This blog post was authored by Alyssa Dittner, BS, RRT, and reviewed by the Bronchiectasis and NTM Content Review and Evaluation Committee.

Ultra-processed foods (UPFs) are whole foods that have been heavily changed. UPFs often include added ingredients like preservatives, extra sugar, and food coloring.¹ These foods have become a large part of many people’s diets. They are convenient and have a long shelf life.¹ However, choosing UPFs can affect weight and overall health, leading to both underweight and overweight individuals experiencing malnutrition and hidden hunger.

Body mass index (BMI) is a way to estimate body fat by looking at a person’s height and weight.² One study found that for those with bronchiectasis, BMI alone doesn’t tell the whole story of their health.² Weight is only part of the picture when it comes to health. UPFs can negatively impact how often someone may become sick and affect strength and muscle mass.^3,4 Many people are concerned with being overweight; however, being underweight can also weaken the lungs and make it harder to fight off infections.²

Malnutrition can occur when the body doesn’t get enough vitamins and minerals, even if a person eats a normal amount of food as defined by the U.S. Department of Health and Human Services.⁵ Many people have diets high in calories from UPFs and feel full. However, they may have malnutrition and hidden hunger because they are consuming fewer vitamins and minerals than their bodies need.⁶

UPFs can include sugary drinks, packaged snacks, instant meals, and processed meats.¹ These foods are often high in sugar, unhealthy fats (like saturated and trans fats), and salt, but are low in important vitamins and minerals.¹ In the U.S., more than half of the average person’s diet comes from UPFs, and this amount increases each year.³

Hidden Hunger: The Quiet Malnutrition

While UPFs often have plenty of calories, they lack important micronutrients. These are small amounts of vitamins and minerals in food that are important for the body to function properly.^7,8 Micronutrients include vitamin D, iron, magnesium, and zinc.^7,8 Diets low in micronutrients can lead to serious health problems and increased symptoms, including:^4,5

• A higher risk of infection.
• Low energy levels and feeling foggy.
• A greater chance of getting chronic diseases, like heart disease, type 2 diabetes, and some cancers.
• Overeating because the body is still hungry for nutrients.

How Diet Affects the Lungs

Studies have shown that a poor diet can affect lung health.⁵ For example, many people don’t have enough vitamin D. Low vitamin D levels are linked to more frequent lung infections and inflammation.² This can make respiratory symptoms worse.² Being underweight (having a low BMI) can also lead to weaker lungs and poorer health outcomes.²

Easy Steps to a Healthier Diet

To fight hidden hunger and improve your lung health, try eating a diet filled with whole foods.^9,10 Whole foods are minimally processed foods that are close to their natural state.⁷ Whole foods contain protein, fiber, healthy fats (monounsaturated and polyunsaturated fats), vitamins, and minerals. These foods give the body the nutrients it needs to stay healthy.

Healthier eating choices could include:^9,10

• Fruits and vegetables:Berries, apples, tomatoes, leafy greens.
• Whole grains: Whole-wheat bread, brown rice, and quinoa.
• Lean protein: Fish, poultry, beans, lentils, and nuts.
• Healthy unsaturated fats: Avocados, nuts, and olive oil.
• Reduce sugary drinks, packaged snacks, fast food, and processed meats.
• Prepare meals at home.

To learn more, visit myplate.gov.

Hidden hunger is a serious concern that can impact your health, including the lungs. You can improve your overall health and well-being by making good choices about your food and focusing on whole nutritious foods. This helps protect you from the harmful effects of hidden hunger and improves your ability to fight respiratory disease. It is important to talk with your health care provider about your diet and any worries you have about your health. Your health care provider may recommend a consultation with a nutritionist to create a personalized eating plan.

Resources

1. Communications NW. Americans are eating more ultra-processed foods. NYU. October 14, 2021. Accessed January 23, 2025. https://www.nyu.edu/about/news-publications/news/2021/october/ultra-processed-foods.html.
2. King L;White H;Clifton I;Spoletini G;Ispoglou T;Peckham DG; Nutritional status and intake in patients with non-cystic fibrosis bronchiectasis (NCFB) - a cross sectional study. Clinical nutrition (Edinburgh, Scotland). 2021. Accessed January 30, 2025. https://pubmed.ncbi.nlm.nih.gov/34461590/.
3. Aljahdali AA, Rossato SL, Baylin A. Ultra-processed foods consumption among a USA representative sample of middle-older adults: a cross-sectional analysis. Br J Nutr. 2024;131(8):1461-1472. doi:https://pmc.ncbi.nlm.nih.gov/articles/PMC10950447/#:~:text=UPF%20intake%20accounted%20for%2051,in%20fibre%2C%20vitamins%20and%20minerals
4. Kong W, Xie Y, Hu J, Ding W, Cao C. Higher Ultra processed foods intake is associated with low muscle mass in young to middle-aged adults: A cross-sectional nhanes study. Frontiers in nutrition. February 19, 2024. Accessed February 5, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC10909937/#:~:text=Upon%20full%20adjustment%20for%20potential,P%20for%20trend%20%3D%200.003.
5. Nutrition and public health. Food and Nutrition Service U.S. Department of Agriculture. 2024. Accessed February 4, 2025. https://www.fns.usda.gov/partnerships/nutrition-public-health.
6. Malnutrition. Johns Hopkins Medicine. June 19, 2024. Accessed January 24, 2025. https://www.hopkinsmedicine.org/health/conditions-and-diseases/malnutrition.
7. The hidden hunger: Micronutrient deficiencies. The Hidden Hunger: Micronutrient Deficiencies | The Institute for Functional Medicine. December 11, 2024. Accessed January 28, 2025. https://www.ifm.org/articles/hidden-hunger-micronutrient-deficiencies.
8. Steele EM, Popkin BM, Swinburn B, Monteiro CA. The share of ultra-processed foods and the overall nutritional quality of diets in the US: Evidence from a nationally representative cross-sectional study - population health metrics. BioMed Central. February 14, 2017. Accessed February 30, 2025. https://pophealthmetrics.biomedcentral.com/articles/10.1186/s12963-017-0119-3
9. Gozzi-Silva SC, Teixeira FME, Duarte AJDS, Sato MN, Oliveira LM. Immunomodulatory Role of Nutrients: How Can Pulmonary Dysfunctions Improve? Front Nutr. 2021;8:674258. Published 2021 Sep 7. doi:https://pubmed.ncbi.nlm.nih.gov/34557509/
10. Current dietary guidelines 2020-2025. Dietary Guidelines for Americans, 2020-2025 and Online Materials | Dietary Guidelines for Americans. Accessed January 29, 2025. https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials.