Fat, sugar, salt… You’ve been thinking about food all wrong

In the late In the 2000s, Carlos Monteiro noticed something strange about the food Brazilian people were eating. The nutritionist had studied more than three decades of data from surveys that asked grocery shoppers to write down every item they bought. In more recent surveys, Monteiro noted, Brazilians bought far less oil, sugar and salt than they did in the past. Despite this, people piled on the pounds. Between 1975 and 2009, the proportion of overweight or obese adults in Brazil more than doubled.

This contradiction alarmed Monteiro. If people bought less fat and sugar, why did they get taller? The answer was in the data. Brazilians hadn’t really cut back on fat, salt and sugar – they were just consuming these nutrients in a whole new form. People traded traditional foods – rice, beans and vegetables – for prepackaged foods bread, sweets, sausages and other snacks. The share of biscuits and soft drinks in the shopping baskets of Brazilians has tripled and fivefold respectively since the first edition. household survey in 1974. The change was noticeable everywhere. When Monteiro first became a doctor in 1972, he had worried that Brazilians weren’t getting enough to eat. By the late 2000s, his country was suffering from the exact opposite problem.

At first glance, Monteiro’s findings seem obvious. If people eat too much unhealthy food, they gain weight. But the nutritionist was not satisfied with that explanation. He thought something fundamental had changed in our food system and that scientists needed a new way to talk about it. For more than a century, nutritional science has focused on nutrients: eat less saturated fat, avoid excess sugar, get enough vitamin C, and so on. But Monteiro wanted a new way to categorize food that emphasized how products were made, not just what was in them. It wasn’t just ingredients that made food unhealthy, Monteiro thought. It was the whole system: how the food was processed, how fast we ate it, and the way it was sold and marketed. “We propose a new theory to understand the relationship between nutrition and health,” says Monteiro.

Monteiro created a new food classification system called NOVA that breaks things down into four categories. Of least concern are minimally processed foods, such as fruits, vegetables, and unprocessed meats. Then come the processed culinary ingredients (oils, butter and sugar) and then processed foods (canned vegetables, smoked meats, freshly baked bread and simple cheeses) – substances that must be used carefully as part of a healthy diet. And then there are ultra-processed foods.

There are a lot of reasons why a product could fall into the category ultra-processed category. It can be made using “industrial processes” such as extrusion, transesterification, carbonation, hydrogenation, casting, or pre-baking. It may contain additives designed to make it hyper-tasty, or preservatives that help keep it stable at room temperature. Or it can be high in fat, sugar and salt in combinations not normally found in whole foods. What all foods have in common, says Monteiro, is that they’re designed to replace freshly prepared foods and keep you coming back for more, and more, and more. “Every day, from breakfast to dinner, you’re consuming something that’s designed to be consumed in excess,” says Monteiro.

The concept of ultra-processed foods has really taken off since it was first introduced in 2009: Brazil, France, Israel, Ecuador and Peru have all included NOVA in their dietary guidelines. Countless health and diet blogs extol the virtues of avoiding ultra-processed foods — eschewing them is one thing both carnivorous and raw vegan dieters can agree on. The label has been used to criticize plant-based meat companies, which in turn have embraced the label. Impossible calls its plant-based burger “unashamedly processed.” Others have pointed out that we cannot possibly feed billions of people without relying on processed foods.

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