Nutrition Pillar, Part 3: What really counts as “processed”?

By Ashlyn Smith, MMS, PA-C, DipACLM, BC-ADM, DFAAPA, LSC

ELM Endocrinology & Lifestyle Medicine

As we continue through ELM's Lifestyle Medicine Series, we’ve talked about what to eat. Now let’s talk about what happens to food before it gets eaten.

Because not all “processed” foods are created equal.

Pumpkins in their original form are unprocessed or Grade 1. The more processing takes place, the less pumpkins look like pumpkins. The most processed form or Grade 4 looks unlike a pumpkin at all, such as a pumpkin pie.

What is food processing?

Food processing is any change from a food’s natural state: from freezing to cooking to ultra-processing.

Think of it like a spectrum:

• Group 1: Unprocessed (an apple)

• Group 2: Minimally processed (unsweetened applesauce)

• Group 3: Processed (apple juice)

• Group 4: Ultra-processed (apple fritter)

As we move along this spectrum, foods tend to:

→ lose nutrients

→ gain additives

→ become less recognizable from their original form

Not all processing is harmful

Some processing is actually helpful or protective.

• Freezing helps preserve the food and nutrients

• Enrichment replaces nutrients lost in processing (like B vitamins in flour)

• Fortification adds beneficial nutrients that do not naturally occur (like vitamin D in milk)

But as processing increases, so do tradeoffs.

What changes as processing increases?

1. Nutrient loss

Refining helps food last longer but removes fiber, B vitamins, and iron, impacting:

• blood sugar control

• gut health

• cardiovascular risk

2. Added compounds

Ultra-processed foods (UPFs) often introduce additives, sugars, and unhealthy fats that are linked to:

• insulin resistance and diabetes

• heart disease

• cognitive decline

3. Harmful byproducts from heat

Certain cooking methods create compounds that stress the body:

• Dry heat (grilling, roasting, broiling) → increases compounds linked to inflammation and cancer (PAHs)

• Frying → forms toxic substances associated with heart disease and cancer (aldehydes)

• Dry heat, frying, and UPFs  → increase glycotoxins linked to advanced aging, diabetes, liver disease, and dementia (AGEs)

  
  

Tip: Moist heat (like steaming, stewing, boiling) tends to produce fewer of these harmful substances, but does not eliminate them.

Why this matters beyond nutrition

This isn’t just about food. It connects to everything we’ve covered:

• Sleep: Highly processed foods are linked to more disrupted, lower-quality sleep

• Stress: Blood sugar swings from UPFs can amplify stress hormones and mood instability

• Mental health: Dietary patterns higher in UPFs and fried foods are associated with higher rates of depression

• Hormones & metabolism: Processing impacts insulin, inflammation, ovulation, and long-term metabolic health

In other words, the more a food looks like its original form, the more your body tends to recognize and respond to it well.

Small steps can support your body to do what it knows how to do: metabolize food that looks and acts like food. 

Pick one small step you can take this week:

1. Remove one ultra-processed food

Just one. Notice what changes: sleep, energy, stress, mental health, or something else.

2. Trade down the spectrum

Swap a Group 3 or 4 food for a Group 1 or 2 version.

Example: Trade out banana bread for a banana.

3. Try the “Unprocess My Plate” challenge

Build one meal this week entirely from whole and unprocessed or minimally-processed foods. Snap a pic of your plate and share with a friend (or post it!) using #ELMEndocrinologyandLifestyleMedicine

Pick a goal that makes sense for you.

I'll use myself as an example: Switching to completely unprocessed aka "raw" foods is not realistic for my preferences and lifestyle. However, I love to trade down on the spectrum: instead of buying a strawberry pastry, I reach for fresh or frozen strawberries to fulfill my sweet tooth.

This wraps the Nutrition pillar of our Lifestyle Medicine series, but it sets the stage for what’s next. Because not everything we consume supports our health…

Next week: You’ve heard red wine can be “good for you.” Myth or medicine?

We’re diving into risky substances: what helps, what harms, and what actually matters.

👉  If you’re looking for realistic guidance on cutting down on unhealthy processing in your nutrition, let’s connect on a free consultation to discuss further!

Disclaimer:

The content on this blog is for informational purposes only and is not intended to provide medical diagnosis, treatment, or replace professional medical advice, diagnosis, or care. Always consult a qualified healthcare provider with any questions regarding a medical condition or treatment.