The Hazards of Ultra-Processed Foods

**Michael Greger** (0:00)
Trying to stay healthy can seem like a full-time job sometimes, especially with all the conflicting information that's out there, but I'm here to make that job a little easier. Welcome to the Nutrition Facts Podcast. I'm your host, Dr. Michael Greger. Did you know that excess consumption of certain ultra-processed foods is linked to increased risk of disease and death? Well, today we'll explore the public authentications of full or partial replacement of animal products with ultra-processed plant-based products and with whole plant foods. How about a century ago, in the context of nutrient deficiency diseases? So there were editorials with titles like Sugar as Food. Heralding sugar as one of the cheapest sources of calories for mere six cents. You could buy 3,000 calories. What a bargain! But the nutrient deficiency era gave way to the dietary excess era. No longer were we dying of nutrient deficiency diseases like scurvy, as much as we were dying from nutrient excess diseases like obesity and heart disease. So it became more about avoiding too many calories, too much saturated fat, too much sugar, too much sodium, but either way still focused on nutrients. This allowed food companies to get away with abominations like frosting-filled cereal because it was fortified with 12 vitamins and minerals, 50% better than the measly 8 in marshmallow Froot Loops.
However, food, not nutrients, is the fundamental unit in nutrition. And to their credit, the field of nutrition started moving towards a more holistic view. So, first-generation dietary guidelines emphasized individual nutrients, moved on to second-generation food-based dietary guidelines, which largely converged on encouraging diets rich in what? Vegetables, fruits, legumes, your beans, split peas, chickpeas, and lentils, whole grains, and nuts. But an area of emerging importance was the degree of food processing. What if, when it comes to nutrition and health, it's not so much the food or the nutrients as much as the level of processing? For instance, a food-based dietary guideline might say something like, eat more vegetable soup. Great! But there's vegetable soup, and then there's vegetable soup. Are we talking a clean-out-the-fridge kind of vegetable soup? A health-haloed quinoa and kale organic, with a heart-stopping 1,200 milligrams of sodium?
How about a vegetable soup with more salt than there are vegetables? Or a vegetable flavor soup that has more artificial colors than MSG than it has vegetables? All soup is not the same. The degree of processing matters. Ultra-processed foods are these industrial formulations, which, besides salt, sugar, oils, and fats, include substances that are really not used in cooking, like added flavors and colors and artificial sweeteners, emulsifiers, other additives used to kind of imitate real foods, like frosted grape Pop-Tart with more grapes on the front of the package than are actually in it, with less grapes than there are salt in the… But look, it may artificially taste like grapes, and look like grapes because of 1, 2, 3, 4, 5 different food dyes. Simply put, ultra-processed foods are foods that can't be made in a home kitchen because they've been chemically or physically transformed in these industrial processes. They typically contain little or no whole foods, are ready to consume and heat up, and are fatty, salty, or sugary, and depleted in dietary fiber and other nutrients. So, it's like all the sweet and fatty, salty snacks, like potato chips and ice cream and soda candy, french fries, burgers, hot dogs, chicken nuggets, fish sticks, basically everything in a box or a bag. Why not just call them packaged foods? Well, they were actually thinking about it, but they were afraid that some consumers might look at a bag of apples or something and be like, uh-oh, get confused or something. OK, but what is so revolutionary about this concept of ultra-processed foods? I mean, wasn't fatty, salty, sugary junk always a bad idea? Why isn't enough? Why is it not enough to just tell people to stay away from junk? Because diet coke. Diet soda is the perfect example why a new kind of term, like ultra-processed, can be so useful. Because it has no calories, no fat, no sugar, so no problem, right? Well, then, why is diet soda consumption associated with premature death, stroke, heart disease, hypertension, diabetes, metabolic syndrome, leukemia? And most studies controlled for body weight, so it's not just because heavier people are more likely to drink it. Health risks are not only related to the nutritional quality of ultra-processed foods, but also to the presence of additives. So, no apparent calories, fat, sugar, salt, but contains caramel color, which results in the formation of formethylaminazole, which is a potential human carcinogen, and contains aspartame, also recently classified as possibly cancer-causing in humans, and contains phosphoric acid, which is a phosphate additive that may be damaging our health as well, and contains a benzoate preservative. If you remove artificial colorings in benzoate preservatives from the diets of preschoolers and then randomize them to be slipped to placebo or a hidden cocktail of colors in benzoate, there's a significant reduction in hyperactive behavior when they got to remove these compounds, and then a significant increase in hyperactive behavior when they got the colorings in benzoate compared to getting the placebo. Now, of course, it could have been the colors and not the benzoate, but that's one of the problems. As little as we know about the effects of these individual additives, we know even less about what combinations of them can do. There's a large body of evidence suggesting toxicity from certain food colors, preservatives, sweeteners, and emulsifiers, in part sometimes through our gut microbiome. Now, industry apologists argue that the Food and Drug Administration carefully evaluates food additives to make sure that they're safe. Of course, until they're not. In fact, to show the system works, they cite the removal of six carcinogenic artificial flavors in 2018 Artificial flavors that had been in the food supply approved for safety since 1964 So, we were exposed more than 50 years before they were banned, and that's their example of the system working.