There’s so much I’d like to share from this well-researched, comprehensive, and often entertaining book, it’s going to require two postings just to scratch the surface.
Chris Van Tulleken wears many hats here - as a doctor, academic, father, twin brother, TV presenter, raconteur, and someone who eats food. The book meanders a fair bit, which would be irritating if he didn’t keep finding such interesting stories.
Dr. Tulleken ate only ultra-processed food for a month as an experiment while he was researching the health impacts of highly-processed food. By the end of the month he had gained 12 pounds. When tested, his hunger and satiety hormone levels were all out of whack. Even a brain scan showed changes in his brain pathways. Whereupon he quit eating UPF “cold turkey” - which his wife pointed out was in fact one of the foods he could still eat.
The definition of ultra-processed food is problematic. But a good rule of thumb is: if any of the ingredients on a package label are things you wouldn’t find in your own kitchen, it is ultra-processed. Basically it is any foodstuff that has been taken apart and put back together using various industrial processes. Even a lot of food that pretends to be healthy - ‘organic’ guava juice, ‘all-natural’ granola bars, ‘zero-trans-fats’ flavoured yogurt and ‘high-fiber” breakfast cereals - are most often ultra-processed.
There’s now good research evidence that the more ultra-processed food you eat, the greater your risk for obesity, cancer, heart disease, stroke, high blood pressure, fatty liver disease, inflammatory bowel disease, depression and dementia. (Increasing the percentage of UPF in your diet by 10% increases your risk of senility by 25%, for example.)
Initially UPF was only shortening lifespans in the rich countries of the world, but as UPF snacks, fast food, and colas have spread to the poorer countries of the world, they too are seeing massive epidemics of chronic disease and obesity.
Van Tulleken recounts a number of the arguments that apologists for UPF make that it is not industrial processing per se which causes UPF to be harmful:
It’s because of the lack of fiber: UPF is pretty much devoid of fiber, which harms the microbiome in your gut that normally would draw extremely important nutrients from your food for you. A lack of fiber also causes any simple carbohydrates in foods to be digested too fast, creating blood sugar spikes and crashes.
It’s because most UPF is loaded with fat, sugar and salt: We are genetically programmed to seek out salt and fat because they were frequently in short supply in stone-age hunter-gatherer diets. Put sugar, salt and fat together in foods and they become downright addictive.
It’s because UPF has too much oil-seed Omega-6 oils: The shift away from saturated animal fats to oilseed oils pushes the body away from a healthy balance between Omega-3 and Omega 6 oils, and creates a variety of inflammatory diseases.
It’s because of a few bad (non) apples: A massive amount of the bad health outcomes from UPF’s is strongly associated with four sub-groups - colas, snack foods, restaurant fast food, and sugar-laden breakfast cereals. The argument is that it’s unfair to demonize all UPF just because of a few bad (non) apples.
It’s because poor people eat more of it: UPF is usually cheaper than unprocessed foods, so it often displaces healthier foods from the diet of poor people. Poor people also smoke and drink more, and live shorter, unhealthier lives, so if they eat more processed foods then perhaps it is partly that which creates the strong statistical correlation between UPF intake and bad health outcomes.
It’s because UPF is so calorie-dense it’s easy to eat too much. The lack of both fiber and water means a small amount of UPF packs a lot of calories. It’s dead easy to scarf down a thousand calories of Doritos or Pringles. Try to eat a thousand calories of lettuce and your stomach will tell you it’s painfully full long before you can reach that goal.
It’s because UPF manufacturers buy massive amounts of TV advertising: You are constantly being massaged and manipulated to snack frequently, eat at fast food restaurants, and eat and drink their brand-name products. So, of course you’ll tend to over-indulge in those foods - it’s the eating too much, not the foods themselves which is the problem.
When I see the above list of excuses as to why the industrial processed food is not so bad health-wise, I’m reminded of the expression “damning with faint praise.” It’s not as though any of the excuses for processed foods given above would encourage you to eat the stuff!
Kevin Hall was one of the researchers skeptical of the growing body of research data which suggested that ultra-processed foods caused weight gain. He believed it was the added sugar, fat and salt, plus the absence of fiber in UPF that was responsible for the obvious explosion in obesity which happened every time ultra-processed foods became common in a country.
He designed an ingenious experiment to prove his hypothesis. He decided to create separate meal plans for minimally-processed foods and ultra-processed foods that were nutritionally equivalent, i.e., both meal plans had exactly the same proportion of fiber, fats, proteins, carbohydrates and salt.
To do this it was necessary to cherry-pick the worst of unprocessed foods and choose only those ultra-processed foods lowest in sugar, fat and salt, plus add fiber supplements to the UPF side. But it was possible to do so.
Half the experimental subjects ate (chef prepared!) minimally-processed foods for two weeks, followed by two weeks of a diet chock-full of UPFs. The other half of the subjects ate from a UPF meal plan for two weeks and then ate minimally processed foods in their final two weeks.
The result was than both groups ate 500 calories per day more during their UPF weeks than during their minimally-processed food weeks. What this means is that if you were someone whose weight was stable on a diet of minimally-processed food, then on a diet of UPF, you’d balloon out by 50 pounds per year of added body fat.
To his credit, Kevin Hall was willing to admit his research showed that it’s not just the sugar, fat and salt in processed food that makes people fat. Something about industrial food processing itself has to be causing obesity, even if we don’t yet fully understand the mechanisms of how it does so.
Don’t expect to see a lot of what I’ve just shared in the the mainstream media, or be told it if you talk to a nutritionist or a dietician.
Later in the book, Van Tulleken itemizes how Agri-Biz has comprehensively bought off academic researchers and professional associations in the nutrition field with massive grants to shape what conclusions any nutrition health studies are allowed to reach. Spending vast amounts of money on media advertising insures that the mainstream media is also reluctant to bite the hand that feeds them.
PS: If you needed any further convincing of the toxicity of Ultra-Processed food, consider this horrific stat: 90 percent of American adults now have stage one or higher markers for a new cardiac syndrome called CKM.
Coincidentally, I have had the book out from the library for a few weeks. I decided to read “Dissolving Illusions” first, though. Thanks for the summary.