The ASN's Statement on Processing

The ASN released it's official scientific statement on processed food. The text of this can be found here. Statements regarding why some found the report controversial can be found here.

The statement seems to have garnered controversy, because of its inclusion criteria for the word 'processed', and for its final conclusion.

The researchers identify that the term 'processed' is quite subjective and ''value-laden''. In an attempt to develop definitions for processed foods, they categorize foods based upon data from focus groups conducted by the International Food Information Council ( a non-profit independent group that doesn't lobby - see here -  but has garnered distrust by those concerned about funding - see here). You can find the IFIC's definitions of processed here.

Source: foodinsight.org

They identify processed foods as being a continuum. Many have taken issue with the idea that simply processing techniques have been included, like washing produce or roasting/grinding coffee (some of this minimal processing does matter e.g. cutting carrots exposes a greater surface area to oxygen, roasting coffee can create antioxidants/carcinogens). While I see why people look that at these as being a bit ridiculous or trivial, it's not a meaningful point to focus on  - more of the authors' point seems to be that many see processed as being equivalent with unhealthy, yet, despite not thinking of them as unhealthy, foods like almond milk, tofu and kale chips are all pretty extensively processed.

The publication makes an argument for the benefits of processed foods - they add to the nutrient intake of the population (contributing significantly in some areas), ensure shelf-life stability and food safety, and add to the convenience/pleasure received from foods. They also note that the promise that food processing holds - everything from reducing the caloric/sodium content of foods, enhancing the delivery of bioactive compounds of interests (omega 3's, antioxidants), and reducing food waste/allergies via nanotechnology (a futuristic promise).

The authors cite where processed food has largely contributed detrimentally - leading to an increase in overall calories, sodium, saturated fats (oddly I don't see any discussion of trans fat), and added sugars.

In their conclusion, they note that processed foods have had their successes, but have also contributed negatively to the health of the population. For me, the really important part of this paper is that it discusses processed food consumption in the context of meeting the dietary recommendations.

Source: AJCN

Anyone who reads this blog regularly knows that I like food science. Humans have always processed foods and the application of new technologies should not be avoided when it comes to food. However, as I've also mentioned, I think we've largely failed when applying technology to foods - designing products that meet only taste and convenience, giving little consideration to nutrition (though hopefully this is changing, with an increasingly concerned market). You could probably have an all out war about whether this was the dubious work of the food industry to increase their profit margins, or a response to market demands - and likely, the answer is somewhere in the middle. 

I like this scientific statement as a whole, though I think I can see where the concern comes from, especially if you take certain quotes out of context. Consuming food, including processed food, while aiming to meet nutrient recommendations and in the context of the dietary guidelines makes sense to me. If one is consuming processed food, in appropriate amounts, that falls in line with a diet following the dietary guidelines, that's okay, and, probably, doing something good for your health. Nothing about this statement, from my reading, made me come away and think Lucky Charms were given the green light - given the 'eat processed foods in accordance with the dietary guidelines' message, Lucky Charms wouldn't fit too well, as the guidelines specifically direct individuals to reduce added sugar and refined grain consumption.

Source: Medpagetoday.com

One issue that I have with the critics is that those who take issue with the statement are comparing things like homemade hummus to a bowl of Lucky Charms. Mr. Bellatti has gone on in his Civil Eats/HuffPost article - see here - to say that ASN refuses to recognize that "a pot of oatmeal is vastly different than making a Three Musketeers bar in a processing plant". I actually find that to be an insulting misrepresentation of this publication. ASN's statement was never saying that foods at one end of the processing continuum are equivalent to and imparting the same health impact as the other end; it's saying that at all parts along the spectrum, there may be food components to limit and that the different versions of the term processed aren't objectively meaningful. Fatty cuts of meat and whole milk are both minimally processed foods, but contain a significant amount of calories from saturated fats without offering more nutrition. Individuals concerned about calories and nutrient density may want to choose leaner meats, and use lower or non-fat dairy. On the same note, down at the highly processed end of the spectrum, you could choose unsweetened almond milk or you could choose the highly sugared ones - both are highly processed, but only one fits nicely into the dietary guidelines. Again, tofu is a pretty highly processed food, and varies in its fat content, but you don't hear many making a big stink about not consuming it. An important note here is to not be reductionist about the dietary guidelines - claims about LuckyCharms being a good source of vitamins and minerals doesn't invalidate the added sugar/low fiber components. This publication gives the 'okay' to consuming processed food - I don't see anywhere that it gives the 'okay' to extensively processed foods that are minimally nutritious.

The publication was certainly very enthusiastic about processed foods, the ways processing can be used to enhance a number of different characteristics of foods, and the future potential that abounds. When I sit back and objectively think of the good processing could do, I am in support of food processing. This doesn't mean I don't hear the criticisms:

Source: Medpagetoday.com

Certainly when walking through the supermarket aisle and looking at the amount of minimally nutritious foods that are available, replete with added sugars/oils/refined grains, packaged in a way that doesn't support portion control, one can see why some are upset by the statement's lack of a harsher spin. The support for food processing seems to have been interpreted as absolving any role food processing has played in the development of the obesity epidemic (what effect size it's had in the obesity epidemic is highly debatable, as a number of biological, psychological, sociological, cultural, economic and political factors have played into this). The point of the paper wasn't supposed to be an indictment of processed foods - it was supposed to be a scientific statement about the role of processing and its contributions to food and nutrition security. This is why I'm not willing to jump to conclusions that this is evidence that the ASN/the authors are bought out or overly influenced by industry - it was a statement to highly educated clinicians in an academic journal, not a public message saying "uninhibitedly eat any processed foods". Indeed, it doesn't appear to me that this was written for the public or meant to be discussed in the public domain. To me, it serves as a guide, from a scientific organization, establishing a common language for discussion, calling for better collaboration from stakeholders in all aspects of the food industry, more responsible use of processing, and better education for consumers.  I think the authors of this paper share the same concerns as those being who see it as controversial; the authors just didn't want to make overarching, subjective, sensational statements about processing.

If there's one thing that I think is missing from the paper, and may have rectified some of the issues people have with it, is a lengthier caveat section, directed towards food processors, about the damage food processing can do (e.g. availability of foods with excess added sugars and trans fats being good examples) -- the negative contributions of processed foods were mentioned but were not really a substantial component of the paper relative to the enthusiasm about processing. The lack of a mention of trans-fat actually blows my mind a bit - i've re-read and 'Cntrl/F' multiple times and didn't see it (lemme know if I'm missing it somehow). A point about the way processed food can reduce a food's nutrient profile (e.g. processings' effect on fiber or potassium) would've also been appreciated. Despite this omission, I still agree with the final conclusion.

 This conversation about processing seems to just serve as a proxy for discussing the role of big food and industry, and the different perspectives surrounding the food system:

             Many who have spoken out against the statement are also very vocal about our current food system. They're not concerned with the ability of processed foods with added calcium's ability to contribute to calcium intake - they want low-oxalate dark leafy greens providing the majority of this. They're often vocal opponents of food science techniques, espousing doctrines of "if you can't pronounce it, don't eat it". There's a part of me that sees this opinion: you wouldn't need to worry about fortification foods if the food system made available inherently nutrient-dense foods. In dietetics, we constantly hear 'food first' - this generally is in reference to getting nutrients from supplements, but enriched/fortified foods essentially fall into this category. The real world question I have is, "does the fact that people are consuming sub-optimum beta carotene intake, due to under-consumption of whole foods like sweet potatoes/carrots/spinach (for any number of reasons)  invalidate the fact that processed foods can improve this?" The argument reminds me of the critiques of golden-rice (GMO rice with added beta carotene). Some have objected to its use because it addresses the symptom (beta-carotene deficiency), and not the cause (lack of regularly available beta-carotene-containing foods). In the continued battle to change the food system, should we forego processing's ability to alter the nutrient content of the food supply? Biofortification is an arguably simpler, much quicker technique to address sub-optimal nutrient intake, and in some cases (like algae oil DHA fortification) might be more sustainable. Making huge systemic changes will require a hugely coordinated effort, and faces a number of barriers - it's easy to point out that the food system has its flaws, it's another thing to address the reality of changing it. Dismissing biofortification in this process would be a great loss in my opinion. I actually really dislike that these are posed as competing interests. Encouraging consumption of biofortified foods can occur without discouraging consumption of whole foods. The idea that we need to improve the food system and that biofortification can't be a part of that is something I highly disagree with. 

At the end of the day, in the here and now, we've got consumers with biologies that crave salt, sweet, and savory foods. We've got a food industry that has responded to market demands, often with little emphasis on nutrition and long-term health. We have individuals who grew up with and are culturally accustomed to these flavor/sensory profiles. We have a health illiterate/confused populous. We've got foods marketed towards kids. We've got schedules and priorities that leave us not planning or cooking our meals as often. We have schools that don't support strong home-ec/culinary education. These are just a few of the huge barriers. Given these issues, I'm partial to acknowledging the roles that food processing can play in filling nutrient gaps, and reducing the intake of total calories/sugar/solid fats, all while meeting consumers halfway at their food preferences. Because certain types of processing have and do contribute poorly to human health in some respects doesn't mean that it should be rejected - it means we should limit processing that harms the overall health-promoting profile of a food, and encourage that which enhances it. Part of the benefits of processing is meeting people in their here and now, offering products that are conveniently healthy - Dan Schultz had a great HuffPost article on this here. I'm against a food supply that is full of extensively processed, minimally nutritious foods. And from reading this ASN publication, I'd put money down that they are too. We all have the same goal of a nutritious, sustainable food supply- this conversation is just turning into a yelling match about how it's done. Standing and yelling prevents us from moving forward. As lead author Connie Weaver stated:

Further scholarly reading on the topic of food fortification and processing can be found here, and here.