What Are the Health Risks of Ultraprocessed Foods?

Courtney: Welcome to Health Matters, your weekly dose of the latest in health and wellness from NewYork-Presbyterian. I’m Courtney Allison.

With emerging research linking ultraprocessed foods to common health conditions, it’s empowering to learn the ways we can eat a diet more full of whole foods and how they can benefit our health.  

Today we’re talking to Dr. Michelle Loy, an integrative health specialist at NewYork- Presbyterian and Weill Cornell Medicine. She’s going to break down what ultraprocessed foods are – and some might surprise you. We’ll also talk about why you should avoid them. She’ll share some tips on what to look out for in the grocery store and for how to integrate more whole foods into your diet.

Courtney: Hi Dr. Loy. Thank you so much for being with us here today.

Dr. Michelle Loy: Thanks so much for having me. I’m excited to be here.

Courtney: So we’re here to talk about processed foods. And there are a few categories. Can you break down what whole foods, processed foods and ultraprocessed foods are?

Dr. Michelle Loy:  Sure. So whole foods are foods in their natural state or minimally processed, and they retain most of their nutritional value.

So examples are fresh fruits, vegetables, whole grains, nuts. Processed foods are foods that are altered from their natural state, usually through methods like canning or freezing, or they may have something added for taste, shelf life, or convenience. So, minimally processed foods would be washed and bagged vegetables, or plain yogurt, or cooked beans, or even, I would say, steel cut oats, because the oat groats have been cut, so there’s minimal processing there. Even fermented foods, for example, like sauerkraut, would be minimally processed.

Courtney:   Can you provide some examples of ultraprocessed foods?

Dr. Michelle Loy:  Ultraprocessed foods are highly manipulated foods that often contain artificial ingredients, additives, and minimal whole food content. So some examples would be soda, chips, packaged desserts.  

So let me give you some examples of some ultraprocessed foods that might be a little bit surprising to people. One example would be like a plant based meat alternative. Well, they often contain additives, flavorings, and texturizers that mimic the taste and texture of meat.

Another big one, probably the top one, in my opinion, protein bars and shakes. These are usually marketed as health foods, but they often contain emulsifiers, artificial sweeteners, preservatives. And I will say with artificial sweeteners, were long thought to be inert in the human body. However, I would say there’s emerging research suggesting that artificial sweeteners may have potentially detrimental effects on, for example, the microbiome, and that may lead to perhaps adverse health effects.

Okay, another example of ultraprocessed food would be certain vegan or gluten free snacks. These cookies or chips or crackers that often replace wheat, but then they’re replaced with refined starches, for example, right? Plant based milk, sometimes they might include stabilizers like carrageenan, emulsifiers, sweeteners, in order to enhance the shelf life or the mouthfeel.

And then energy drinks or functional waters. They often have added vitamins and minerals, but they also have artificial flavors, colors, and sweeteners. You’d be surprised if you look at the label.

Courtney:   You know, I try to really be health conscious, but as you’re talking, I’m thinking some of the choices I make, like eating a plant based burger or adding electrolytes to my water, maybe aren’t as healthy as I thought.

I’m curious too to hear about protein powders.

Dr. Michelle Loy:  So protein powders, they contain isolates and they’re very popular, whether you’re talking about animal whey or vegetarian pea protein, right? And I’d like to maybe unpack this sort of sticky controversy around these protein powders.

So people will ask me often, is this protein powder, especially this plant protein powder, like soy yellow pea being the most popular, is this healthy for me? Well, these proteins, which ultimately go into a protein powder or plant based meat, they’re extracted from whole foods. If it’s a plant protein, let’s say soy or yellow pea.

However, in the process of separating the protein from the rest of the whole food, the whole soy being a yellow pea, that can be subjected to like hexane to remove the oil or some different acidic or alkaline chemicals or flavor masking agents. So they might be free from cholesterol or from, like, factory farm processing, unlike their animal counterparts.

But they might have, like, other things. Flavor enhancers, stabilizers, texturizers, sweeteners. So I would consider, you know, these plant protein isolates in the ultraprocessed category. But if someone wants to move from an animal based to a plant based dietary pattern, they may choose foods that have some isolate plant proteins as like a short term transition tool, you know?

But the aspirational goal would be to replace the plant based meat substitute, maybe with, like, a patty made with beans and whole grains or vegetables, if health is the main goal, right? And again, emphasizing whole plant foods over protein isolates removes most of the potential risks with these highly processed ingredients.

If we emphasize whole plant protein sources like legumes, nuts, seeds, they contain the health promoting nutrients and compounds that are stripped out during the, you know, protein isolate processing. So they will have the fiber, the vitamins and minerals, essential fatty acids, the phytonutrients, the antioxidants, the soy isoflavones, which are beneficial.

So it’s a win-win choice.

Courtney: How do processed foods contribute to an increased risk of developing or dying from certain types of cancer? I’ve read that there are some studies showing a link.

Dr. Michelle Loy:  Right. So there are some links or I would say associations between ultraprocessed foods and chronic diseases. Now, this research is still emerging, but there was, there are a number of studies, one in 2018 and one I think a little more recently, linking an increase in ultraprocessed food consumption to higher risk of cancer, various types of cancer.

We’ve seen the same thing with cardiovascular disease. A 2020 article showed that individuals with diets high in ultraprocessed foods had a 30 percent higher risk of cardiovascular events. And same with diabetes. Ultraprocessed foods seem to contribute to insulin resistance, and then actually also mental health.

I just saw a study, actually it’s a 2022 study that linked more frequent consumption of fruit with reduced symptoms of depression and greater positive psychological wellbeing.  So there does seem to be a benefit to eating whole foods and potentially a risk to eating ultraprocessed foods. And probably the chronic diseases may be affected by, you know, the added sugars, the unhealthy fats and the artificial ingredients in the ultraprocessed foods.

So it’s not like we can never eat processed foods. But I think of it kind of like, maybe like a slow leak in a tire, in your health tire. Like one meal is not going to hurt, but over time  it could lead to potentially, like, a bigger blowout. So I think it’s important to do our best to try to eat more from, I usually say, the plant rather than the factory plant, you know, from the farm rather than the factory.

Courtney:That’s great advice.  So, I’m wondering, when you’re shopping in the grocery store, how can you actually tell if something is ultraprocessed? Like, how do you identify ultraprocessed foods?

Dr. Michelle Loy:  So, I usually tell my patients there’s a number of red flags. Long ingredient lists with unfamiliar names.

Actually, people may be surprised. I saw one website with 262 hidden names for sugar. And what is even more surprising is that most of these processed sweeteners, let’s say, initially were unprocessed. They came from natural sources. So the majority of these were whole foods before processing. So it was oats or brown rice or whole corn or beets or coconut. Then when all these fiber nutrients are removed, and they were processed into, for example, in the case of corn, multidextrin, or high fructose corn syrup, right? It started out as corn, which is fine. Great. Corn is good.

But the body responds differently to these food-like substances. Other foods to look out for would be foods with ingredients that were added. I mentioned this for flavor or texture, like, especially in, like, jarred pasta sauce or salad dressings. I tell my patients there’s so many options at the store. So many different types of jarred pasta sauce.

Look at the label and find one that doesn’t have sugar in it and save your sugar for the dessert that you really want to eat mindfully and joyfully later.

Courtney:  And it’s interesting you bring up jar sauce because that’s one that’s so easy to go for too. Like I’ll try to make my own sauce if it’s a weekend or if I have the time, but during a weeknight I’m thinking, okay, I’m getting some tomatoes in, but you’re right, look for that sugar.

Dr. Michelle Loy: Exactly.  You don’t even taste it. You know, and same with yogurt or, you know, salad dressings. Ready to eat foods, you know, can be very, are obviously more heavily processed. Oftentimes the pre-made foods, the frozen pizzas, the microwave microwaveable dinners. And then a big one that may be surprising are foods that are marketed as diet, natural, vegan, vegetarian, plant based, healthy, low calorie, because I always say whole foods don’t need labels like apples and carrots and avocados and lentils and buckwheat and walnut.

They don’t have labels. They don’t need to be advertised as natural, vegan, or healthy, right? But then the vegan, gluten free, healthy bars with maltodextrin or oat syrup do need some kind of marketing. So that’s another clue.

Courtney:  I mean, it sounds like buyer beware. If it has to tell you how great it is, maybe you should be a little bit suspicious.

You mentioned that your body processes these ingredients from what was once a whole food differently, such as something like high fructose corn syrup.

Dr. Michelle Loy:  Right.

Courtney:  Can you describe what’s going on in your body when you eat a whole food versus something that is processed?

Dr. Michelle Loy:  Here’s a good example. A lot of my patients will ask me about juices, if that’s something that would be healthy for them.

Is it as healthy as eating a fruit, for example? Well, first of all, I’ll say, do you know how many oranges it takes to make a glass of orange juice? It’s going to be at least a few oranges, right?

Courtney:  Yeah.

Dr. Michelle Loy:  So most people, when they drink the orange juice, they could drink it in like, if you’re in a rush, drink it in less than a minute, but it would probably be pretty hard to eat three, four, or five, six oranges that quickly.

You’d have to peel it and chew it, right?

Courtney: Yeah.

Dr. Michelle Loy:  And so the difference is, with the oranges, when you’re chewing and eating it, you’re processing the fiber along with the orange flesh and the sugars in the oranges, right, along with the phytonutrients, all that kind of stuff. So the way the body sees these foods is a little bit different.

And because of the way the fiber is going through the body, it kind of, I think of the fiber as a way of shepherding the sugars in the fruit to the place where it needs to, rather than going straight to the liver. Even complex carbohydrates with, which break down into glucose, but they come with their fiber the body sees it differently.

And so the spike in the glucose is not as extreme. It’s much more gradual and that, in general, is better for our health and our body. And we want to kind of maintain our glucose level. So I would say nature knows how to do its own packaging, really. And there’s a lot of carb phobia, but there’s nothing wrong with whole complex carbohydrates.

They are good. They come with their fiber and it’s like nature knows that.

Courtney: Do you have any advice for how listeners can limit the amount of processed foods in their diets? You know, people who have very busy lives.

Dr. Michelle Loy:  So, I mean, meal prepping does help when you, when, you know, on the weekends or when we have time and even batch cooking, you know, there are, there are studies showing that home cooked meals are linked to better dietary quality.

And it doesn’t have to be like completely from scratch, especially if you, sometimes I’ll say, if you can just spend half hour or something roasting a bunch of different types of vegetables or bulk cooking some grains, you know, if you can freeze it in small jars, then you can easily put together foods or meals quickly from those base components. You know, you can replace snacks with, like, swap chips with nuts or candy with fresh fruit or hummus and crudités, you know, carrot sticks, things like that.

Using spices and herbs. I talk a lot about that in my practice instead of like pre-made sauces. It doesn’t take that long. Actually earlier today, I made a pesto out of just some parsley that I had frozen early in the summer. I just took it out and added a lemon and some salt and some garlic and just, you know, made a little pesto.

And now that can be added to a lot of things later on in the week, right? Into a pasta dish or on vegetables or, you know, marinating some kind of protein. So, so it doesn’t take that long to make sauces that can be very delicious and easy to integrate. I’m a big fan of beans and lentils. They’re very inexpensive and you can do, you know, either dried edamame or roasted chickpeas, roasted soy nuts.

Those are really easy to carry, add some dried fruit, maybe some cacao nibs if you want to be kind of like, like a mix.

Courtney:  It’s nice just hearing about all these health benefits, is just motivating to do things like meal prep, but also you’re describing like really delicious sounding ways to do it.

Any other budget friendly strategies you want to share for adding more whole foods into diets?

Dr. Michelle Loy:  Well, I mean, the other thing I would say is frozen fruits and vegetables are great. And again, they can, you know, you don’t have to worry about them going bad.

And you could take it out when you need to. And they’ve been minimally processed, just flash frozen. So they maintain their nutritional value. You know, if you can have fresh that’s great, but if not, always have some in your freezer.

Courtney: Dr. Loy, this is so, so helpful. Thank you.

Dr. Michelle Loy: Thank you for having me.

Courtney: Our many thanks to Dr. Michelle Loy. I’m Courtney Allison.

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