. They may have been pressed, refined, milled, or dried. These options aren’t supposed to be eaten alone; they’re meant to be added to foods during meal preparation.
According to NOVA "As long as they are used in moderation in culinary preparations based on natural or minimally processed foods, oils, fats, salt, and sugar contribute toward diverse and delicious diets without rendering them nutritionally unbalanced." (1)
oils made from seeds, nuts and fruits, to include soybeans, corn, oil palm, sunflower or olives
white, brown and other types of sugar and molasses obtained from cane or beet
honey extracted from honeycombs
syrup extracted from maple trees
Group Three: Processed foods.
Processed foods are food products manufactured by industry with the use of salt, sugar, oil or other substances (Group 2) added to natural or minimally processed foods (Group 1) to preserve or to make them taste better.
They are generally recognized as versions of the original foods. Most of these foods have two or three ingredients. They’re edible by themselves but can also be added to other dishes. The foods in this group are processed to make it more stable or add to the food's qualities.
canned or bottled legumes or vegetables preserved in salt (brine) or vinegar, or by pickling
canned fish, such as sardine and tuna, with or without added preservatives
tomato extract, pastes or concentrates (with salt and/or sugar)
salted, dried, smoked or cured meat or fish
fruits in sugar syrup (with or without added antioxidants)
Group Four: Ultra-processed food and drink products.
Ultra-processed foods are industrial formulations made either entirely or mostly from substances extracted from foods (oils, fats, sugar, starch, and proteins), derived from food constituents (hydrogenated fats and modified starch), or synthesized in laboratories from food substrates or other organic sources (flavor enhancers, colors, and several food additives used to make the product hyper-palatable). They are generally highly palatable, inexpensive, and can be consumed anywhere at any time.
Ultra-processed foods usually have a lot of preservatives, dyes, colors, added flavors, non-sugar sweeteners, or other ingredients that change the texture or appearance of the food.
These foods are meant for you to eat right away and they don’t usually require much preparation.
fatty, sweet, savory or salty packaged snacks
pre-prepared pizza and pasta dishes
ice creams and frozen desserts
pre-prepared burgers, hot dogs, sausages
chocolates, candies and confectionery in general
pre-prepared poultry and fish ‘nuggets’ and ‘sticks
cola, soda and other carbonated soft drinks
sweetened and flavored yogurts, including fruit yogurts
infant formulas & drinks, and meal replacement shakes (e.g., ‘slim fast’)
margarines and spreads
distilled alcoholic beverages such as whisky, gin, rum, vodka, etc.
Although the NOVA classification system is not recognized by the FDA or the USDA, I believe it's a starting point to learning which foods are heavily processed and which are not.
How Do Processed Foods Affect Your Health?
Frequent consumption of highly processed food increases your risk for diabetes and cardiovascular disease (2). A recent review showed that frequent consumption of ultra-processed food can actually change the bacteria in your gut which can lead to inflammation (3). These effects might even affect future generations through what's called "epigenetic change". It's important to note that this review was mainly based on studies done with animals, so we still need more research to fully understand how it affects humans.
In addition, ultra processed foods are generally low in nutritional content so if you consume these foods on a regular basis, you might not be getting all the nutrients your needs. This is why it's important to include more fruits, vegetables, whole grains, and healthy fats to ensure you are getting adequate nutrition.
The 64-million dollar question then is this: can you include processed food in a healthy diet?
I believe that you can. There are many minimally processed foods that can easily be a part of a healthy diet. The meal I mentioned earlier (shown above) is a good example: two slices of a frozen pizza combined with a nutrient-dense, high fiber salad and homemade dressing.
Christine Rosenbloom, PhD, RDN FAND, Professor Emerita, Georgia State University, says "I am not worried about one specific food, but how processed foods fit into the entire dietary pattern. I would rather see a child eat a bowl of Lucky Charms with milk and a glass of 100% fruit juice than a pop-tart. The cereal contains some sugar, but it is also enriched and fortified with needed vitamins, and minerals and when paired with milk and fruit....a good combination."
Many people don't have access to fresh fruit and vegetables so meals that contain some processed food combined with nutritious foods are better than eating ultra-processed foods.
I think the key is to stick with minimally-processed foods and limit the amount and frequency of ultra-processed foods that you consume as much as possible. Keep in mind that other lifestyle factors affect our risk for diabetes and heart disease, such as physical activity, stress reduction, avoidance of smoking, and good sleep hygiene.
How Can You Minimize Your Intake of Processed Foods?
As often as possible, stick to foods that aren’t changed too much from their natural state. Typically, the less processed it is, the better. Some examples of processed foods that can add benefits to your meals include:
Whole-grain or whole wheat bread
Milk products or juices with added vitamin D and calcium
Canned fruits stored in water or natural fruit juice
Frozen berries (blue berries, black berries, etc.
There are a few other ways to minimize intake of processed foods:
Read your labels. The fewer ingredients, the better. Look for whole food options, like raw vegetables and fruit, or options with less ingredients.
Choose food from the fresh sections. One way to avoid processed foods is to look in the fresh section at the grocery store. You’ll find more wholesome choices here.
Look for less processed meats. Meats that are less processed, like seafood or chicken breasts, are better for you than processed meats. Avoid heavily processed options like sausage or bacon.
Cook more at home. When you go out to eat, it’s hard to tell what’s actually in your food. If you cook at home, you’re in control of the ingredients you put in your meals.
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Monteiro C.A., Cannon G., Levy R.B., Moubarac J.C., Louzada M.L., Rauber F., Khandpur N., Cediel G., Neri D., Martinez-Steele E., et al. Ultra-processed foods: What they are and how to identify them. Public Health Nutr. 2019;22:936–941. doi: 10.1017/S1368980018003762.
Cordain L., Eaton S.B., Sebastian A., Mann N., Lindeberg S., Watkins B.A., O’Keefe J.H., Brand-Miller J. Origins and evolution of the Western diet: Health implications for the 21st century. Am. J. Clin. Nutr. 2005;81:341–354. doi: 10.1093/ajcn.81.2.341.
Zinocker M.K., Lindseth I.A. The Western Diet-Microbiome-Host Interaction and Its Role in Metabolic Disease. Nutrients. 2018;10:365. doi: 10.3390/nu10030365.