Chapter 11
Lifestyle+ — 2
Big Food makes a lot of these. Of course, it is not just how much you eat but what you eat. Ultra-processed foods (UPFs) are like UFOs; they are alien, industrially produced, unnatural substances; they’re not even food. I’m not going to name brands of foods, but they are not what you’d find in a standard home kitchen to make meals from. There are basically two major dimensions—chemical and physical—by which industrial processing does its damage. First, these foods and beverages contain additives and industrial ingredients. It’s a long list, but here are some of the chemicals you should avoid or limit: coloring agents, sweeteners such as maltodextrin, high-fructose corn syrup, fruit juice concentrates, dextrose, lactose, artificial sweeteners, hydrogenated oils, palm oil, calcium propionate, soy protein isolate, modified starches such as maltitol, calcium caseinate, hydrolyzed beef gelatin, and emulsifiers such as soy lecithin, xanthan gum, guar gum, and diacetyl tartaric acid esters of mono- and diglycerides.
Second, the manufacture of these foods involves physical changes in texture and form—molding, extrusion, prefrying—to maximize digestibility and accelerate digestive tract absorption, which in turn produces spikes in blood glucose and insulin. That’s the opposite of dietary fiber, which slows digestion, reduces glucose spikes, and does us a lot of good.
Extrusion cooking requires temperatures above 100°C and shear forces that “melt” or “extrudate” food that is then molded into chips, snack bars, cookies, breakfast cereals, packaged pizzas, chicken nuggets, and doughnuts. Contaminants from packaging with such substances as bisphenols, mineral oils, and phthalates are not recognized in an otherwise helpful classification system known as NOVA: Group 1-unprocessed, Group 2-processed culinary ingredients, Group 3-processed foods, and Group 4-ultra-processed.
Unprocessed or Minimally Processed Foods
Processed Culinary Ingredients
Processed Foods
Ultra-Processed Foods
Foods that did not undergo processing or underwent minimal processing technics, such as fractioning, grinding, pasteurization, and others
Obtained from minimally processed foods and used to season, cook, and create culinary dishes
Unprocessed or minimally processed foods or culinary dishes that have added processed culinary ingredients; necessarily industrialized
Food products derived from foods or parts of foods, being added cosmetic food additives not used in culinary
In a much-referenced randomized trial by Kevin Hall and colleagues at the inpatient NIH Clinical Center, two groups were given either unprocessed foods or ultra-processed foods for fourteen days (fig. 3.1). Participants could eat as much as they desired. It is no surprise which group ate an extra five hundred calories a day, mostly of carbohydrate and fat, with a significant change in weight gain. The explanation for this overeating of ultra-processed food likely involves the disruption of gut-brain signals that unprocessed food conveys to the brain.
Eating ultra-processed food is associated with a markedly heightened risk of cardiovascular and metabolic diseases. These foods induce abnormal lipid levels, insulin resistance, and systemic inflammation. Furthermore, a diet rich in these foods is linked to 80 percent elevated risk of metabolic syndrome, 40 percent higher risk of type 2 diabetes, 23 percent increased risk of hypertension, 55 percent risk of obesity, and 66 percent risk of cardiovascular death. Increasing UPF in the diet leads to higher risk of cardiovascular, coronary artery, and cerebrovascular disease. Among older adults, a mere 10 percent increase of UPF intake is associated with a 16 percent increased risk of cognitive impairment. Regular consumption of ultra-processed red meat, such as bologna, bacon, sausage, and hot dogs, has been associated with a 14 percent higher risk of dementia. There is a remarkable dose-response curve.