Chapter 13
Lifestyle+ — 4
Why hasn’t the United States joined other countries like Brazil, Israel, Belgium, Chile, and Uruguay in publishing guidelines for people not to eat UPFs? There could be demands to reformulate UPFs, but that’s not happening. In the United States, the multinational corporations behind Big Food have a supersized chokehold influence on the Department of Agriculture. Big Food spends twice as much lobbying the government as the tobacco and alcohol industries combined. The F in FDA stands for Food, but there is little evidence that our regulatory body has true oversight and authority about potentially toxic constituents that we’re eating. There’s not even heightened UPF awareness led by the FDA or other public health agencies. In late 2023, the FDA proposed banning brominated vegetable oil, a food additive found in beverages for a century that was previously banned in Japan and Europe. Likewise, Red Dye No. 3 (found in candy), propylparaben (found in baked goods), and potassium bromate (found in packaged breads) have been banned by the European Union because they are all linked to serious health problems. In the United States, only California approved such a ban for all four of these additives, but that won’t take effect until 2027. Recall how it took the United States multiple decades after Europe to ban trans-fat foods, despite unequivocal evidence of cardiovascular harm.
Over time, it is quite likely that ultra-processed foods will be regarded as akin to cigarettes; public awareness of their dangers were suppressed for decades. Realistically, UPFs will not be banned, but there could be regulations enacted to reduce their toxicity and to enforce conspicuous labeling on all foods and beverages that spotlight their risks. Such labeling worked well in terms of public health for cigarettes.
Sweeteners
While sugar activates our dopaminergic reward circuits and provides hedonic value, too much of a good thing is clearly bad. The biggest source of added sugar in diet is from sugar-sweetened beverages. There are fifty grams of simple sugar in a can of Coca-Cola, and forty-four grams in a Starbucks Frappuccino. As seen in a large cohort of more than thirteen thousand people age forty-five and older, followed for six years, consumption of high sugary beverages, including fruit juices, was associated with a 24 percent increased all-cause mortality. This finding was independently replicated and extended by several other studies, in much larger cohorts and with longer follow-up, for both increased cardiovascular and cancer-related mortality. Notably, atrial fibrillation increased more than threefold during a ten-year follow-up among the two hundred thousand participants who drank more than two liters per week. The consistency of all the reports indicate that consumption of sugary beverages should be limited, and this includes moderating the intake of fruit juices for children. The evidence for fueling the burden of oral diseases including cancers and dental caries is also clear.