Best Practice

Ultra-processed foods and the Real Food Rebellion

School food Pupil wellbeing
What is on the menu in your canteen? Are you doing all you can to eliminate ultra-processed foods? George Winter finds out about a new education project seeking to inspire schools to take action
Image: Adobe Stock

The Labour government is to introduce a Bill – announced in the recent King’s Speech – which includes a requirement that all primary schools provide free breakfasts for all children. But free breakfasts are worthless if they are poor quality – and when it comes to poor quality, ultra-processed foods (UPFs) are persistent offenders.

 

What are UPFs?

UPFs are “industrial formulations of many ingredients, mostly of exclusive industrial use, that result from a sequence of industrial processes” (Rauber et al, 2019). There’s a positive association between UPF consumption and excessive dietary added (or free) sugar in-take – and excessive free sugar in-take “is associated with obesity, type 2 diabetes, dental caries and several other health outcomes”. Yet “UPFs account for 56.8% of total energy in-take and 64.7% of total free sugars in the UK diet” (Rauber et al, 2019).

 

UPFs and physical health

Someone regularly encountering poor nutrition in children is Dr Monica Gupta, a London hospital-based NHS consultant paediatrician and founder of Holistic Paediatric Health.

Dr Gupta has concerns about “the significant normalisation of highly sugary breakfast cereals eaten by children across most cultures”.

She continued: “I see many children and young people in my clinic with abdominal issues – usually pain – and changed bowel habits – mainly constipation. I routinely take a dietary history, often finding that children’s diets consist of UPFs, with a significant consumption of refined carbohydrates and sugar.”

Dr Gupta has detected a surge in parents reporting their child as a “picky eater”. She explained: “Once a child’s palate has been repeatedly exposed to the higher salt and sugar content of packaged food, it makes sense that they’d refuse the ‘bland’ flavour of broccoli, for example.

“The child doesn’t realise what’s good or bad for them; they just know how that food feels and tastes in their mouth. If it’s a pleasant experience they want more. When ‘real’ food is offered, it’s rejected. 

“Flavour enhancers in so much of our food makes it more palatable, especially to children. Some parents consider white toast with jam and orange juice or (usually chocolate) cereal with milk, a healthy start to the day. It’s not. I’ve also noticed that dental caries is rife.”

Another concerned metabolic expert is Gloucestershire-based GP Dr Ian Lake, one of a growing number of pioneering physicians demonstrating the benefits of low-carbohydrate management in both type 1 and type 2 diabetes. Around half of Dr Lake’s adult patients have conditions attributable to, or exacerbated by, poor diet and lifestyle.

He said: “I’ve had great success with simple dietary change in diverse conditions that respond sub-optimally to medications: from migraines, irritable bowel syndrome and heartburn, to the easy wins in obesity and type 1 and type 2 diabetes.” 

As with Dr Gupta, Dr Lake – a founder member of the Public Health Collaboration that promotes real food lifestyles for improved health – sees children with dental caries: “Also, there’s more ADHD than when my career began, and I don’t think it’s because of improved diagnoses. Refined sugars activate excitatory pathways in the brain, which isn’t helped by UPFs.”

 

UPFs and mental health

Peer-reviewed evidence confirms Dr Lake’s observations: Wiss and LaFata (2024) cite an association between UPF intake and childhood ADHD, commenting that the “lack of consideration for the influences of UPFs on mental health is particularly problematic given the growing scientific support for the addictive properties of these foods”. They note an estimated prevalence of UPF addiction of “approximately 12% among children, a level of addiction unprecedented among youth”.

And Liu et al (2023) report that “frequent consumption of individual (candy and sweet bakery products) and multiple UPFs may decrease verbal comprehension index scores and thereby impact cognitive function in children aged 4 to 7 years”.

Southport-based clinical and health psychologist Dr Jen Unwin, specialising in food addiction, is co-founder of Food Addiction Solutions, a project hosted by the Collaborative Health Community charity. Dr Unwin’s co-founder, nutrition consultant Heidi Giaever, leads a project called Collaboration for Kids focused on preventing future food addiction by encouraging children to eat real whole foods.

Dr Unwin and colleagues (Unwin et al, 2022) present evidence that UPFs like pizza, chocolate, crisps, biscuits and ice cream are the five most problematic foods for those with food addiction symptoms. 

In her work with adults, Dr Unwin observes that “the rapid mental and physical benefits of real food diets still surprise me”.

She continued: “People feel mentally clearer and calmer and have more energy after just a few days. I’m also struck by the contrast between our real food-fed grandchildren – who are energetic, calm, cheerful children of normal weight – and their friends, who eat the more usual diet high in UPFs such as cereals, snacks, pizzas and ice cream.”

 

The challenge of UPFs

Dr Lake believes doctors aren’t well trained in nutrition, making metabolic medicine a difficult concept to grasp: “It’s assumed that the standard recommended diet of low fat, low refined sugar, and low salt is healthy almost by default,” he explained. “But those guidelines were established to primarily prevent heart disease and aren’t sensitive enough or adequate for other conditions.”

Dr Lake emphasises that the current dietary guidelines were never intended for children: “Even the effectiveness of a low-fat diet in heart disease is contentious. Using guideline macronutrient ratios as a guide for all diseases ignores the fundamental problem that nutrition must be therapeutic and specifically targeted in many conditions. Children especially need the best nutrition a nation can afford if they’re to fulfil their potential.”

And Dr Lake contends that adding non-nutrient additives to enhance flavour, shelf-life, appearance, palatability, and boost the need to eat more is unnecessary: “Food has always been processed, like smoking, salting and drying, but the level of refinement and sheer percentage of this stuff we consume are unprecedented. UPFs have long shelf lives … leave them on the shelf.”

 

Real Food Rebellion

There are grounds for optimism. One project gathering momentum is the Real Food Rebellion, whose educational modules, developed by teachers and health professionals, explain why real food is best and how to make healthier choices. 

The project serves both primary and secondary schools and is led by Chris Hill, a retired school leader with 35 years’ experience who is also a community governor at her local primary school in Chesterfield.

Ms Hill has been a volunteer at Public Health Collaboration since 2021 and given her background in education she was asked last year to become project lead for a school-based programme to educate children countrywide on the benefits of real food and the dangers of UPFs. 

She continued: “I’d already forged relationships with other like-minded Public Health Collaboration volunteers who willingly joined the project. We wanted a name reflective of the urgency to supplant UPFs with real food, and a need to rebel against current dietary norms – and Real Food Rebellion was born.”

As a teacher, Ms Hill has witnessed the effects of poor diets on children: “The sugar highs and lows; depression and poor mental health; stress and anxiety are at record levels; rocketing numbers of children with obesity and type 2 diabetes. Developing children are fed artificial food-like substances that fuel ill-health, anxiety and metabolic diseases that will cripple the NHS. Real Food Rebellion is about educating children in a creative way while sowing seeds of change.”

A pilot programme will begin during the 2025 summer term, but recent months have already seen widespread primary school interest and participation in the pre-pilot phase of the project.

The first to complete this pre-pilot was Dunesville Primary School in Doncaster, part of the Brighter Futures Learning Partnership Trust, which is a creative partner in the project.

Ms Hill continued: “We’ve also schools in Chesterfield; Auchtermuchty Primary and Strathmiglo Primary in Scotland; and schools in Dorset. The interest from primary schools eager to participate in next year’s pilot is overwhelming.”

Tim Newton, principal contact for schools applying to the Real Food Rebellion pilot, added: “This year’s pre-pilot courses involved around 150 secondary and 150 primary pupils, but we’ve now sent information packs – containing welcome letters, summaries of the courses and registration forms – to a further 20 primaries, 12 secondaries, four all-through schools, and four special schools interested in participating in next year’s full pilot project.

“These applicants cover diverse regions in England and Northern Ireland, including disadvantaged and prosperous areas. From the responses we’ve received, we expect that thousands of pupils may be involved next year.”

Schools wishing to participate in the pilot for summer term 2025 should contact Mr Newton for an information pack (see below). 

 

Next steps

Ms Hill hopes that once the pre-pilot and pilot programmes have been run they will have enough feedback from children and teachers to enable them to create the final version of the programme. 

The plan is then to make this available to schools to run through their PSHE curriculum, both at primary and secondary level in the academic year 2025/26 (it is expected that this will entail a small charge to cover the cost of materials, etc).

She added: “Participating schools in the pilot will have free access to the whole programme for the whole school. With the programme designed in collaboration with children and teachers, we’re confident it will get the key messages across in an exciting and innovative way. 

“We include training and information for parents and staff too, and advice and weekly support on cooking and budgeting. We hope to break-down the barriers faced by families that make it hard to escape the junk food trap.”

Dr Lake, who is collaborating with Real Food Rebellion, says they have done “an amazing job with a knowledgeable team and almost no financial resources to bring this topic to the attention of schools”. He added: “Think of the potential if it was funded and supported by government.”

In the UK’s National Food Strategy (Dimbleby et al, 2021), it is observed: “For sound commercial reasons ... companies invest more money into researching, developing and marketing unhealthy foods.” Refreshingly, Real Food Rebellion is rebelling against this.

  • George Winter is a freelance journalist and Fellow of the Institute of Biomedical Science.

 

Headteacher Update Autumn Term Edition 2024

  • This article first appeared in Headteacher Update's Autumn Term Edition 2024. This edition was sent free of charge to UK primary schools in September 2024. A free-to-download digital edition is also available via www.headteacher-update.com/content/downloads 

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