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2024 has been a bad year for ultra-processed food. In January, a British Medical Journal review compiled results from 45 studies and demonstrated direct associations between ultra-processed food and negative health outcomes, from increased deaths due to heart attack and stroke to a higher risk of developing diabetes, cancer, sleep disorders, anxiety and depression.
In May 2024, a study in the journal Neurology uncovered a link between ultra-processed food and dementia. Researchers found that a 10 percent increase in these foods was associated with a 16 percent higher likelihood of developing cognitive impairment. This increase was seen even in individuals who otherwise adhered to healthy diets.
The science is convincing, but data alone won’t change behavior. That’s because the modern American diet relies so heavily on ultra-processed food — i.e., items loaded with chemicals such as emulsifiers, artificial colors and flavors, preservatives, and thickeners — that nearly 60 percent of daily calories come from these substances. Consumption has increased over time and is prevalent across all age groups, including children.
It is difficult, if not downright impossible, to eliminate all ultra-processed food from today’s diet, but there are ways to cut down on intake. Here are five ways to start.
1. Opt for food with the least amount of processing. The healthiest choice is unprocessed food — meaning food that comes directly from plants and animals, such as fresh fruits and vegetables, chicken, fish and eggs.
Second choice is minimally processed foods that go through slight modifications. Think chopped and frozen vegetables or shelled nuts. This degree of processing doesn’t significantly change a food’s quality.
Third choice is food containing a small number of added ingredients, such as crackers consisting of just wheat, oil and salt, or whole-grain bread baked with flour, yeast, sugar, salt and oil.
Ultra-processed substances are packed with additives. These include traditional junk foods such as sodas, chips, candies and doughnuts, as well as hot dogs, store-bought white bread, french fries, and many ready-to-eat meals and frozen pizzas.
When possible, select the least-processed option. Choose chicken breast over nuggets and an apple over fruit gummies.
2. Shop the perimeter of the store first. In general, grocery stores have fresh items along the outer edges and processed and ultra-processed foods in the middle aisles. Try to get most items from the perimeter. (Though not everything along the outer edge is healthy; for instance, deli meats, which are ultra-processed, are often found there.)
Whole, unprocessed foods don’t have and don’t need labels because the sole ingredient is the food item. For all others, look carefully at the ingredient list. Choose products that have mainly whole food ingredients, with as few additives as possible.
3. Look out for ultra-processed substances masquerading as healthy food. It’s unfortunate that manufacturers are allowed to market ultra-processed products as “nutritious” and “healthy” when they are anything but. Be aware — many products carrying these labels are no better than other forms of junk food.
Breakfast cereal is a major offender. Many brands contain a lot of added sugar, multiple flavorings and preservatives. Same with granola bars and energy drinks.
Instead of these cereals, opt for oatmeal made from rolled oats and sweeten it with honey and fresh fruit. Choose nuts and dried fruit for on-the-go snacks. Energy drinks should be thought of in the same category as sodas and are best avoided.
4. Cut down on sugary drinks. Speaking of soda, this is a good place for many people to start making cuts. That’s because there is no ambiguity about soda being junk food; all store-bought sodas are ultra-processed, including diet sodas and those that claim to have fruit ingredients.
The option to switch to is, of course, water. Those who miss carbonation and flavor can try carbonated water with a dash of fruit juice.
5. Think harm reduction, not elimination. In the food environment we live in, it would take an enormous investment of time and resources to completely avoid ultra-processed food. This is not realistic. Instead, we should aim for harm reduction.
That means being aware of our choices and cutting down on unhealthy substances where we can. Sometimes, victory is simply choosing the less bad option. Research demonstrates that the more ultra-processed food someone eats, the worse off they are, so every bit of reduction counts.
At the end of the day, what we should all advocate for are policy changes that stop incentivizing manufacturers to produce ultra-processed food. It shouldn’t take so much effort to avoid these substances that are chemically manipulated to stimulate cravings and end up shortening our life spans.
Leana S. Wen, a Washington Post contributing columnist who writes the newsletter The Checkup with Dr. Wen, is an emergency physician, clinical associate professor at George Washington University and author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.” Previously, she served as Baltimore’s health commissioner.