Ultra-processed plant-based foods are on the rise, particularly in the out-of-home (OOH) environment. But are they healthy?
Fresh research funded by the World Health Organization (WHO) Regional Office for Europe has sought to find out, with a particular focus on one popular food product: ultra-processed plant-based burgers.
Spotlight on ultra-processing and plant-based
Most, but not all, plant-based burgers are considered ultra-processed, according to the Nova definition of ultra-processed food (UPF). A survey of plant-based burger patties in major Australian supermarkets revealed that 80% fell into Nova Group 4.
What does ‘ultra-processed’ mean?
Developed in 2019, Nova splits level of food procession into four groups: from raw and minimally processed foods; to processed culinary ingredients; processed food; and ultra-processed food. This last category is an ‘industrial creation’ by definition.
Understanding the health implications of ultra-processed plant-based foods feels pertinent in Europe, where the rise in non-communicable diseases (NCD) is the leading cause of morbidity and mortality. In the WHO European Region, overweight and obesity affects almost 60% of adults and nearly one in three children.
A shift towards plant-based diets has the potential to decrease NCD, but only if the food products consumed contain the right (and not wrong) nutrients. Acknowledging that previous studies have assessed the nutritional composition of plant-based food labels, the WHO is now focusing on plant-based foods in the OOH environment.
Plant-based burgers: the good news
Concentrating on the WHO European Region, the new study – published in the British Journal of Nutrition – assessed ultra-processed plant-based burgers sold in Amsterdam, Copenhagen, Lisbon and London.
A total of 41 plant-based burgers were purchased OOH in each country and transported via cold chain to the lab in Lisbon, where their nutritional content and amino acid compositions were assessed. The plant-based burgers included the patty, bread and condiment.
Findings were mixed. Ultra-processed plant-based burgers were found to be a source of protein, dietary fibre and essential minerals. The intake of plant-based protein, dietary fibre and minerals, which are ‘abundantly’ present in plant-based burgers, has been linked to reduced risk of certain NCDs such as cardiovascular disease.
Further, since in Europe current intake levels of certain essential nutrients including dietary fibre, and minerals such as iron and potassium, are generally below the daily recommendations, consumption of these burgers may contribute to daily requirements.
And the not-so-good news? High in fat, salt and calories
But on the other hand, ultra-processed plant-based burgers were also found to contain nutrients directly linked to NCD: notably sodium, total fat, saturated fatty acids. Relatively high levels of energy were also recorded.
In the WHO European Region, energy, sugar, fatty acids and salt intakes generally exceed the recommended levels and their intake should be decreased. High intake of sodium has been linked to cardiovascular disease, stroke and high blood pressure risk, whereas the overconsumption of sugar and unhealthy fatty acids are linked to obesity and type 2 diabetes risk.
“Therefore, besides the beneficial nutritional factors present in ultra-processed plant-based foods, they are also a source of unhealthy compounds,” note the researchers.
“The contradiction raises the question whether the healthier aspects of plant-based burgers outweigh the less healthy aspects, which is contingent on an individual’s dietary patterns and nutritional status.”
Ultra-processed plant-based burgers a source of (low quality) protein
The other downside for plant-based burger consumers and manufacturers, is that although these products are a source of protein, the protein in question is of low quality.
To synthesise a protein from amino acids, a specific quantity of amino acids is required, explain the researchers. The study revealed that Cys and Met amino acids were below the limit of detection – limiting protein creation.
It should be noted that if complementary foods are consumed within three to four hours, deficient amino acids can be supplied, which would enhance the amino acid content.
Although not the focus of this study, the researchers also questioned whether additives included to mimic the sensory properties of meat may negatively impact the bioavailability of nutrients present.
So are ultra-processed plant-based burgers healthy?
According to the WHO nutritional profile model, used to prevent inappropriate marketing to children, a relatively small percentage of OOH ultra-processed plant-based burgers are unhealthy. A total of 10% contained too much total fat and 20%, too much salt.
Ultra processing and nutrition: the debate rages
Does being ultra-processed automatically make a food or drink unhealthy?
For some, ultra-processed foods are developed to drive excess consumption and consequently poor health outcomes. For others, Nova Group 4 is so broad it’s unreasonable to judge all these foods the same way. And for others still, UPF should not be discussed in the context of nutrition, nor should have any place in dietary guidelines.
Although the WHO acknowledges that Nova assesses the degree of processing a food has undergone only, it also argues that many Group 4 foods contain high levels of fat, salt and sugar (HFSS), which make them unhealthy.
Nova definition aside, recent study findings linked UPF consumption to a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, and mortality outcomes. The study is considered the world’s largest on ultra-processed food.
As to how the level of processing impacts the plant-based burgers’ healthiness or unhealthiness, the researchers stressed that was not the focus of the study. “Our research does not aim to determine the healthiness of highly processed foods in relation to their degree of processing, but in terms of the nutritional composition, as with any other food,” explained Dr Kremlin Wickramasinghe, regional adviser for nutrition, physical activity and obesity at the WHO Regional Office for Europe.
The reason? There is a general perception that plant-based products are generally good for health. “There is a need to better understand what the nutritional composition of these products were, and draw this to the attention of both policymakers and public to consider the nutritional composition and make data widely available,” he told FoodNavigator.
“WHO promotes the concept that minimally processed food, low in free sugars, salt, saturated fat, trans-fat, and free from non-sugar sweeteners are the core of any healthy diet.”
Source: British Journal of Nutrition
‘Nutritional composition of ultra-processed plant-based foods in the out-of-home environment: a multi-country survey with plant-based burgers’
Published online 15 January 2024
DOI: https://doi.org/10.1017/S0007114524000023
Authors: R. E. Vellinga, H. L. Rippin, B. G. Gonzales, Y. Sun, C. Motta et al.