There have been several news articles today (20 July 2022) on the ‘ultra-processed food’ (UPF) content of school food and packed lunches in the UK, following a new publication in Nutrients. In this research, Dr Jennie Parnham and colleagues looked at the diets of more than 3,300 children in primary and secondary schools, collected through the National Diet and Nutrition Survey. They reported that UPF intake was ‘high’ amongst both primary and secondary school children, with the highest intakes in those consuming packed lunches, those in secondary schools and in lower income households. Here we share our response to this latest publication and subsequent news headlines.
The term ‘ultra-processed foods’ is increasingly used in research on diet and health, and high intakes have generally been associated with an increased risk of ill health. However, the majority of the studies to date are observational, and so can’t establish that eating more ultra-processed foods actually causes ill health. It may be that the people in these studies have a poor lifestyle and eating habits overall.
The foods and drinks usually referred to as ‘ultra-processed foods’ are those produced in factories that can contain additives such as colours, flavours, emulsifiers or preservatives, or ingredients we do not typically find at home. This NOVA definition of ultra-processed foods, which was also used to categorise foods within this study by Parnham and colleagues, is based purely on the level of processing – not on the nutrient content of the food. Ultra-processed foods include an enormous range of products. It includes a high proportion of foods that are high in saturated fat, sugar and salt, such as confectionery, fried snacks, cakes and sugary drinks, which most of us know are foods we should be eating less of. But the definition also includes some foods that can be part of a healthy, balanced diet such as wholemeal sliced bread, lower sugar yogurts, wholegrain breakfast cereals and baked beans. Hence, it is essential to consider the nutritional contribution these ultra-processed foods may be making to the diet, rather than treating them all as a single group of unhealthy foods.
This is worthwhile noting when interpreting the findings of Parnham and colleagues. The reported data do not tell us about the nutritional intake at school lunchtimes. To understand this, it is important to think about the specific foods consumed within each meal type (school meal or packed lunch) rather than considering the foods based on broad classifications of ‘minimally-processed foods’ and ‘ultra-processed foods’.
Processing foods can help to make foods more accessible, convenient and affordable and this might explain why children in lower income groups had higher amounts of these types of foods in their packed lunches. Ensuring food – including healthier processed foods lower in saturated fat, sugar and salt - is accessible and affordable is particularly important at this time, with the cost-of-living crisis impacting so many households.
The publication also called for a renewed focus on school food and suggested including a maximum amount of ultra-processed foods in existing mandatory school food-based standards. These food-based standards do already specify which types of foods should be served at school, and how often, with set limitations on certain foods including foods high in fat, sugar and salt. What is really important is that we understand how well these standards are being implemented in practice and support schools to improve where necessary. The Food Standards Agency and Department for Education have recently announced a joint project to design a pilot study aimed at ensuring the compliance of food standards in schools with several Local Authorities in England. It is hoped that this work will help to drive up the standards for school food.
With obesity rates of 23.5% in Year 6 pupils, as reported in the provisional findings from the government’s National Child Measurement Programme (NCMP) for England in 2021/22, making healthier food choices is important. A healthy, balanced diet (and school meal or packed lunch) can be achieved without having to exclude all ultra-processed foods from the diet, but it is important to make better choices within processed foods and we should be looking to make these the easiest, most accessible and more affordable choices.
We have previously (Feb 2021) shared survey results revealing confusion amongst most people about what foods would be considered ultra-processed or processed, and the role they play in the diet, which you can read about here.
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Please note that advice provided on our website about nutrition and health is general in nature. We do not provide any personal advice on prevention, treatment and management for patients or their family members.