By Andre Degenszajn, executive director of Instituto Ibirapitanga

Few topics stir public debate as much as food. Recommendations about what should be eaten and what should be avoided are everywhere, spread by researchers in universities and by experts and pseudo-experts on social media. Amidst this cacophony, Brazil benefits from having the Dietary Guidelines for the Brazilian Population — a policy that provides the official government recommendations for the population’s diet — which last year celebrated the 10th anniversary of its second edition. Recognized worldwide and having inspired the creation of similar guides in several countries, the publication is based on the NOVA classification, developed by Professor Carlos Monteiro and researchers from Nupens — the Center for Epidemiological Research in Nutrition and Health at the School of Public Health at USP.

The NOVA classification was groundbreaking for shifting the focus from nutrients, which underpins the well-known but outdated food pyramid, to an emphasis on the degree of food processing. Although the concept behind the Dietary Guidelines was established 15 years ago and has strong support in the scientific community, it has more recently been subject to increasing questioning. These concerns coincide with — and are largely motivated by — the growing awareness of the impact of the current dietary patterns on human health.

According to the classification, in summary, foods are organized into four categories: unprocessed or minimally processed foods; culinary ingredients; processed foods; and ultra-processed foods. The first category refers to foods as they are found in nature or those that have undergone physical processing without altering their essential characteristics (freezing, pasteurization, milling, dehydration, etc.). The second group consists of ingredients that, when combined with the first group, produce processed foods. These are foods that can be made in a common kitchen — and have been prepared by humans since the beginning of civilization. The last group refers to ultra-processed foods, which are industrial formulations that use fragments of foods like soy, corn, and wheat, combined with chemical additives, sugar, and other substances to enhance flavor, texture, and appearance, making these otherwise inedible products palatable. The result is a cheap, mass-produced product, convenient due to its long shelf life and easier transport and storage compared to most fresh foods.

At the same time, ultra-processed foods are generally low in nutritional value and highly addictive. These characteristics, combined with massive investments in advertising and lobbying by the industry, have led to a rise in their consumption across much of the world, accounting for nearly 60% of the calories consumed in populations like that of the United States. The magnitude of the impacts — both on health and the industry — along with the growing body of scientific evidence supporting the NOVA classification, has exponentially expanded the international debate about ultra-processed foods.

Why has the debate about ultra-processed foods gained traction recently?

Although researchers from Nupens/USP and other academic institutions have been systematically producing and disseminating evidence on the topic — and the Dietary Guidelines have been around for over a decade — the public debate around ultra-processed foods has gained more visibility in recent years. Several factors may have contributed to this.

In 2019, National Institute of Health researcher Kevin Hall conducted a randomized clinical study with 20 participants over four weeks, in which half of the group followed a diet free of ultra-processed foods, while the other half followed a diet based on ultra-processed foods. After two weeks, the groups switched diets. Both diets were controlled to offer the same number of calories, energy density, macronutrients, sugar, sodium, and fiber. The goal of the study was to establish a causal relationship between the consumption of ultra-processed foods and weight gain — and the result was positive. This study demonstrated in a controlled experiment what observational studies had already indicated — and was crucial in shaking the confidence of skeptics and mobilizing industry attention.

While in the scientific field, evidence was piling up, discussions about ultra-processed foods were still not central in public debate and in the general media. One reason for this may have been that the concept was developed by a group of Brazilian researchers who, despite having broad international academic recognition, were conducting first-rate research on the global periphery.

A few years later, in 2023, driven by some skepticism about the concept of ultra-processed foods, British infectious disease specialist Chris Van Tulleken decided to conduct another experiment. Unlike the one conducted by Kevin Hall, he himself was the subject, following a diet composed of 80% ultra-processed products for 30 days. While this percentage may seem excessive, it reflects the diet of 20% of young people in the UK. The result was a six-kilogram weight gain and two years to get back to his original weight. This experiment led to the book “Ultra-processed people“, published in Brazil by Elefante, as well as a documentary, podcasts, and numerous interviews and articles worldwide. This helped popularize a concept — and a discussion — that had been struggling to break out of academia.

Over the past year, articles in major newspapers around the world have multiplied, addressing the impacts of ultra-processed food consumption. While there was previously resistance to adopting the term, it has now become a constant in debates about nutrition and health.

Where do the resistances come from?

One of the main difficulties with the NOVA classification and the concept of ultra-processed foods is that it presents a structural challenge for the food industry. Used to “nutritionism“, which reduces food to a set of nutrients, the industry has specialized in formulating and reformulating products to supposedly be “healthier,” “lower in calories,” “higher in fiber,” “lower in fat,” “higher in protein,” etc. The problem is that the classification of foods by their degree of processing challenges the very process by which these products are made. It is not about subtracting or adding an ingredient, but about completely abandoning the methods used to manufacture these health-damaging products, which are not only convenient but highly profitable.

As a result, some groups and researchers, whether impartial or not, have begun to question the NOVA classification, citing difficulties in application, lack of precision, and excessive generalization in the classification, arguing that it fails to distinguish between bad ultra-processed foods and the less harmful ones. Recently, the investigative journalism agency O Joio e o Trigo published an article reviewing the arguments and pitfalls of the “good ultra-processed foods” discourse. In major newspapers and magazines, several articles have been published speculating about the need to distinguish between different types of ultra-processed products, particularly claiming that some can provide important nutrients, such as ultra-processed breads, cereals, and yogurts. According to one study, the true villains would be processed meats and sugary beverages.

The fact that there may be less harmful ultra-processed products does not make them better or equivalent to their processed counterparts. More important than establishing specific distinctions between selected products is the need to transform the foundation of the diet — or what it has become with the advent of ultra-processed foods.

Ranking ultra-processed foods to highlight those that supposedly offer benefits or less harm is the most effective way to keep things as they are or to deepen the ongoing trend of increased ultra-processed food consumption overall.

Even the “less harmful” products, through the eating behaviors they encourage, reinforce patterns that ultimately drive up ultra-processed food consumption.

The investment in producing controversies surrounding the concept of ultra-processed foods has also led to new attacks on the classification, this time sponsored by the Novo Nordisk Foundation — maintained by the company that makes most of its profits from a drug used to combat obesity. It doesn’t take much effort to highlight the conflict of interest. In an initiative developed in partnership with the esteemed The British Medical Journal, the foundation sponsored a project to make an “update” to the NOVA classification, supposedly based on new evidence. This episode led to the publication of an open letter by Professor Carlos Monteiro, in which he requests that the project not make any reference to any connection, update, or improvement of NOVA. With a discourse of modernization and improvement, the classification risks being replaced by an evolution that distorts and drains its meaning. It’s the old strategy of keeping things as they are — or producing a regression — under the guise of innovation.

Ironically, an (unreliable) ally in the fight against ultra-processed foods has emerged from the least expected source. Immunization denier and spokesperson for false health claims, Robert F. Kennedy Jr., the U.S. Secretary of Health, has been the main proponent of an ultra-processed food-free diet within the U.S. government. It’s surprising that from a government embroiled in conflicts of interest with the private sector comes one of the most outspoken voices against ultra-processed foods. Regardless of his methods, RFK has been effective in pushing this debate forward in the United States — it remains to be seen whether his incisive speeches will lead to real change.

This movement is likely to not only popularize and spread the debate on healthy eating but also provoke increasing resistance. The forthcoming clash will be based on scientific evidence, but above all, on political dynamics. In this sense, building alliances that go beyond research centers and a systematic exercise of social control over the conflicts of interest that permeate the relationship between the industry and regulatory processes is crucial. It is an important legacy that this generation has the opportunity to leave for the next.