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Navigating Processed Foods on the Path to Eating Disorder Recovery

Ultra processed food have been getting a lot of press lately – most of which is negative! There have been claims of processed foods being linked to high bloods pressure, cardiovascular risk heart attack, stroke and even early death! However, there are limitations to current research and caution is still needed when it comes to making dietary recommendations.



What are Ultra Processed foods?

The NOVA classification system categorises foods based on the extent and purpose of their processing. It doesn’t take into account the nutritional value of food or the importance that ready made foods can have in someone’s Eating Disorders recovery.


Unprocessed or Minimally Processed Foods (Group 1):

These include foods that have not been processed so they are eaten in their original form. Examples are fruits, vegetables, meats, eggs and milk.


Processed Culinary Ingredients (Group 2):

Group 2 includes substances derived from Group 1 foods, such as oils, fats, sugars, and salt, which are commonly used in cooking and preparing meals.


Processed Foods (Group 3):

This category encompasses foods that have undergone deliberate processing to make them more palatable or convenient. Examples include canned vegetables, cheese, and freshly baked bread.


Ultra-processed Food and Drink Products (Group 4):

Group 4 comprises food that have 5 of more ingredients and have different additives and preservatives.







What does this classification system tell us? It's essential to recognise that classification systems based on the 'extent of processing' are not universally agreed upon. Processing itself serves important roles, not only in terms of food safety and extending shelf life but also in addressing issues of accessibility to affordable nutrition and reducing food waste. Contrary to the perception that all processed or ultra-processed foods are inherently unhealthy, there are instances where they play a beneficial role, especially for certain population groups with more restricted diets. Some processed and ultra-processed foods contribute significantly to helping populations meet their nutritional requirements. Notably, the concept of food fortification, involving the addition of essential vitamins and minerals to enhance micronutrient density, can lead to the classification of foods as processed or ultra-processed. Yet, this fortification brings positive health benefits, supporting individuals in achieving their daily nutritional needs.


Let’s take a look at the evidence when linked to eating disorders . . .

In 2020 a retrospective observational study was published investigated the association between ultra-processed foods and disordered eating behaviours. The electronic health records of 70 female and 3 male patients diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) from 2017 to 2019 were reviewed. The NOVA classification was used to categorize the degree of processed foods in their diets.

Patients with Anorexia Nervosa reported consuming 55% NOVA-4 foods (Ultra processed foods). Those with a diagnosis of Bulimia Nervosa or Binge Eating Disorder had up to 70% of their intake from NOVA-4 foods. Food consumed during a binge episodes were found to be 100% ultra-processed. These finding have been back up by Figueiredo et al 2022 and Bjorlie et al 2022 who found that highly palatable foods are primarily consumed during binge episodes in individual with Binge Eating Disorder and may be associated with greater binge-eating frequency. However, the NOVA classification was not used.


However the methodology used doesn’t allow for a connect to be made to link the type of food eaten to the extent of the Binge Eating. It only tells us that people are more likely to binge of these ultra-processed foods, and that ultra-processed foods are usually more palatable.





So what next?


The full impact of UPF consumption on the intricate brain systems involved in Binge Eating Disorder (BED) remains a subject of ongoing exploration. We cannot blame UPF for binge eating behaviours. Binge eating is a mental health diagnosis and not one caused by the food we eat. We know that the body reacts differently to different foods, and this varies from person to person. Influencing factors include insulin resistance, sleep, stress, exercise, and the microbiome.


Processed foods play a very important part when it comes to accessibility, meal preparation, re introducing foods in high-risk situations and help to make foods more interesting and fun – things that are a really important part of ED recovery.


These findings identify the need for further investigation into the metabolic and neurobiological implications of ultra-processed food intake, particularly in relation to disordered eating, with a focus on episodes of binging.


It's crucial to adopt a nuanced perspective that acknowledges the potential positive contributions of processed foods while maintaining a balanced and varied approach to overall nutrition.


Take home messages:

Ultra-Processed foods have very important place in ED recovery.

Ultra-Processed foods can help us meet our nutritional needs.


Foods that fall into the Ultra Processed foods category has not been assessed for their nutritional value.


References:

Ayton, A., Ibrahim, A., Dugan, J., Galvin, E. and Wright, O.W., 2021. Ultra-processed foods and binge eating: A retrospective observational study. Nutrition, 84, p.111023.



British Nutrition Foundation 2023. Position statement on the concept of ultra-processed foods (UPF). Available Online < https://www.nutrition.org.uk/news/2023/position-statement-on-the-concept-of-ultra-processed-foods-upf/>


Cardello AV, Schutz HG & Lesher LL (2007). Consumer perceptions of foods processed by innovative and emerging technologies: A conjoint analytic study. Innovative Food Science and Emerging Technologies 8(1), pp.73–83.

Dwyer J, et al. (2012). Is “Processed” a Four-Letter Word? The Role of Processed Foods in Achieving Dietary Guidelines and Nutrient Recommendations. Advances in Nutrition 3(4), pp.536–548.


Elizabeth, L., Machado, P., Zinöcker, M., Baker, P., & Lawrence, M., 2020. Ultra-Processed Foods and Health Outcomes: A Narrative Review. Nutrients,


Figueiredo, N.; Kose, J.; Srour, B.; Julia, C.; Kesse-Guyot, E.; Péneau, S.; Allès, B.; Paz Graniel, I.; Chazelas, E.; Deschasaux-Tanguy, M.; et al. Ultra-processed food intake and eating disorders: Cross-sectional associations among French adults. J. Behav. Addict. 2022, 11, 588–599. [Google Scholar] [CrossRef]


Monteiro, C.A., Cannon, G., Lawrence, M., Costa Louzada, M.L. and Pereira Machado, P. 2019. Ultra-processed foods, diet quality, and health using the NOVA classification system. Rome, FAO.

Schulte, E., Chao, A., & Allison, K., 2021. Advances in the Neurobiology of Food Addiction. Current Behavioral Neuroscience Reports, pp. 1 - 10.

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