Eat fewer ultra-processed foods (chips, instant noodles, pastries, ready meals)

There’s no direct cost involved, though you’ll need to spend time either preparing meals yourself or selecting minimally processed ingredients each day. The real challenge is overcoming the long-standing habit of opting for convenience over health.

One review combined multiple existing studies into a single analysis, using raw data without any subgroup categorization. The results showed that individuals consuming higher amounts of ultra-processed foods had a 21% greater risk of death (RR 1.21) and a 50% greater risk of cardiovascular death (RR 1.50) compared to those eating less of these foods. These findings were classified as “highly suggestive” and “convincing” respectively. Yet when assessed using standard GRADE criteria, the overall certainty of the evidence is rated as low or very low.

Lane MM 等 (2024). Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ. https://doi.org/10.1136/bmj-2023-077310

There are three main points of contention here. First, the NOVA classification system groups foods with vastly different nutritional profiles into the same category. Second, ultra-processed foods overlap heavily with sugary drinks and processed meats (discussed in items 7 and 19), making it hard to isolate which factor is having the actual effect. Third, GRADE ratings for this evidence also remain low. Consequently, it’s hard to predict exactly how much additional benefit this recommendation will provide after following items 7 and 19. The opposing evidence comes solely from the low GRADE rating given in this same review; no original studies have yet produced contradictory results. For now, it’s best to first adhere to items 7 and 19 — avoiding sugary drinks and limiting processed meat intake — before focusing on this recommendation.