A few years ago, my not-quite-teenage son began commenting on whether or not the food I was making was a “superfood.” Salmon and blueberries had been designated by him as “super” and not because they were particularly tasty (although I think they are). According to my son and the latest articles he had perused on the internet, there was supposedly a magical array of nutrients in the food that would somehow help us to live longer.

“The search for superfoods (or whatever they were called back then) has been a time-honored tradition since at least the 1950s, when American physiologist, Ancel Keys traveled to countries around the Mediterranean and documented their lower rates of heart disease, cancer, and other ailments.”

I was just glad he was eating salmon and blueberries and let him keep on thinking they were magically super since I was also super exhausted trying to get my kids to eat foods that were nutritionally sound. So, if nutritionally sound was being rebranded as super, I wasn’t going to argue the point.

The allure of finding a faraway magical food or foods, is in many ways like the quest for the Fountain of Youth, and so, my son had hit on a historically popular trend. The search for superfoods (or whatever they were called back then) has been a time-honored tradition since at least the 1950s, when American physiologist, Ancel Keys traveled to countries around the Mediterranean and documented their lower rates of heart disease, cancer, and other ailments. He posited it was something in their diet. It was called the Seven Countries Study and like its name implies, Keys looked at food from seven countries—which happens to be a lot of countries and a lot of different foods. The common threads in the so-called Mediterranean Diet, were identified as olive oil, fish, fruits, veggies, nuts, whole grains, and wine.

Scientists wondered what exactly was in those foods that was so super and began doing research studies that added nuts or wine or olive oil to see if those things in isolation were helpful. Many of those studies (though poorly designed) showed that they were. And so, in the coming decades, Americans were encouraged to eat more of those foods. Not a bad idea, but not the whole story either. Despite switching over from canola oil to olive oil and from white pasta to whole grain pasta (which isn’t exactly traditionally Mediterranean), our higher rates of disease persisted. It turns out that you can’t take out two or three components of a healthy diet and add them to an unhealthy diet and viola—expect similar results. Even worse, you can’t extract a chemical or two, package them in a supplement and declare victory over disease.

Resveratrol was supposed to be one of the substances that made blueberries super and was also found in red wine. But instead of having to find berries out of season or drink wine which was high in calories (and also one would be limited by the alcohol content if one were sensible), a pill was created. Why bother with actual foods and beverages if one could just find a magic pill? Better yet, pill purveyors could charge upwards of $100 a bottle and so advertised their wares heavily. By offering the secret to longevity with barely any effort required, daytime talk shows brought in lots of viewers, clinics sprung up, and people parted with billions of dollars. And yet, our life expectancy has not increased.

What is starting to be increasingly recognized by researchers is that it isn’t one substance or a handful of foods that make the Mediterranean Diet special. It isn’t even the Mediterranean. There is longevity to be found around the world (see: “Blue Zone” below) where there are fewer chronic diseases and people live longer lives (but even Blue Zones are somewhat Western-centric and undoubtedly there are many other places that would qualify). Blue Zone residents practice lifestyles where they eat whole, fresh foods, have communities ties, and walk or do a fair amount of physical work. This is what was going on in the Mediterranean when Keys visited.

And yet, as my son made clear, we are still looking for the magical super foods, or even more reductive, magical supplements, when the answer for how to eat and how to live has been staring us in the face for decades (Hint: the answer isn’t in a supplement).

In the past decade, we have learned that the more ultra-processed food you eat, the higher your risk of obesity, heart disease, cancer, gastrointestinal maladies, and maybe even dementia. The problem is, these so-called foods are getting harder and harder to avoid. A recent JAMA (Journal of the American Medical Association) article notes that kids’ consumption of a substance called ultra-processed foods has increased significantly in the past 20 years, going from about 61% to 67% or what is now two-thirds of their diets.

Kids’ consumption of ultra-processed foods has increased to 67% of their diets.

Why are ultra-processed foods so hard to avoid?

The reason these substances are hard to avoid is that they’ve been manufactured and marketed to look like real, actual food, but perhaps a bit cheaper and flashier. Take pizza, for example. My husband likes to make pizza. He makes a dough from scratch with the following ingredients: wheat flour, water, yeast, salt. He makes his sauce from scratch too with tomatoes, salt, pepper, a little bit of sugar, garlic, basil, oregano. The cheese, he buys, but it contains only milk, cultures, and salt. Compare that to the ingredients of a frozen supermarket pizza (which may not be any better, ingredient-wise than the take-out pizza you get from your local chain). Can you picture what all the individual ingredients in my husband’s pizza look like in your mind’s eye? Now can you picture what all the ingredients listed on the frozen pizza look like? I can’t.

I’m not arguing that my husband’s pizza is health food. It isn’t. It’s a processed food. It’s not a banana or an apple or kale for that matter, but it’s still recognizable as food to our bodies. The stuff that we are all now consuming, and our kids are consuming at an alarming rate, isn’t. Your mind can’t picture what some of the ingredients widely used in 67% of kids’ diets look like and your body isn’t quite sure what to do with some of them either. They are more than just processed. They are ultra-processed.

A New Nutrition Classification

That’s why in 2009, a new nutrition classification system, called NOVA, put ultra-processed foods into its own category.

We have to be able to name a thing as a first step in figuring out what to do about it, so NOVA groups foods into four categories:

• Category 1 is made up of foods that are unprocessed or minimally processed. Unprocessed foods are eaten as nature gives them to you—an apple, banana, or kale. If you take the kale and bake it into chips, you’ve processed it, but minimally (it’s still basically kale).
• Category 2 is made up of what are called processed culinary ingredients like oil or salt. Nature does not give us oil or salt directly. We have to make them from basic starting points (pressing olives in the case of oil and grinding whatever it is that salt comes from—rocks? The sea?). They should be used sparingly to enhance the flavor of Category 1 foods.
• Category 3 foods are processed foods. It generally is how we have historically preserved food to last a bit longer. Bread and pasta are processed. Real cheese and yogurt are processed. The ingredients used to make them have to go through a few steps to get to their final stage, but they are essentially still wheat or milk.

Category 4 are the ultra-processed foods. NOVA says these are made up of: substances that are of “rare” or of “no culinary use” or are “additives whose function is to make the final product sellable, palatable and often hyper-palatable. Food substances of no or rare culinary use, employed in the manufacture of ultra-processed foods, include varieties of sugars (fructose, high-fructose corn syrup, ‘fruit juice concentrates’, invert sugar, maltodextrin, dextrose, lactose), modified oils (hydrogenated or interesterified oils) and sources of protein (hydrolysed proteins, soya protein isolate, gluten, casein, whey protein, and ‘mechanically separated meat’). Classes of additives used only in the manufacture of ultra-processed foods, are flavours, flavour enhancers, colours, emulsifiers, emulsifying salts, artificial sweeteners, thickeners, and foaming, anti-foaming, bulking, carbonating, gelling and glazing agents.”

Category 4 foods are the culprit in many diet-related diseases…

Here’s what I want to communicate clearly—Category 1 foods are best, but Category 2 and 3 foods are fine as long as we don’t go crazy with them. Category 4 foods are the culprit in many diet-related diseases and now we can identify them (at least when we have access to the list of ingredients).

What’s the next step?

Well, according to the JAMA study, in the past 20 years, there was a notable DECREASE in the consumption of sugary beverages by kids. This is probably due to numerous campaigns to steer kids away from sodas. So, we know how to make our diets healthier and it’s not just about avoiding fast food. Ultra-processed foods are in pricier restaurants too. They are in our school cafeterias and in our homes, though the JAMA article notes that the more we eat at home, the less ultra-processed foods we tend to eat. If we can put them in, we can take them out. We didn’t always eat ultra-processed foods. They are a relatively recent invention. Like sodas, we can learn to limit them or cut them out entirely. NOVA means “new” in Portuguese and it’s a good, new way to think about what we eat this year.