In recent years, there’s been increasing hype about the potential health risks associated with so-called “ultra-processed” foods.

But new evidence published this week found not all “ultra-processed” foods are linked to poor health. That includes the mass-produced wholegrain bread you buy from the supermarket.

While this newly published research and associated editorial are unlikely to end the wrangling about how best to define unhealthy foods and diets, it’s critical those debates don’t delay the implementation of policies that are likely to actually improve our diets.

What are ultra-processed foods?

Ultra-processed foods are industrially produced using a variety of processing techniques. They typically include ingredients that can’t be found in a home kitchen, such as preservatives, emulsifiers, sweeteners and/or artificial colours.

Common examples of ultra-processed foods include packaged chips, flavoured yoghurts, soft drinks, sausages and mass-produced packaged wholegrain bread.

In many other countries, ultra-processed foods make up a large proportion of what people eat. A recent study estimated they make up an average of 42% of total energy intake in Australia.

How do ultra-processed foods affect our health?

Previous studies have linked increased consumption of ultra-processed food with poorer health. High consumption of ultra-processed food, for example, has been associated with a higher risk of type 2 diabetes, and death from heart disease and stroke.

Ultra-processed foods are typically high in energy, added sugars, salt and/or unhealthy fats. These have long been recognised as risk factors for a range of diseases.

It has also been suggested that structural changes that happen to ultra-processed foods as part of the manufacturing process may lead you to eat more than you should. Potential explanations are that, due to the way they’re made, the foods are quicker to eat and more palatable.

It’s also possible certain food additives may impair normal body functions, such as the way our cells reproduce.

Is it harmful? It depends on the food’s nutrients

The new paper just published used 30 years of data from two large US cohort studies to evaluate the relationship between ultra-processed food consumption and long-term health. The study tried to disentangle the effects of the manufacturing process itself from the nutrient profile of foods.

The study found a small increase in the risk of early death with higher ultra-processed food consumption.

But importantly, the authors also looked at diet quality. They found that for people who had high quality diets (high in fruit, vegetables, wholegrains, as well as healthy fats, and low in sugary drinks, salt, and red and processed meat), there was no clear association between the amount of ultra-processed food they ate and risk of premature death.

This suggests overall diet quality has a stronger influence on long-term health than ultra-processed food consumption.

When the researchers analysed ultra-processed foods by sub-category, mass-produced wholegrain products, such as supermarket wholegrain breads and wholegrain breakfast cereals, were not associated with poorer health.

This finding matches another recent study that suggests ultra-processed wholegrain foods are not a driver of poor health.

The authors concluded, while there was some support for limiting consumption of certain types of ultra-processed food for long-term health, not all ultra-processed food products should be universally restricted.

Should dietary guidelines advise against ultra-processed foods?

Existing national dietary guidelines have been developed and refined based on decades of nutrition evidence.

Much of the recent evidence related to ultra-processed foods tells us what we already knew: that products like soft drinks, alcohol and processed meats are bad for health.

Dietary guidelines generally already advise to eat mostly whole foods and to limit consumption of highly processed foods that are high in refined grains, saturated fat, sugar and salt.

But some nutrition researchers have called for dietary guidelines to be amended to recommend avoiding ultra-processed foods.

Based on the available evidence, it would be difficult to justify adding a sweeping statement about avoiding all ultra-processed foods.

Advice to avoid all ultra-processed foods would likely unfairly impact people on low-incomes, as many ultra-processed foods, such as supermarket breads, are relatively affordable and convenient.

Wholegrain breads also provide important nutrients, such as fibre. In many countries, bread is the biggest contributor to fibre intake. So it would be problematic to recommend avoiding supermarket wholegrain bread just because it’s ultra-processed.

So how can we improve our diets?

There is strong consensus on the need to implement evidence-based policies to improve population diets. This includes legislation to restrict children’s exposure to the marketing of unhealthy foods and brands, mandatory Health Star Rating nutrition labelling and taxes on sugary drinks.

These policies are underpinned by well-established systems for classifying the healthiness of foods. If new evidence unfolds about mechanisms by which ultra-processed foods drive health harms, these classification systems can be updated to reflect such evidence. If specific additives are found to be harmful to health, for example, this evidence can be incorporated into existing nutrient profiling systems, such as the Health Star Rating food labelling scheme.

Accordingly, policymakers can confidently progress food policy implementation using the tools for classifying the healthiness of foods that we already have.

Unhealthy diets and obesity are among the largest contributors to poor health. We can’t let the hype and academic debate around “ultra-processed” foods delay implementation of globally recommended policies for improving population diets.

Gary Sacks, Professor of Public Health Policy, Deakin University; Kathryn Backholer, Co-Director, Global Centre for Preventive Health and Nutrition, Deakin University; Kathryn Bradbury, Senior Research Fellow in the School of Population Health, University of Auckland, Waipapa Taumata Rau, and Sally Mackay, Senior Lecturer Epidemiology and Biostatistics, University of Auckland, Waipapa Taumata Rau

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Bushfires are currently burning in Australian states including Victoria, Tasmania, Western Australia and South Australia. In some areas, fire authorities have warned residents about the presence of smoke.

Bushfire smoke is harmful to our health. Tiny particles of ash can lodge deep in the lungs.

Exposure to this type of smoke may worsen existing conditions such as asthma, and induce a range of health effects from irritation of the eyes, nose and throat to changes in the cardiovascular system.

Public health recommendations during smoke events tend to provide general advice, and don’t often include advice specifically geared at children. But children are not just little adults. They are uniquely vulnerable to environmental hazards such as bushfire smoke for a number of reasons.

Different physiology, different behaviour

Children’s lungs are still developing and maturing.

Airways are smaller in children, especially young children, which is associated with greater rates of particle deposition – when particles settle on the surfaces of the airways.

Children also breathe more air per kilogram of body weight compared with adults, and therefore inhale more polluted air relative to their size.

Further, children’s detoxification systems are still developing, so environmental toxins take longer to effectively clear from their bodies.

Meanwhile, children’s behaviour and habits may expose them to more environmental toxins than adults. For example, they tend to do more physical activity and spend more time outdoors. Higher levels of physical activity lead to more air inhaled per kilogram of body weight.

Also, a normal and important part of children’s early play is exploring their environment, including by putting things in their mouth. This can result in kids ingesting soil, dust and dirt, which often contain environmental contaminants.

For these reasons, it’s important to consider the specific needs of children when providing advice on what to do when there’s smoke in the air.

Keeping our environments healthy

The Australian government offers recommendations for minimising the health risks from exposure to bushfire smoke. The main advice includes staying indoors and keeping doors and windows closed.

This is great advice when the smoke is thick outside, but air pollutants may still accumulate inside the home. So it’s important to air your home once the smoke outside starts to clear. Take advantage of wind changes to open up and get air moving out of the house with a cross breeze.

Kids are natural scientists, so get them involved. For example, you and your child can “rate” the air each hour by looking at a landmark outside your home and rating how clearly you can see it. When you notice the haze is reducing, open up the house and clear the air.

Because air pollutants settle onto surfaces in our home and into household dust, an easy way to protect kids during smoky periods is to do a daily dust with a wet cloth and vacuum regularly. This will remove pollutants and reduce ingestion by children as they play. Frequent hand washing helps too.

Healthy bodies and minds

Research exploring the effects of bushfire smoke exposure on children’s health is sparse. However, during smoke events, we do see an increase in hospital visits for asthma, as well as children reporting irritation to their eyes, nose and throat.

If your child has asthma or another medical condition, ensure they take any prescribed medications on a regular schedule to keep their condition well controlled. This will minimise the risk of a sudden worsening of their symptoms with bushfire smoke exposure.

Make sure any action plans for symptom flare-ups are up to date, and ensure you have an adequate supply of in-date medication somewhere easy to locate and access.

Kids can get worried during bushfires, and fire emergencies have been linked with a reduction in children’s mental health. Stories such as the Birdie’s Tree books can help children understand these events do pass and people help one another in times of difficulty.

Learning more about air pollution can help too. Our group has a children’s story explaining how air pollution affects our bodies and what can help.

It’s also important for parents and caregivers not to get too stressed, as children cope better when their parents manage their own anxiety and help their children do the same. Try to strike a balance between being vigilant and staying calm.

What about masks?

N95 masks can protect the wearer from fine particles in bushfire smoke, but their use is a bit complicated when it comes to kids. Most young children won’t be able to fit properly into an N95 mask, or won’t tolerate the tight fit for long periods. Also, their smaller airways make it harder for young children to breathe through a mask.

If you choose to use an N95 mask for your children, it’s best to save them for instances when high-level outdoor exposure is unavoidable, such as if you’re going outside when the smoke is very thick.

N95 masks should be replaced after around four hours or when they become damp.

If your child has an existing heart or lung condition, consult their doctor before having them wear an N95 mask.

Our team is currently recruiting for a study exploring the effects of bushfire smoke in children. If you live in south east Queensland and are interested in participating in the event of a bushfire or hazard reduction burn near your home, please express your interest here.

Dwan Vilcins, Group leader, Environmental Epidemiology, Children’s Health Environment Program, The University of Queensland; Nicholas Osborne, Associate Professor, School of Public Health, The University of Queensland, and Paul D. Robinson, Conjoint Professor in Respiratory and Sleep Medicine, Child Health Research Centre, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.