BNF warns against focusing solely on UPF classification

The British Nutrition Foundation (BNF) has released a position statement cautioning against using the NOVA system in isolation to determine the healthfulness of foods and drinks.

What is the NOVA system?

The NOVA system categorises foods based on the degree of industrial processing they undergo, without taking into account their nutritional profile.

Group 1 - Unprocessed or minimally processed foods

Natural foods which have undergone minimal processing such as cleaning, cooling, or freezing. Examples include meat, nuts, seeds, bulk grains, vegetables, fruits and tubers, eggs and legumes.

Group 2 - Processed culinary ingredients

Products extracted from natural foods or processes such as pressing, grinding and crushing. Foods in this group includes oils, all types of sugars, syrups, starches, salt, butter, lard, and coconut fat.

Group 3 - Processed foods

Products manufactured with the use of salt, sugars and or other substances from group 2 which are added to foods from group 1. Foods such as canned or bottled legumes and vegetables, tomato pastes, fruit in sugars, sugared and salted nuts, freshly made breads (unpacked), cheeses, smoked or cured meats or fish, canned fish and meats are included in this group.

Group 4 - Ultra-processed foods

Industrial formulations made mainly from substances extracted from food, contain modified or hydrogenated fats, or synthesized laboratory ingredients which includes any additives and fortification with vitamins and minerals. This group as well as incorporating all high fat salt sugar (HFSS) foods such as confectionary, sweetened beverages, processed meats and ready meals, also includes sliced whole meal bread, all breakfast cereals, margarines and spreads, plant-based drinks (sweetened and unsweetened), lower fat products and artificially sweetened drinks.

Research which is predominantly based on observational studies indicates a direct association between consumption of group 4 'ultra-processed foods' and non-communicable diseases such as obesity, type 2 diabetes and cancer.

The NOVA system fails to take into account the nutritional profile of the food.

It is essential to differentiate between foods that fall within the 'ultra-processed' group based on their nutritional profile to determine their impact on health outcomes accurately. Simply grouping all ultra-processed foods together and associating them with negative health outcomes ignores the significant variations in the nutritional quality of these foods. Some ultra-processed foods can have a nutrition profile established to have positive health outcomes, while others have a nutrition profile established to produce negative health outcomes. Therefore, it is crucial to consider the nutritional profile of each food item before making any health associations.

The BNF's view

Following its extensive review of the literature, the BNF emphasises that the NOVA system should not be used on its own to guide national dietary guidelines or classify foods as good or bad for health.

The NOVA system is at odds with many healthy eating national guidelines. While it places foods like salt and foods high in saturated fat (such as lard and fatty meats that are not processed) into Group 1/2 which are encouraged, these foods are generally recommended to be limited in most healthy eating guidelines. On the other hand, foods such as polyunsaturated fat spreads, soya mince, tofu, wholemeal sliced bread, and foods that have been reformulated to have a lower negative nutrient content are classified as ultra-processed and discouraged, despite their potential health benefits.

"It's great if you can cook from scratch when you have time, but I know for me, as a working parent it's often not an option. We need to make healthy eating easier and more affordable, not more difficult and expensive. Choosing healthier processed foods is one way that we can help people fit healthy eating into their lives."

Bridget Benelam, BNF spokesperson

A number of observational studies have explored the associations between the NOVA system and health outcomes, however, it is important to note that a direct causal effect has not been demonstrated. Studies have failed to differentiate between healthy and unhealthy nutritional profile group 4 foods when making correlations with health outcomes. This is a significant limitation that can lead to inaccurate associations between ultra-processed foods and negative health outcomes. Only when the nutritional profile is taken into consideration can health outcomes be more clearly defined.

Finally, the NOVA system categorizes fortified foods and those modified for medical purposes, such as gluten-free bread or fortified plant-based alternatives to dairy, as ultra-processed alongside high-fat, salt, and sugar (HFSS) foods. This classification fails to differentiate foods with potential health benefits from foods with established negative health benefits.

In conclusion

The NOVA system should not be used as the sole criteria to guide national dietary guidelines or classify foods as healthy or unhealthy. While some foods classified as 'ultra-processed' by NOVA may have negative health outcomes, others such as fortified and reformulated foods with improved nutrient profiles can provide affordable options for consumers to improve their health outcomes.

On the other hand, some foods classified by NOVA as minimally processed or processed culinary ingredients can be high in saturated fats, sugars, and salt, which have an established association with negative health outcomes. Therefore, it is crucial to consider the nutritional profile of foods in addition to their processing level when evaluating their impact on health outcomes.

Save article as PDF

Save article as PDF