Sir, – In 2009, Prof Carlos Monteiro of the University of Sao Paulo published a paper proposing a new classification of foods which he named as the “Nova” classification, with four main categories ranging from unprocessed foods to ultra-processed foods (UPF). The latter have attracted enormous attention in the scientific literature and high intakes of UPF have been associated (solely by correlation) with a wide range of diseases. In a recent article in The Irish Times, “It delivers a taste bomb of pure pleasure, but ultra-processed food is killing us”, Health, January 31st), the case is made that UPF are at the heart of what is wrong with the modern diet.
However, the devil is in the detail and not the headline.
My morning breakfast is entirely ultra-processed according to Monteiro’s Nova food classification: toasted wholewheat bread with a low-fat spread and a low-fat, vanilla-flavoured yogurt. The reason that they are classified as ultra-processed foods is that they all contain an approved food additive. My whole wheat bread contains a raising agent, sodium bicarbonate or baking soda, present in all commercial flour. My low-fat spread contains an emulsifier, lecithin, naturally present in eggs and soy oil. My yogurt contains a flavouring agent, vanillin. There is not a shred of scientific evidence that these foods are doing me any harm and there is ample evidence that my breakfast is nutritionally sound. Again, I stress, these are classified as ultra-processed foods.
So what other foods are demonised by Nova? The list includes commercially prepared toddler food, breakfast cereals, chocolate, ice cream, sugar-free soda, biscuits, cakes and sweets.
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We know that breakfast cereals and commercially prepared baby food have a high and positive impact on population nutrient intakes of adults and toddlers respectively. We also know that sauces, biscuits, cakes and sweets make a small contribution to population nutrient intakes. The advocates of ultra-processed foods are asking us to eschew these foods and to seek out exactly the same foods free of additives. They make no biological case for this. All additives permitted in foods are approved by the European Food Safety Authority, the US FDA, the Australian and New Zealand Food Authority and, of course, the World Health Organisation.
There are foods that the advocates of the Nova classification highlight such as fast food burgers, huge breakfast rolls, large pizza servings, fish and chips, etc. And fine if they are taxed to the gills and labelled with a skull and crossbones. But in so doing they also need to respect the Christmas pudding rule. This is a food with a very high caloric density and bathed in fat and sugar but is eaten for only a few days of the year. Its population impact is minimal.
It is utterly unrealistic to advocate the Nova classification as the basis for public health nutrition strategies. Our treasured national food consumption databases, which the Irish taxpayer funds, can identify which foods and food patterns are best suited to our national strategies of public health nutrition. As for the putative hyper-palatability of ultra-processed foods, palatability is a personal, not a food, attribute. And the alleged quasi-addictive effects of ultra-processed foods are hard to imagine in wholewheat bread and low-fat yogurt.
The devil is in the detail and the detail deserves reading before populist nutrition advice frightens people unnecessarily. – Yours, etc,
MICHAEL J GIBNEY,
Professor Emeritus
of Food and Health,
Institute of Food and Health,
University College Dublin,
Dublin 4.
