You're listening to Food is Food, the podcast that will support you to ditch diet culture, break free from food rules, and debunk nutrition misinformation. I'm your host, Talia Chiquelli, specialist eating disorder dietitian and founder of the TC Nutrition Clinic. If you would like to learn more about our one-to-one nutrition support and group program, or download your free portioning guide, head to www.taliachely.com. Each week we will cover topics that delve deeper into nutrition, intuitive eating, psychology, diet culture, and the consequences of under-eating. Our relationship with food is so complex and it's influenced by our thoughts, emotions, and life experiences. Which is why healing from disordered eating is about more than just food. Welcome back to Food is Food. Maeve Hannon is a registered dietitian who specializes in eating disorders, disordered eating, and food freedom. She's the founder of Dietetically Speaking, a platform offering evidence-based information, practical tools, courses, and one-to-one support to help people build a healthier, more peaceful relationship with food. Maeve advocates a compassionate, weight-inclusive approach to nutrition and is passionate about cutting through the online nutrition BS by sharing clear, evidence-based, and practical messages via her website, weekly newsletter, and Instagram page. Welcome to Food is Food, Maeve. Thank you so much for having me on.
SPEAKER_01I am delighted to be here.
SPEAKER_00Yes, just before we hit record, we were saying that we haven't had a sort of face-to-face online conversation for like four years, which is just crazy.
SPEAKER_01It is because we used to be in so much contact. You know, I used to work in your clinic, we would be in touch all the time. And yeah, things changed a lot after I became a parent and life changed.
SPEAKER_00Yeah, yeah. I was actually going to say as a fun fact for the listeners, so Mave was the very first dietitian I brought on to the TCN team. Oh yeah, I forgot I was the first. Yes. Such a like honor. And that's my fun fact for today. And Mave has a wonderful clinic called Dietetically Speaking. If you want to find Mave, she'll share at the end of the episode. So, Maeve, I want to chat to you today all about ultra-processed foods. I have a bad habit of saying UFPs, which is not what I mean to say. UPS. I don't know why I do that. Sort of like UFO, I say UFP. Yeah, yeah. So um, ultra-processed food, there is so much noise and misinformation out there at the moment. And what I'm experiencing in clinic when I have conversations about ultra-processed foods is that a lot of people actually aren't aware of how they're categorized and what it actually means. So, can you tell us to start what is an ultra-processed food?
SPEAKER_01Yes, definitely. I think it's a really important place to start because I think a lot of people have a preconception of what an ultra-processed food is, but it's actually quite a difficult thing to define. It's quite complicated and confusing, even for professionals to properly get their head around. But it is helpful to have a bit more clarity on that so we actually know what we're talking about. I think really what people think of when they think about ultra-processed food is what a lot of people would think of as like treats or snacks. Or if you have a black and white perspective on food, you'd be thinking of like kind of bad, unhealthy food that I shouldn't eat too much of, or like in brackets, you know, junk, those kind of phrases and terms. I think people kind of use a bit interchangeably with ultra-processed foods. Of course, I don't advocate using those terms at all. Food is not good or bad, and it's all about nuance and context. But I just think it's important to name that up front because I do think that's what goes through a lot of people's heads when they're hear about UPFs. And when a lot of people online are talking about UPFs, they're kind of framing it in that way. So, first of all, there's no universal agreement on what an ultra-processed food actually is. There is one main definition that's used most often, and this is from the Nova research group. This was a Brazilian research group, but even within their definition, it can be interpreted differently. So basically, what an ultra-processed food is, it's defined as a food that is made mostly or entirely from substances derived from foods and additives with little, if any, intact whole foods. So it does include a lot of the foods people would think of when they think about UPFs, like things like sweets and crisps and ready meals and pastries. I mean, it would depend on the ready meal actually, whether it meets the exact criteria. But I think people are often surprised that it includes things like shop bought bread, like including whole grain bread, fortified cereals, again, whole grain cereals, you know, shop bot hummus, fish fingers, fortified soy milk, whereas unfortified soy milk that doesn't have any calcium in it isn't ultra-processed. And then there are other foods that people find surprising that don't always meet the criteria for UPF, like certain kinds of shortbread biscuits and ice creams and crisps. Sometimes they actually don't fall into that category of ultra-processed food, even though they're still potentially kind of higher in fat salt and sugar. So it's all about classifying food on how process it is. And I think it's really important to highlight here that it's not based on the nutritional value of that food. So it's not that, you know, we do already have evidence and guidelines and things around, you know, foods that are higher in fat, salt, and sugar, for like that are targeted at the general public. But ultra-processed isn't using that definition and classifying foods in that way. It's all about how processed the food is, which in my view isn't a very helpful lens to view food through. I think we need to be looking at kind of the big picture, the individual context, the nuance, the nutritional factors, of course, not just how processed that food is, because it's really become a way of just another way of classifying food as good or bad, or healthy or unhealthy, which just isn't the case. It's way more complicated than that, which I'm sure we will go on to chat about.
SPEAKER_00Yeah, oh, I couldn't agree more. And I think it's also important that in the Nova classification they speak about like the first sort of stage is more of like a whole food. It's not been sort of touched, and then it goes into a processed food. And that's where, again, a lot of people aren't aware that even like tinned corn or canned chickpeas are technically a processed food. So it's gone through a process to get it into the supermarket and onto your plate. And I think it's so helpful, maybe, that you share some of those examples, like shortbread biscuits, which might be sort of butter, flour, and sugar, which might fall into a different new nutritional category when we think about what nutrients might it might be providing, but it doesn't fall into the category of an ultra-processed food, whereas something like homice, which has multiple ingredients to make it, falls into the category of opti-processed. It's just, yeah, it just doesn't really make any sense to be using this criteria if we're looking at the nutritional value of food.
SPEAKER_01Yeah, I couldn't agree more. And I think that's just I find myself repeating that phrase just again and again that how processed a food is does not define its nutritional value. Yeah. And you know, if anyone listening takes away one message from this, I think that's just the key thing to remember. Yeah, it's just it's it's not about nutrition, it's about that degree of processing.
SPEAKER_00Yeah. And I think one of the main messages that are online, so very different to the message, our key takeaway for today, but one of the main messages online is that ultra-processed foods are bad for us and we should be avoiding them. What evidence do we have sort of for and against that sort of very bold statement and extreme view that we see online?
SPEAKER_01So I love getting into this talking about the research because I just think it's really helpful for people to be informed and have that full picture because it's so skewed the information that we get about this. So we do have a substantial amount of research around ultra-processed foods. I mean, when I say substantial, it's still quite a new area, like it is only recently enough to find, but there is kind of building research around it. And the key thing to mention here though is that the really vast majority of this research is observational. So it's following people over time and their food and their health are monitored and tracked. And some of these studies find a link between higher intake of ultra-processed foods and a greater risk of certain diseases, you know, like heart disease and diabetes and things. And sometimes they look at mortality risk as well. But the important thing there about this being observational is when we have an observational study, you know, it does add value from a research point of view, but it doesn't tell us cause and effect. So we can say that X causes Y. So the example I use most of the time for this is quite appropriate now that the weather is getting quite warm, is that like in the summer, both the incidence of ice cream sales and shark attacks go up. So this doesn't necessarily mean that those two things are linked, though. It's like, well, yes, it's summer, so people are buying ice cream and swimming more, but it doesn't mean that like eating ice cream is going to make a shark attack you. So it's similar when it comes to this research, is that the direction of that relationship isn't clear. And there are so many things that can confound and impact that relationship in terms of different lifestyle factors and different diseases, and you know how much access someone has to healthcare and different foods and how active they are, and do they smoke? And there's so many that it's and researchers do try and control for some of those things, but there's just so many, it's a complex web that you just can never control for all of those things. And it can be that people who are already at a higher risk of diseases or already have certain diseases are more likely to go for UPFs rather than necessarily being that UPFs cause those diseases. And we saw that in a study called the NutriNet Sante study. They found this link between UPFs and mortality, but when they excluded people with pre-existing illnesses, then that link went away. So that kind of really showed us that UPFs can be a marker for other risk factors rather than like the risk factor, like the independent risk factor in itself. So basically, it might be that it's not necessarily UPFs causing illness, but again, as I said, people who already have illnesses may be more likely to eat UPFs, um, you know, due to convenience and finances and necessity and everything. Um, so it's so it's just a much more complex web. And all that observational research, we can't necessarily say that that's a clear link. And then, you know, we've had a few randomized control trials, but a lot of the time, like they're just focusing on like weight loss as the outcome, and they're not always looking at overall health. And and when there are studies that have found positive outcomes, then you know they don't get as much attention. So basically, a few studies have found that a diet can be both nutritious and high in ultra-processed foods, and also that like cooking from scratch isn't always more nutritious or health promoting, like it really obviously depends like what you're cooking. So, one of the studies looked at people preparing meals from recipe books from like TV chefs versus having ready meals, and actually the ready meals were lower in like salt and saturated fat and things like that. And then there are a few studies that found that you can have a nutritious balanced diet when it's like predominantly made up of UPFs. So, one of those studies actually was a recent one, and they were looking at like UPF intake and outcomes mainly trying to lose weight. But they found that people were much more able to stick to the diet that had more UPFs in it, but both of the diets were following the EWEL guide in the UK. So that showed us that okay, it was easier to stick to this and you were still eating in a balanced, nutritious way, and people still like got beneficial outcomes on the UPF diet in terms of some of the heart health markers were actually better in that group than in the minimally processed group. And I do think that point about the dropout rate is really important as well because it shows that even in this context of this study. So this was a study where people were living at home, they were sent all their meals, it was like really convenient, it was over the course of like eight weeks, and there was a lot of thought gone into like, you know, what food they were sent and everything, but they were also kind of free to live their life and eat what they wanted and order, have some say in what they were ordering and things. Even with all of that support over that short period of time, I think it was about like 20% of people dropped out. So it's also about like how realistic is this to follow? And if it's not realistic to follow, then it's just causing like stress and shame and anxiety for people when it may not be realistic. And, you know, in my view, from the evidence we have, it isn't necessary to avoid UPFs, and it can actually be worse if you are, you know, avoiding nutritious UPFs. Your diet can become less varied if you don't allow yourself to have processed foods. You, as I mentioned, like the soy milk example, like a lot of people are switching to like less processed versions of plant-based milks, and their calcium intake is plummeting, you know, big impact on their bone health. So, yeah, there are so many reasons why it's unnecessary and harmful, these messages, and not backed by good evidence.
SPEAKER_00Yeah. Oh, thank you. There's so many bits of solid evidence in that. Thank you. Sorry, I went a bit deep there. I no, I like the depth, it's really important because what you're really sharing is that the the current research is not ideal from the perspective we don't have as many randomized control trials, but from the evidence that we do have, it's sort of looked at ultra-processed foods from different angles and in different contexts. And I think that's really important for us to take away. And what you were sharing at the beginning around the observational studies, again, I think is just so important because it's really hard when we sort of conduct studies that look at nutrition to be able to control for all aspects of a person's life. And when we look at those key lifestyle behaviors when it comes to our health, in terms of stress, nutrition, exercise, sleep, smoking, alcohol, really difficult to find a cohort of people that are, you know, sort of exactly living their lives exactly the same for all of those key behaviors, which is where that nutrition just needs to have that context and nuance layered to it as well.
SPEAKER_01Oh, 100%.
SPEAKER_00And in the work that we do, especially Maeve, and you're sort of hinting towards this, what we see is that when people sort of start to label their food and categorize their food with, I'm avoiding ultra-processed foods because they're bad for me, they're unhealthy, is that it can be very damaging to a person's relationship with food because it increases anxiety and fear and worry. And so this is why, as an eating disorder dietitian, I actually think it's really important for a lot of people to include ultra-processed foods, especially if they're experiencing anxiety and fear around it. So they need to expose themselves to those foods in order to overcome the fear. From your perspective, Maeve, are there any other reasons why it's it is important that we don't demonize ultra-processed foods and why it's okay to include them as part of a balanced diet?
SPEAKER_01So that's a great question. I talk about this with clients all the time. And first of all, it's really important in terms of yes, food exposures and breaking food rules and making sure that there isn't restriction there as part of the recovery from an eating disorder or disordered eating. So I do find that most of the fear foods that I'm going through to support my clients with, a lot of the time they fall into that UPF category. And it's really important to neutralize those foods and to reduce those fears for their relationship with food and for their enjoyment and variety and everything in their diet. But there are so many different reasons as well. I think it's always important to zoom out and think about well, what is health? If we are trying to aim for health, and if that's what people are saying, well, avoid UPFs to be healthy, then let's look at right, what do we mean by health? And I always go back to the World Health Organization definition of health, which includes physical, social, and emotional well-being. And if we think about that in the context of UPFs, well, restricting UPFs can definitely damage social well-being if you know you can't go for a pizza with friends, have cake at a birthday, you know, all of these things, or just feel kind of stressed and anxious having to check all the labels and menus and things before you go out. Then the mental health side of it, of course, it's that restriction is damaging to your relationship with food, that food anxiety, so that will impact mental well-being. But even physically, I've touched on some of the reasons why you can end up having less helpful nutrients in your diet, less variety. Um, and if you have a more difficult relationship with food overall, then that's going to have a knock-on impact on your physical, social, and mental well-being. So it's this really like interconnected web. And I think demonizing and really fearing UPFs worsens overall health. Whereas I think the angle a lot of people are coming from is those observational studies that I mentioned and just viewing it through that really narrow lens, which, as I said, I don't think is good enough evidence to base these opinions on and these choices. But also when we zoom out and look at overall health, I just find it really unhelpful. And there's so many other just kind of like realistic, like day-to-day factors as well. So, like the convenience aspect of it, the food safety, the I've mentioned variety a few times, but really what I mean by that is you know, there are foods that aren't available to us all year round. So having like tinned and frozen versions, and yeah, that can really increase the variety that we're having, and the like the food safety as well, of like, you know, having some preservatives in some of our food. And then there's of course the like the enjoyment and variety factor, and like a lot of these foods are really tasty and satisfying. And I mean, a lot of them, like to be clear, are designed to be like specifically tasty and enjoyable. But when you don't fear them, when they're not something that's off limits, or like this treat that feels like on this big pedestal that's bad, and I can only have sometimes, then it's not a big deal. When you get to that point of having a healthy relationship with food, being an intuitive eater, you can take them or leave them, and you'll eat them and they'll be satisfying, but you know, you won't be binging on them, you won't be obsessing about them. And you know, I just see time and time again when people heal their relationship with food, you end up eating in a way that's satisfying and enjoyable, but it's also nutritious because to like satisfying eating just is nutritious. You end up eating a variety of foods and having the different food groups to keep you full and going, and because it's it's what your body needs, it's it's what it's asking for. So yeah, I think that that's an important part of it as well. That like it takes them off that pedestal. And there's so many different individual factors, like for some people who are at the real kind of restoration phase of recovery, then UPFs can be really important, you know, some of them being more nutrient-dense as well. So yeah, I just feel like there are so many reasons why it's really important to include them, like for anyone who wants a healthy relationship with food, but it's really particularly important for those who are going through recovery.
SPEAKER_00Absolutely. And I think from a more general population perspective, my short answer is it will depend as to how much a person includes ultra-processed foods in their diet because of context. So there might be some people that are able to cook food from scratch the majority of the time. And there are some people that, due to where they're living, how they're living, financial situation, whatever else is happening, the best way that they can nourish their body is by having a higher percentage of ultra-processed foods in their diet. And neither is right, neither is wrong. It's what's best for the person at the time. 100%.
SPEAKER_01And I think like something really important that we're touching on there as well is like a lot of these anti-UPF messages like are really ableist because people who, if you have chronic illnesses and disabilities, then you might really need to rely on these foods. And there's a big crossover as well with you know, the whole like kind of trad wife movement and kind of like conservativism and things as well. So yeah, I just feel like it's important to acknowledge kind of all of those things that are impacting this messaging, and it's you know, it's such a privilege to be able to cook from scratch a lot of the time. And I people often come at me with the argument of like, well, you know, Whole Foods, most of them are fairly cheap, and if you buy them in bulk and prep and freeze food and all that, and yet that that's great and that does work for some people. But if you don't have the cooking facilities, if you are working two jobs and also a parent and you don't have the time for that, if you live in a food desert and you don't have access, if you don't have a car where it's difficult, or I don't know, if there is delivery in your area, so many. There are just so many factors. It's just not always realistic for people, and people are doing their best. And I have so many people reach out to me who are just like racked with guilt over this, like parents of kids with multiple allergies and fussy eating, and they have their safe foods that work for them and their family, but now the parents feel like they're poisoning their kids, and they're like, I feel so awful about this. So there are just so many ways that I'm seeing this harm people, and a lot of people reaching out saying how it's leading to relapses in their eating disorders, and how it's played a like a pivotal role in the development of their eating disorder as well. And yeah, when we talk about this, and one of the reasons why I'm so passionate about it is because I can just I see and I hear the harms. That it's causing, and it's just really worrying because a lot of it, I can see absolutely why people feel concerned about this and feel drawn into this. There are a lot of people who seem to be like reliable people spreading some of these messages, and just to kind of say there that if somebody isn't actually a nutrition expert, if they're not a registered dietitian or registered nutritionist, then I would be very cautious about following nutrition advice, even if somebody is a doctor or a scientist or a biochemist, all of these things. Someone can be an expert and a reliable person in one way, but it doesn't make them a nutrition expert. And similarly, even if there's somebody who seems to just like be an influencer and just have it all together and you just want to kind of emulate their life, that's such a human thing to be drawn to that. But we're not seeing the full picture of everyone's life and relationship with food. And yeah, I just think they're kind of important reminders as well when it comes to this conversation.
SPEAKER_00Yeah, and I know what you're sort of highlighting too as well, even think about it in the nutrition space, is that there's sort of extra caveat I'll put onto that, is that if you're seeing a message that is quite an extreme or black and white, that's when I would really encourage you to just stop and think. Because with nutrition, it's very rare that we would ever have such a strong opinion in either direction of any sort of argument because context is so important at an individual level. There may be statements that we can make sort of a population level, like you know, the World Health Organization makes recommendations for salt and sugar intake, but the messages online are never going to be about you as a human, and that's what we have to remember that we have to change the advice for you. Yes, absolutely. And what we're seeing more of, and I know this is another area that you're so passionate about, Maeve, is how this I think has also influenced label reading. And there's some really huge accounts online at the moment that are encouraging their community to read back of packets, read labels in quite a harmful way. And I'm all for what I call whether it be calorie awareness or you know, nutritional awareness in terms of what is this food providing me. I think it's important that we we know where food comes from, what ingredients make up a particular food. However, it shouldn't lead for you to feel so anxious and worried about consuming a particular food. And I think that the current messaging from some of these accounts online is just that is that if a product contains X number of ingredients or X ingredient, that it should be avoided. So from your perspective, May, because I know you've spoken about this online, what what are you noticing in terms of in clinic and online around label reading?
SPEAKER_01Yeah, I'm seeing it a lot online on social media. As you said, some really big accounts, really popular. And again, I can really see why people are drawn to this. And I always feel like in another life I would be drawn to this type of thing as well if I hadn't become a dietitian and done, you know, learned everything I did. So I can see why it's it's the appeal to simplicity, and they are positioning themselves as experts, even though they're generally not experts in nutrition. But it's like, okay, this simple swap, and it's like this is they're telling you this, but it's actually this, and it's this big secret. And again, it's the fear, it's like let's be fearful of these ingredients, and then like apps like the Yucca app, which is really, really triggering and really demonizing of food, and basically saying that like additives are bad. So, yeah, there's this kind of a whole kind of storm of things coming together, and I'm definitely seeing it in clinic as well. Understandably, then people are feeling anxious about these things. Again, what I find really insidious about it is it's when there are some grains of truth mixed in with misinformation and fear-mongering. I feel like that's the kind of most harmful combination because it's like, oh, well, you know, they recommended this swap and this is a good option, or they highlighted that, you know, this packet says it was. I'm thinking of a specific example now that it was made in Ireland, but actually it wasn't, you know, that's misleading. So there are some truths there where it's like, okay, well, yeah, actually that is misleading, and like that's fine to call out this certain thing, but there's just a lot of yeah, misinformation and fear-mongering where it's like read and it's promoting going in and reading every label, like pouring over labels. Like that's a recognized symptom of disordered eating, is obsessive label reading. And it's become really normalized. It's like people are recommending it. And I agree with you, it's not like I'm not saying like never read a food label, it's you know, it's fine depending where you're at in your relationship with food. There are actually some of my clients who I would recommend trying to never read a food label, if that's realistic. But if we're talking about somebody who doesn't have an eating disorder, then it's okay to look at some labels and you know to get a rough idea of things, or it's really important for some people who have food allergies and that kind of thing. But I'm just really worried about like the normalization of like, yes, let's read every single label and let's worry about all these additives, particularly when people online are talking about these additives. They, you know, again, it's it's not helpful, it's not evidence-based what they're saying, but it's like whipping up a lot of fear to the point where, like, yes, normal everyday foods, like some of the examples we gave, like sliced bread and hummus and things, like people fearing those and not being sure what to buy, or feeling like you have to buy these really like expensive, like minimal ingredients products. Again, there's like the kind of elitism that comes into it, or that you have to, yes, spend all your time cooking everything from scratch and just putting uh so much extra pressure on top of people. It just can very easily become a rule and like it can spiral. It can start off by being like, I want to be informed, I'm gonna start looking at my food labels and I'm gonna follow these people online. But that can really spiral for people and become really obsessive and take the joy out of food and lead to so much stress. And yeah, it's it's just a lot of oversimplification, like making it out that all additives are bad when you know they are safety approved, particularly like in the UK and in Europe. And it's not always accurate, like the number of calories we get on a label is very much an estimation, and there are lots of studies that show us that that can be quite inaccurate, and yeah, it's really not helpful to become obsessed and fearful about this, but I think it's becoming like really worryingly normalized.
SPEAKER_00Yeah. And I think as a dietitian, from like a very general perspective, and this is where it might be individual, that if someone, for example, is got low iron and we talk about finding some simple swaps to increase iron intake, like that is a really like healthy way that we would approach label reading, or as you said, looking at allergies, or if someone follows a vegan diet, like there are situations where we'll look at labels and that's absolutely fine. But you're right, it's at when it turns into an obsessive behaviour. And what I would say to the listeners is that if you are noticing that your approach to label reading has become obsessive and it's now causing a lot of anxiety and worry, that is enough of a reason. Please do reach out for support, whether it be speaking to your GP and being referred to local services or reaching out to, you know, either Mave or I. It's really important because that one behaviour can spiral in into others. And Mave and I see that in our clinics all the time.
SPEAKER_01Yes, 100%. And unfollow those accounts that are triggering and unhelpful as well.
SPEAKER_00Yeah, for sure. Are there any final messages that you want to share with the listeners today, Mave?
SPEAKER_01I guess going back to that key message that I'd mentioned early on, just remembering that how processed food is doesn't define its nutritional value and it's not healthy for you to be fearful or obsessed about food. Zoom out, think about your big picture of your overall health, your physical, mental, and social well-being, and just check in with yourself. Is this becoming unhealthy? Is this becoming obsessive? Am I fearing these foods? Do I need any support with this? And absolutely, yes, reaching out for support when needed. You know, the sooner the better, really, if these things are starting to emerge. But also just acknowledging that it's not like a failing if you have struggled with this or if you've been like really involved in some of those communities, because there is that kind of like community element of it as well. It's very understandable the fears and how how they're drawing people into this. But ultimately, it's just really, you know, take care of yourself and yeah, try and surround yourself with information that is evidence-based, helpful, and not triggering.
SPEAKER_00Yeah. Well, thank you so much for that really powerful message.
SPEAKER_01And Maeve, where can listeners find you? So you can follow me on Instagram. I'm at Dietetically Speaking. I have a website as well, Dietetically Speaking, where I have generally monthly articles if I'm organized. Um I have like a weekly newsletter as well, linked on my Instagram and my website. And you get like a first steps to food freedom freebie as well. And when you join the newsletter, yeah, they're all my current kind of main places where you can find me.
SPEAKER_00Yeah, fantastic. And I'll include them all in the show notes as well.
SPEAKER_01Oh, thank you.
SPEAKER_00Well, thank you so much, May, for joining today. It's great to have you. Thank you for tuning in to Food Is Food. If you found the episode nourishing, hit subscribe so you don't miss our weekly episodes. And just before we wrap up, a little reminder that the discussions in each episode are for informational purposes and don't replace individualized advice. Because every recovery journey is so unique. Please consult your healthcare provider for support. That's all for today. Stay nourished and see you next time.