I had UPF anxiety – what I learned when I gave up oat milk (and then went back)

I can’t pinpoint exactly when it began, but a few months ago I realised I didn’t want to drink oat milk anymore. In particular, it was Oatly – the phenomenal Swedish success story – that no longer exerted the same pull on my brain it once did. Previously, I would be pleased when I spotted the (easily recognisable) grey cartons behind the till in a coffee shop. I’d stock up on it in the supermarket. Until, all of a sudden, I wanted to avoid it. I’d become wary of what it might contain, nervous about some undefined impact it might have on my longer-term health. I started making my porridge with water and switched my coffee order from a flat white (so much milk!) to an Americano with a dash of oat milk. When I did permit myself to buy oat milk for tea at home, I opted for the Plenish brand with just three ingredients (oats, water, salt – marketed as “natural” with an emphasis on no added sugar, oils or additives) or the new M&S own-brand three-ingredient equivalent. The composition of Oatly by comparison is water, oats, rapeseed oil, dipotassium phosphate, calcium carbonate, potassium iodide, salt, riboflavin, and B12.

Not impressed by three-ingredient options

If I’m honest, my enjoyment of these swaps was low. I think the three-ingredient options generally taste horrible. When added to hot drinks they disappear, and are almost tasteless unless added in vast quantities. Unlike Oatly, which has a discernible taste and smooth mouthfeel more akin to cow’s milk (which I can’t drink because of intolerance). So why had I felt compelled to change? Was it that I thought fewer ingredients was a guaranteed step towards healthier eating? Did I have an unrecognised, but growing anxiety about longer ingredient lists? Or a newly learned fear that any processing – regardless of the reason – is best avoided? (Photo: mixetto/Getty)

Ultra-processed foods (UPFs)

Unless you’ve been living in a cave, you will be familiar with recent coverage of ultra-processed foods (UPFs). The message is that UPFs – foods with more than five ingredients and those which you’re unlikely to find in a domestic kitchen – are bad, causing everything from cancer and dementia to early death. They make up a lot (57 per cent) of the modern British diet, and we should do our best to reduce our consumption. The Brazilian scientist Fernanda Rauber described them (hideously) as “not food” but “industrially produced edible substance”. The term UPF was coined 15 years ago, with the creation of the Nova classification scale (which ranks foods from 1-4, based on the level of industrial processing) but Google trend history shows that it is in the last five years that public interest has boomed. (Photo: Dan Kitwood/Getty)

‘The new Coca-Cola’?

Last year, the book Ultra Processed People by Chris van Tulleken became a bestseller; the government began a roundtable on UPF policy; an app (Open Food Facts) was designed to detect UPFs in shops; and journalists everywhere from BBC Panorama to this newspaper tested out 100 ways to be UPF-free. I have read, edited, and commissioned many such pieces. The message? Ditch UPFs. Against this backdrop, I also started to see pieces specifically targeting oat milk as a problem UPF. Biochemist Jessie Inchauspé (known as the Glucose Goddess) said in a video: “[Oat milk is] starch juice – so it leads to a big glucose spike”. Another far more damning assessment went so far as to call Oatly “the new Coca-Cola”. The piece is from 2020, and is not written by a health expert, but kept being reshared online. (Photo: Peter Cziborra/Reuters)

I realised this drip, drip, drip, of anti-oat sentiment (against a background of UPF warnings) had left a sour taste and I’d committed to weaning myself off without actually confirming if any of these supposed problems – glucose spikes, seed oil emulsifiers, processing – were a real issue for my diet. I just switched. (Photo: Scott Olson/Getty)

‘It's not trying to kill you’

“Oatly is not trying to kill you,” Dr Federica Amati, head nutritionist at Zoe, who has a PhD in medical science, jokingly tells me over the phone after I explain my predicament. Amati says that in recent years, experts, like her, have been keen to raise awareness of the health dangers of UPFs (especially when they make up the bulk of your diet) and apply more pressure to manufacturers and government to improve quality higher up the food chain. But, from a consumer perspective the negativity around UPFs, she acknowledges, “is terrifying”. She explains: “We need to be really careful because we can’t make people fear all food.” She says she has come across people scared of extra virgin olive oil because it is processed, despite it being “one of healthiest foods we have”, as well as Greek yoghurt or wholemeal loaves of bread. “If you take the approach that anything with ingredients you wouldn’t have in your kitchen is bad, then you’d cut out a huge amount, and not just harmful UPFs. For example, tomato sauces with citric acid – a shelf stabiliser – or foods with inulin, a type of fibre,” she says. “If you try to remove all of these it is super hard to do. I don’t think that is a helpful way to approach it.”

Criticisms of oat milk

What about oat milk then? Specifically that longer Oatly ingredient list I was avoiding. Is that bad? “On a technicality, it is UPF,” says Dr Duane Mellor, dietician at Aston Medical School. “But is there evidence it is harmful? No.” The ingredients I was shunning, he explains, were actually useful fortifications – B12, B2, calcium. In the three-ingredient options this was gone. “Some foods need to be fortified and we shouldn’t stigmatise fortification. We must make it easier to have a nutritionally complete diet”. (All three experts I spoke to agreed with his assessment, Amati described it as “positive processing”.) And the other criticisms? The inclusion of rapeseed oil, demonised as harmful by some commentators. (A small amount is added to Oatly to give a better mouthfeel, to make it more fatty like dairy.) “There is a lot of hype but a lot less evidence,” says Mellor. “There is a good study from the 90s showing it reduced the risk of people having second heart attacks.” (Photo: Matt Cardy/Getty)

Sugars in cows’ milk

While the much-maligned glucose spikes are just a normal response to eating, Oatly does not have a high glycemic load, says dietician Rosemary Martin. “It is considered in the low category. And if you’re eating it with other things, nuts or fruits, they change the glucose response anyway”. And she adds, there are sugars in cows milk because of the presence of lactose. Of all of the points I raised about possible negative impacts, I was told the concern was unfounded. “I think oat drinks are a fantastic choice,” says Martin. (Amati actually feeds Oatly to her children.) The more pressing question for everyone, says Mellor, is how much of these products we are drinking. “If you’re having a splash that’s very different to a large latte made with any milk, which contains more calories and sugar”. Especially if you opt for added syrups. (Photo: John Stillwell/PA)

‘A new form of clean eating’

Beyond the oat milk reservations, my growing UPF anxiety is something that experts are noticing. Dr Mellor says that people “like the idea of clean food” and the anti-UPF narrative has fed into that, but it is not as simple as more ingredients are always bad. “We need to be careful that by trying to simplify things, are we missing out? Other than it sounding healthier, is it actually healthier? What is the purpose of this food? If just to make coffee paler, that’s fine. But using it as a key source of nutrition [if you’re vegan] three-ingredient options are not going to do that.” In fact, anxiety over cutting out all processed foods could be the next evolution of orthorexia, which Beat charity describes as “an unhealthy obsession with eating ‘pure’ food”. Amati says: “For some influencers online, it has become a [new] form of clean eating. It is that it has a holier-than-thou meritocracy and that’s unfair because we know households that consume most UPFs are those that have the least income”. (A 2019 study found among poorer demographics, it can be as high as 80 per cent of adult diets.) (Photo: Kseniya Ovchinnikova/Getty/Moment RF)

‘Not all UPFs are equal’

Amati and her colleagues became so aware of the binary, reductionist treatment of foods that are processed (bad) and unprocessed (good), they created a tool – the Zoe risk scale – to show more nuance. “Not all UPFs are equal,” reads the tag line. It lists foods like Weetabix, Pip and Nut Crunchy Peanut Butter, Green & Black’s 70 per cent chocolate, and Nescafe instant coffee as no risk despite being processed. Asda Hummus and Jason’s Seeded Sourdough are also low risk. “Some UPF result in negative health outcomes, some don’t… to feed as many people as we have [on earth] we need some processed foods,” says Amati. “Tinning, freezing, jarring, drying, all these things are important. It’s not sustainable to only eat fresh produce. What we need to do is find balance, encourage people to cook more.” In the rush to reduce the number of UPFs people are eating – which is crucial and must not be overlooked – we must not make people feel guilty about eating anything that has been processed.(Photo: Getty)

No more health reservations about Oatly

The experts say there are some things to still look out for when buying these milks: no added sugars, says Amati, and avoid emulsifiers like Carrageenan gum or CMC, while Mellor says we should push for standardisation of oat milk products so consumers always know what they’re getting. But, we certainly do not need to be scared of all ingredient lists. Now Oatly has returned to my fridge, I do not have health reservations about it being there, and every time I take a sip of my creamy coffee I’m grateful that positive processing exists to make it so much more tasty than the other options. (Photo: Alvarez/E+/Getty)

Speaks to greater fears about our bodies

But, I’m aware it was not really about just the oat milk. In our information age, I’ve learned to question how we end up with messaging around our diets – is it via experts (as it should be) or just by osmosis online? Are we falling prey to social media dietary trends without even realising we’re absorbing their messages? I definitely thought I was more savvy than to succumb to unfounded scaremongering, but the evidence suggests otherwise. Although the type of milk we put in our coffee doesn’t seem hugely consequential, it speaks to greater fears about what we’re putting into our bodies every day, and the choices we make every day in the supermarket. And with so much oft-conflicting nutritional advice, perhaps the healthiest long-term approach is to try and avoid letting fear dominate what ends up our plate. (Photo: d3sign/Getty)