Ultra-Processed People: Chapter 3
Disclaimer: This series is a review and summary of Ultra-Processed People by Chris van Tulleken. Unless otherwise noted, all research discussed comes from the author's presentation of the evidence. I have not independently reviewed the original scientific studies referenced in the book. My commentary reflects my interpretation of the book and should not be taken as an independent evaluation of the underlying research.
Chapter 3 - “Sure, ultra-processed food sounds bad, but is it really a problem?”
In this chapter, Chris interviews Kevin Hall for a more in-depth look on the study he performed that was referenced in the previous chapter. This was the study where 20 people ate a diet of UPF for two weeks and then switched to a non-processed diet. Both diets contained the same amounts of macronutrients. The question to solve was: does the processing matter? Or is it just a matter of nutrients within the diet? (Van Tulleken 56-57).
The non-processed food was prepared by in-house chefs and was comprised of things like spinach salads with chicken breast, apple slices, sunflower seeds, and grapes. The vinaigrette dressing was made with olive oil, fresh squeezed lemon juice, apple cider vinegar, ground mustard seed, black pepper and salt. This was compared to the UPF meal of a spam sandwich with diet lemonade. Remember, the participants could eat as much as they wanted to represent a real-life scenario where people have access to as many calories as they want. The participants ended up rating the meals almost identically in terms of familiarity and pleasantness. (Van Tulleken 57).
The results? On the UPF diet, participants ate an average of 500 calories more per day than those on the unprocessed diet. They also gained weight in accordance to that surplus. The people that ate the unprocessed diet, lost weight, even though they could still eat as much as they wanted. Chris explains that due to the “familiarity and pleasantness” ranking from before, it’s not that the UPF was more delicious, but there was some other factor driving the UPF group to overeat. The UPF in the study was also void of its typically aggressive marketing, meaning the effect of the UPF was probably underestimated yet. (Van Tulleken 57-58).
The team behind the study addressed the cost between supplying the UPF and preparing the unprocessed foods. It cost Hall’s team about $100/week to supply 2,000 calories per day of UPF, while the cost for the unprocessed diet was about $150. Not only was there a cost increase, but the meals were prepared by professional chefs who can make any combination of ingredients taste good. For a regular person, you have a significant time investment on top of the cost, and risk that the food you prepare doesn’t turn out.
Next, Chris takes on many of the correlations between UPF and health in general. He references a study of more than 100,000 people that was published in the British Medical Journal which suggested a link between UPF and cancer. In summary, they found that with a 10% increase of the proportion of UPF in the diet, there was roughly a 10% increase in the overall risk of cancer and the risk of breast cancer. Now was this because of the nutrient-bled UPF, or was it because of the processing itself? “Their finding was that, even after adjusting for nutritional content in this way, the result remained statistically significant.” In a separate study, one conducted by a Chinese group who analyzed data from 92,000 Americans, they found that increased consumption of UPF is associated with increased death from cardiovascular disease. The conclusion of these correlations was this: “UPF isn’t harmful simply because it’s fatty, salty and sugary”. Another quote from Chris, “It is the ultra-processing, not the nutritional content, that’s the problem.” (Van Tulleken 60-61).
Here is the laundry list of other things increased UPF intake is strongly associated with increased risk of (Van Tulleken 62):
death - so called all-cause mortality
cardiovascular disease (strokes and heart attacks)
cancers (all cancers overall, as well as breast cancer specifically)
type 2 diabetes
high blood pressure
fatty liver disease
inflammatory bowel disease (ulcerative colitis and Chrohn’s disease)
depression
worse blood fat profile
frailty (as measured by grip strength)
irritable bowel syndrome and dyspepsia (indigestion)
dementia
Next, there is a whole critique of the NOVA system in which food is scored (something I haven’t broken down in this blog series, but is extensively covered in the book, so please read it), but Chris outlines on page 64 that the critics of this system all have significant conflicts of interest. It exposes how deep you can dig to find out who funds some of these retorts against studies showing harmful UPF effects. (Van Tulleken 64-65).
Another paper critiquing NOVA is credited to a woman named Julie Miller Jones, with a statement at the end saying, “The concept and much background for the present paper resulted from work of the Ad Hoc Joint Food and Nutrition Science Solutions Task Force.” According to Chris, this “Task Force” represented the Academy of Nutrition and Dietetics, who have sponsors that include major nutrition companies like Abbott and BENEO (which is a subsidiary of the largest sugar company in the world). The “Task Force” also represented the American Society for Nutrition, who has sustaining partners such as Abbott, Danone, Mars, Mondelez, Nestlé, PepsiCo, and General Mills. Chris also adds that Julie Miller Jones, even if she was the sole author, wouldn’t have been “without reproach”. She is a scientific advisor to companies like Quaker Oats and the Campbell Soup Company. (Van Tulleken 65).
