“Ultra-Processed People”

Chris van Tulleken: Ultra-Processed People
(Published June, 2023)

Reading this book was a very fascinating experience, and very different from my expectations. It’s not just another rant about big food companies, it’s a detailed survey of the science of ways that humans can be caused to eat too much. It's about how the brain can create the conditions for obesity when you give it a chance. But above all, it's about how artificially created flavors, nutrients, emulsifiers, and other manufactured ingredients have changed the modern diet, and have contributed to a big increase in obesity and related diseases, especially diabetes. The author builds the case for this carefully and in detail, which I'm not qualified to try to replicate in my review.

For example, think about these: saccharine, high-fructose corn syrup, xanthan gum, aspartame, dimethyl cellulose, modified food starch, canola oil, sodium stearoyl lactylate, calcium sulfate, ammonium sulfate, calcium propionate, sodium acid pyrophosphate — random ingredients from packaged food labels that I searched for on the web. 

Are these really foods? Yes and no! Van Tulleken provides a general view of the enormous expansion of ultra-processed food in our diet since the invention of saccharine in 1879, and the explosion of new additives in the last quarter of the 20th century. He talks about the motive of food companies: making money, and how they market these foods to achieve their ends. He explains: 

"Usually the aim of UPF is to replace the ingredients of a traditional and much loved food with cheaper alternatives and additives that extend shelf life, facilitate centralised distribution and, it turns out, drive excess consumption. Pies, fried chicken, pizza, butter, pancake mix, pastries, gravies, mayonnaise – all these began as real food. But the non-UPF versions are expensive, so their traditional ingredients are often replaced with cheap, sometimes entirely synthetic, alternatives." (p. 20). 

An enormous number of such substitutes and additives are included in a diet of ultra-processed food:

"It’s not clear how much or even how many additives we eat. In the EU, there are more than 2,000 permitted for use. In the US, the number is (terrifyingly) unknown, but is thought to be higher than 10,000. As production has become entirely automated, with computer-controlled robots cutting vegetables, grinding meat, mixing batter, extruding dough and wrapping the final product, many additives are required so that food can withstand the process. If colours or flavours are lost as food is subjected to this robotic mauling, then, as we’ve seen, they can simply be chemically replaced." (p. 210). 

The consequences of more than a century of creating food and drugs that derail the brain’s natural control over hunger and satiety are documented in a fascinating way, which I can’t begin to summarize. I've picked one passage that I find essential:

"UPF, especially products with particular combinations of salt, fat, sugar and protein, can drive our ancient evolved systems for ‘wanting’: ‘Some ultra-processed foods may activate the brain reward system in a way that is similar to what happens when people use drugs like alcohol, or even nicotine or morphine.’ This neuroscience is persuasive, if still in its early stages. There is a growing body of brain-scan data showing that energy-dense, hyperpalatable food (ultra-processed but probably also something a really good chef might be able to make) can stimulate changes in many of the same brain circuits and structures affected by addictive drugs." (p. 153).

Even if you think you know all about ultra-processed foods and how they affect their consumers, you really ought to read this book and find out more than you already know! You may be more ignorant than you realize — I thought I had read a lot about the subject, and I certainly was ignorant. You may also have seen quibbles that say that no one really knows what ultra-processed food is. Reading the book, I concluded that this argument is tendentious. Maybe you can find some marginal items. So what.

Throughout the book, van Tulleken reviews the research literature on each scientific topic, which is fascinating and also challenging. I was particularly interested in his analysis of which researchers were compromised because they accepted funding from the food and additive industries, which often resulted in their finding what the big food corporations wished they would find. This is a sad state of affairs, but often documented by other writers as well.

Everywhere, since I read van Tulleken’s book, I see journalists' accounts that seem to support or amplify the major points of he made. Ultra-Processed People does not discuss one huge current trend: the use of injectable drugs to change human cravings for food and thus to offer a new way for people to lose weight. These articles are documenting the way the newly popular drugs reverse effects that in many cases could be due to consequences of ultra-processed food. I hope that van Tulleken will eventually add this topic to his book and to this: “Most UPF is not food. It’s an industrially produced edible substance.”

Ultra-processed food is everywhere!

Here are two examples of articles on topics relevant to the book that appeared in the New York Times on January 16, 2024, just to show how this seems to be everywhere:

• “Diabetes Is Fueling an Amputation Crisis for Men in San Antonio” 
• "In the Ozempic Age, Has ‘Craveable’ Lost Its Selling Power?"

Review © 2024 mae sander

Ultra Processed

The best ripe apricots in the world from the Santa Barbara Farmers' Market, 2012.
How I wish it was always easy to get unprocessed food! 

“There is very clear observational data showing that people who have higher intakes of ultra-processed foods have higher levels of ill-health, whether it be cancer, cardiovascular disease, high blood pressure, obesity or type 2 diabetes.” (Statement from Dr Sarah Berry, a nutrition expert in the area of cardio-metabolic health at King's College in England.)

The Guardian today has an article titled "Fast food fever: how ultra-processed meals are unhealthier than you think." Understanding ultra processed food (UPF) and its consequences interests me quite a bit. This is a challenging subject: research on the effects of UPF has disclosed its association with obesity, cardiovascular disease, diabetes, dementia, and colon cancer. The article summarizes research on the role of inflammation in these and other health problems, and describes the mechanisms by which UPFs may trigger inflammation. It also discusses some political efforts in the UK to overcome some of the damage that they cause, including improving the foods and educating the consumers. This is a complex and active area of research, which I will not try to duplicate here -- you can read the article if you want details.

The ongoing research has created some understanding of a mechanism by which the food becomes such a risk to one's health. Obviously, humans since prehistoric times have been processing foods by chopping them up, cooking them, fermenting them, and other techniques, but UPF is something new. An expert epidemiologist quoted in the article summarizes: 

“The ultra-processed nature of modern food generally means that the complex structure of the plant and animal cells is destroyed, turning it into a nutritionally empty mush that our body can process abnormally rapidly.”

Defining UPF is a scientific issue in itself. Four categories have been defined, but like all continuums, there are issues with classifying some foods. This doesn't mean it's not useful, just a challenge! There are various ways to classify and define processing; the article divides foods into the following groups: 

1.  "unprocessed or minimally processed foods (fruit, vegetables, meat, eggs, milk)"
2.  "processed culinary ingredients such as sugars, oils and butter"
3.  "processed foods (canned vegetables and fish, bread, jam)"
4.   foods which "have undergone industrial interventions such as extrusion, moulding and milling" and which are "mostly low in protein and fibre, and high in salt, sugar and fat."

One problem I have with this simple classification is that I don't know how it would describe some traditionally processed foods, especially those that use fermentation to change the chemistry of the food. Traditional fermented dairy products like cheese and yogurt; traditional fermented vegetables like sauerkraut, tofu, and kim chee; and the production of bread using yeast fermentation -- all have a very long, pre-industrial history, which is not covered in this article. Not to even mention beer and wine!

Do Calories Count?

Another Guardian article, "Number crunching: why ultra-processed foods have a calorie problem" was published a few months ago, dealing with a different aspect of the general problem of UPF and how to choose a healthful diet. This article explains the limitations of calorie information, and how different foods and different processing methods can result in calorie counts that are quite misleading. Particularly, the calories in UPF are much more readily digested, with a variety of consequences, mostly not very good. 

A specific example about readily available food choices in England makes this point clearly:

"There are, for example, 678 calories in a Pret a Manger hummus salad, 684 in three Mars bars, and 708 in a portion of a Sainsbury’s fish and chips ready meal. These very similar numbers don’t tell us that the salad provides a third of our recommended daily fibre and half our daily fat; that the fish and chips contain almost half our daily salt but also half our daily protein; or that the chocolate bars would bust our sugar allowance. By only looking at calories – as on restaurant menus – we lose other, much more helpful information."

There's so much to learn and understand in the world of nutrition!

 

Review of articles by mae sander, © 2022.