When discussing processed food, many may think of reconstituted meat, tinned foods or ready meals. Yet a vast number of everyday foods are processed, from condiments to confectionary, and crisps to cream. Any food or drink that has been changed in some way when it’s made or prepared is considered processed.
The excessive consumption of ultra-processed foods (UPFs) has long been associated with serious health consequences, such as caries, type-2- diabetes, dementia and stroke risk. As such, dental practitioners should guide patients, particularly those at a greater risk from those health conditions, to manage their diet and be more aware of the harmful effects of UPFs.
Getting to grips
In an average British diet, 56.8 per cent of total energy intake and 64.7 per cent of total free sugars come from UPFs, with the majority of people exceeding the recommended limit of energy from free sugars. Comparatively, only 10 per cent of total energy intake in Italy is sourced from UPFs. The UK’s diet relies heavily on these unhealthy foods but, whilst it is easy to encourage patients to avoid all UPFs, it is more realistic for practitioners to guide them away from the most harmful ones – as not all processed foods have a negative impact.
Researchers in Sao Paulo, Brazil, designed the NOVA Food Classification system to help people differentiate between foods by the varying levels of processing they have undergone. The system highlights four groups:
- Group one: unprocessed/natural foods or minimally processed foods.
- Group two: processed culinary ingredients.
- Group three: processed foods.
- Group four: ultra-processed foods.
Examples of minimally processed foods that are beneficial include pasteurised milk, which has had the bacteria removed, and yoghurt without sugar, which is good for the gut microbiome. Group three is a combination of groups one and two, where salts, sugars, oils or other substances are added to natural or minimally processed foods to enhance their taste or shelf-life, such as fruits in sugar syrup and salted, dried or smoked meats. Group four foods are categorised as industrial formulations, to the point that natural group one foods form a tiny proportion of UPFs, and are hazardous when excessively consumed. These include carbonated soft drinks, pre-prepared pizzas, and breakfast bars.
Harmful helpings
Some UPFs contain trans fats; an unhealthy product of partially hydrogenated oils. Such culprits include fried foods, margarine, and packaged snacks. These raise the levels of LDL (bad cholesterol) and lower the levels of HDL (good cholesterol), leading to atherosclerosis. This can create blockages in the circulatory system, increasing the risk of heart attacks. Furthermore, processed meats like hot dogs and sausages are preserved using nitrates and nitrites. When cooked, these form carcinogenic nitrosamines, enhancing the risk of cancer. These are foods that at-risk patients should consume sparingly.
The overlap between a poor diet, severe health complications and oral health diseases is clear. Research has found that exposure to UPFs was consistently associated with 71 per cent of adverse health outcomes. The high levels of saturated fats, sugar and salt found in UPFs also increase the risk of developing severe health complications, such as obesity and type-2-diabetes. As these are often tied to diet, they enhance the risk of periodontitis as well, with poor dental hygiene causing sugary food debris to become trapped in the oral cavity. This leads to inflamed gingivae and a higher risk of caries.
Here to help
Guiding at-risk patients away from UPFs can be challenging because they are often cheaper than natural or minimally processed foods. For instance, tinned meat or fish can cost far less than fresh. In the current economic climate, it may be difficult to encourage the consumption of more expensive alternatives. Instead, displaying posters or leaflets that depict an overview of the NOVA Food Classification system, as well as highlighting the association between UPFs, oral health, and systemic health, can support patients. Alongside this, practitioners must recommend a consistent oral hygiene routine to minimise the impact of unhealthy UPFs on the mouth.
Interdental cleaning can access the tooth surfaces that a toothbrush cannot, removing trapped food. The Flexi series of interdental brushes from Tandex, consists of 11 different sizes for an effective cleaning process. With a malleable brush and a flexible handle, each interdental brush can be customised for a comfortable experience. This increases compliance, ensuring that the teeth and gingivae are consistently healthy. With the Flexi range, the damage caused by UPFs on the mouth can be dramatically reduced.
Processed foods are inescapable. Therefore, dental professionals must educate their patients on the health hazards of UPFs, highlighting the unhealthier foods, suggest healthier alternatives and promote a reliable oral hygiene routine.
References available on request.
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