by wayne persky |
RSS Feed Some authorities have referred to ultra-processed foods as "a silent killer". How realistic is that opinion?
Ultra-processed foods have become a major part of our diet.
In recent years, the consumption of ultra-processed foods has surged, raising significant concerns among health professionals and researchers. These foods, characterized by their high content of additives and minimal nutritional value, are now a staple in the American diet. According to research from Florida Atlantic University (2024, February 20), nearly 60% of the average adult's diet and almost 70% of children's diets in the U.S. consist of ultra-processed foods.1 This shift in dietary habits could be the new "silent killer," akin to the unrecognized dangers of high blood pressure in previous decades, according to some authorities.
Exactly what are ultra processed foods?
Ultra-processed foods (UPFs) generally include food products that have undergone multiple industrial processes, and contain numerous added ingredients. Typically, they're significantly altered from their original state, and they include substances not commonly used in home cooking. They're often offered in highly convenient, ready to eat, or minimal preparation, forms. Despite the fact that they often have a high calorie content, most UPFs have a low level of essential nutrients. Common examples include snacks and baked goods, sugary drinks, frozen meals, prepackaged microwave dinners, sugary cereals, processed meats (such as sausages, hotdogs, chicken nuggets, deli meats, etc.), dairy-based desserts (such as ice cream, flavored yogurt, pudding cups, etc.), artificially sweetened products (such as sugar-free drinks and candies), bread and bakery products, and condiments and sauces.
The NOVA Classification System is used to rate UPFs.
Group 1 includes unprocessed or minimally processed foods (e.g., fresh fruits, vegetables, grains, meats).
Group 2 includes processed culinary ingredients (e.g., oils, butter, sugar, and salt).
Group 3 includes processed foods (such as canned vegetables, cheeses, freshly made bread).
Group 4 includes ultra-processed food and drink products (e.g., soft drinks, sweet or savory packaged snacks, reconstituted meat products, pre-prepared frozen dishes).
Various health risks have been associated with UPFs.
The extensive processing and the presence of artificial additives in UPFs have been linked to various adverse health outcomes, including obesity, diabetes, cardiovascular disease, and cancer. Additionally, for some people, digestive problems have been associated with the consumption of UPFs.
As the consumption of UPFs continues, our health is trending downward.
In the study mentioned above, health professionals urge a shift toward whole foods, and the reduction of the consumption of UPFs, pointing out that life expectancy in the US has declined for the first time in over a century, and the decline parallels the increasing rates of noncommunicable diseases that coincide with the rise in the consumption of UPFs. However, note that the decline in life expectancy also parallels other events, not the least of which was the disruption caused by Covid 19
UPFs also tend to have labeling problems.
The labeling on UPFs often misleads consumers about their healthfulness. Research from University College London (UCL) highlights some of these issues, revealing the complexities and potential misguidance problems in current food labeling systems (Dicken, Batterham, and Brown, 2024).2
The problems with the "traffic light" labeling system.
The primary problem with the labeling system used in some countries (using the U. K. as an example) is the front-of-package labeling (FOPL). The UK uses a "traffic light" system. Although this type of labeling is not mandatory, many food manufacturers choose to use it. This system uses red, amber, and green lights to indicate high, medium, and low levels of energy, fat, saturated fat, sugar, and salt, respectively. While this system aims to help consumers make healthier choices, it does not account for the degree of food processing, which is a significant oversight given the (alleged) health risks associated with UPFs.
Using the NOVA classification system, researchers at UCL compared the nutrient content and processing levels of foods to categorize foods into four groups: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. Their study, was published in the British Journal of Nutrition, and it yielded several noteworthy findings.
Using the NOVA classification system, researchers at UCL compared the nutrient content and processing levels of foods to categorize foods into four groups: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. Their study, was published in the British Journal of Nutrition, and it yielded several noteworthy findings.
Labels on UPFs typically:
1. Contain higher levels of unhealthy ingredients, including calories, fat, saturated fat, sugar, and salt, compared with minimally processed foods, and this often results in more red and fewer green traffic lights on their FOPL (which would suggest that the labeling system is working correctly).
2. Lead to misleading health perceptions. Although this doesn't apply to all UPFs, some UPFs may appear healthy based on their labeling despite being less nutritious than minimally processed foods, leading consumers to mistakenly believe that UPFs are healthy options.
3. Tend to overlap between nutritional content and processing, typically having a worse nutritional profile and FOPL score when compared with minimally processed foods. Even so, some UPFs still manage to receive favorable POPL scores, and that creates confusion.
Because the current labeling system generally fails to incorporate the degree of processing into its assessment, consumers are often misled. For example a low-fat yogurt might appear to be healthy due to its green traffic light regarding fat content, but it can still be high in sugar and heavily processed. The resulting complexity makes it difficult for consumers to make truly informed choices.
UPFs have been shown to cause dozens of health issues.
A recent online Medical Xpress article describes the findings of a study published by the British Medical Journal (BMJ) (2024, February 28).3 The study provides consistent evidence linking higher exposure to UPFs with an increased risk of 32 damaging health outcomes, including the ones mentioned above, and many others, such as major heart and lung conditions, mental health disorders, and early death.
The BMJ study conducted an umbrella review of 45 meta-analyses from 14 review articles, encompassing nearly 10 million participants. This comprehensive analysis revealed that higher consumption of UPFs is consistently associated with numerous adverse health outcomes. Some of the significant findings of that study include:
1. Higher intake of UPFs is linked to a 50% increased risk of cardiovascular disease-related death. This convincing evidence underscores the significant impact of these foods on heart health.
2. The study found a 48-53% higher risk of anxiety and common mental disorders among individuals with high UPF consumption. This association highlights the potential mental health implications of diets rich in ultra-processed foods.
3. There is a 12% greater risk of developing type 2 diabetes associated with high UPF intake. The study also found highly suggestive evidence of a 40-66% increased risk of obesity and related metabolic disorders.
4. High consumption of UPFs is associated with a 21% greater risk of death from any cause. This finding is particularly concerning as it suggests a broad and significant impact on overall mortality.
5. The study also indicated increased risks of various other issues, including sleep problems (22%), depression (22%), and several gastrointestinal and cardiometabolic conditions, although the evidence for these associations remains limited.
6. Various characteristics of UPFs lead to various health issues. For example, the high levels of added sugars, fats, and salts can lead to obesity, hypertension and diabetes. Additionally the additives and preservatives used in UPFs can disrupt gut microbiota, possibly contributing to various gastrointestinal and inflammatory conditions.
The BMJ study conducted an umbrella review of 45 meta-analyses from 14 review articles, encompassing nearly 10 million participants. This comprehensive analysis revealed that higher consumption of UPFs is consistently associated with numerous adverse health outcomes. Some of the significant findings of that study include:
1. Higher intake of UPFs is linked to a 50% increased risk of cardiovascular disease-related death. This convincing evidence underscores the significant impact of these foods on heart health.
2. The study found a 48-53% higher risk of anxiety and common mental disorders among individuals with high UPF consumption. This association highlights the potential mental health implications of diets rich in ultra-processed foods.
3. There is a 12% greater risk of developing type 2 diabetes associated with high UPF intake. The study also found highly suggestive evidence of a 40-66% increased risk of obesity and related metabolic disorders.
4. High consumption of UPFs is associated with a 21% greater risk of death from any cause. This finding is particularly concerning as it suggests a broad and significant impact on overall mortality.
5. The study also indicated increased risks of various other issues, including sleep problems (22%), depression (22%), and several gastrointestinal and cardiometabolic conditions, although the evidence for these associations remains limited.
6. Various characteristics of UPFs lead to various health issues. For example, the high levels of added sugars, fats, and salts can lead to obesity, hypertension and diabetes. Additionally the additives and preservatives used in UPFs can disrupt gut microbiota, possibly contributing to various gastrointestinal and inflammatory conditions.
UPFs are associated with an increased all cause mortality risk.
A 30-year study conducted by researchers in the United States and published in The BMJ highlights a concerning link between high consumption of UPFs and an increased risk of early death. The study, which spanned over three decades, tracked the health outcomes of 74,563 female registered nurses and 39,501 male health professionals (Fang, et al., 2024).4 Participants were initially free of cancer, cardiovascular diseases, and diabetes. Every two years, they provided updates on their health and lifestyle habits, and every four years, they completed detailed food questionnaires. This extensive follow-up allowed researchers to gather robust data on the dietary patterns and health outcomes of the participants.
48,193 people died during the study.
During the study period, over 48,000 deaths were recorded, including deaths due to cancer, cardiovascular diseases, respiratory diseases, and neurodegenerative diseases. The researchers found that higher consumption of ultra-processed foods was linked to a slightly higher risk of all-cause mortality. Specifically, participants in the highest quarter of UPF consumption (averaging seven servings per day) had a 4% higher risk of total deaths and a 9% higher risk of other deaths, including an 8% higher risk of neurodegenerative deaths, compared to those in the lowest quarter (averaging three servings per day). While this doesn't appear to be a relatively high increased risk, it's enough to be significant, by medical standards.
Certain UPFs were strongly associated with higher mortality rates.
1. Ready to eat meat, poultry, and seafood-based products showed the strongest and most consistent associations with increased mortality.
2. Both sugar sweetened and artificially sweetened beverages were linked to higher all-cause mortality.
3. Consumption of dairy based desserts was also associated with an increased risk of death.
4. Ultra-processed breakfast foods contributed to the higher mortality risk as well.
The study highlighted that while UPFs are often high in added sugars, fats, and salts, they lack essential nutrients like vitamins and fiber, which may contribute to their adverse health effects. Interestingly, no significant associations were found between UPF consumption and deaths due to cancer or cardiovascular diseases.
And that particular finding raises a very troubling point.
Cancer and cardiovascular disease are listed at the very top of the list of the most common causes of death (at least in the US) these days. If the study found that UPFs don't contribute to the risk of the most common causes of mortality, how can they possibly be associated with higher mortality risks? In that case, higher mortality risk could only happen if the consumption of UPFs leads to rare, or at least uncommon fatal health issues.
As unlikely as that might be, clearly this raises a valid question about the choice of statistical methods used to analyze the data in these research studies. In other words, the study results appear to be confounded (at least, in my opinion). That doesn't necessarily mean that the study findings are invalid, but it certainly raises some doubts about their statistical value.
As unlikely as that might be, clearly this raises a valid question about the choice of statistical methods used to analyze the data in these research studies. In other words, the study results appear to be confounded (at least, in my opinion). That doesn't necessarily mean that the study findings are invalid, but it certainly raises some doubts about their statistical value.
In another study, UPFs have been associated with insomnia.
A new study published in the *Journal of the Academy of Nutrition and Dietetics* suggests a significant association between the consumption of ultra-processed foods (UPFs) and chronic insomnia, adding to the growing body of evidence on the negative health impacts of these foods (Duquenne, et al., 2024).5 The study, led by Marie-Pierre St-Onge, at Columbia University, utilized data from the NutriNet-Santé study, which included over 39,000 French adults. Participants provided detailed dietary records and information on insomnia symptoms every six months from 2013 to 2015. The research aimed to explore the link between UPF consumption and chronic insomnia, independent of sociodemographic, lifestyle, diet quality, and mental health factors. In the study,
1. On average, UPFs accounted for 16% of the participants' total daily energy intake.
2. About 20% of participants reported chronic insomnia.
3. Individuals with chronic insomnia consumed a higher percentage of their daily energy from UPFs.
The study found a statistically significant association between higher UPF intake and increased odds of chronic insomnia. The risk was slightly higher in males than females, with an odds ratio of 1.09 for males and 1.05 for females per a 10% increase in UPF intake. But again, this appears to be a rather modest association, rather than a truly significant effect.
1. On average, UPFs accounted for 16% of the participants' total daily energy intake.
2. About 20% of participants reported chronic insomnia.
3. Individuals with chronic insomnia consumed a higher percentage of their daily energy from UPFs.
The study found a statistically significant association between higher UPF intake and increased odds of chronic insomnia. The risk was slightly higher in males than females, with an odds ratio of 1.09 for males and 1.05 for females per a 10% increase in UPF intake. But again, this appears to be a rather modest association, rather than a truly significant effect.
Summarizing
Numerous research studies have found significant health risks associated with ultra-processed foods (UPFs), and because UPFs are a major part of the American diet, and they're commonly characterized by high levels of additives, and poor nutritional value, and they've been linked to health issues such as obesity, diabetes, cardiovascular disease, cancer, mental health disorders, and early death, how important is it for us to minimize their consumption?
Putting this all into perspective, it appears that the evidence, although significant, is less than overwhelming, or even compelling, when compared with research regarding health risks in general Yes, there's a large body of evidence that suggests that UPFs probably increase the risk of developing health issues, but the evidence appears to be relatively modest — reminiscent of the old saying about a lot of tempest in a teapot.
The bottom line seems to be that yes, most Americans would be significantly better off if they avoided, or at least minimized UPFs in their diet, but until better evidence becomes available it's rather difficult to conclude that UPFs are having truly substantial effects on our overall health, let alone acting as a "silent killer", except possibly in extreme cases.
Putting this all into perspective, it appears that the evidence, although significant, is less than overwhelming, or even compelling, when compared with research regarding health risks in general Yes, there's a large body of evidence that suggests that UPFs probably increase the risk of developing health issues, but the evidence appears to be relatively modest — reminiscent of the old saying about a lot of tempest in a teapot.
The bottom line seems to be that yes, most Americans would be significantly better off if they avoided, or at least minimized UPFs in their diet, but until better evidence becomes available it's rather difficult to conclude that UPFs are having truly substantial effects on our overall health, let alone acting as a "silent killer", except possibly in extreme cases.
References
1. Florida Atlantic University. (2024, February 20). "Could ultra-processed foods be the new 'silent' killer?." ScienceDaily. ScienceDaily, Retrieved from https://www.sciencedaily.com/releases/2024/02/240220144443.htm
2. Dicken. S. J., Batterham, R. . L, and Brown, A. (2024). Nutrients or processing? An analysis of food and drink items from the UK National Diet and Nutrition Survey based on nutrient content, the NOVA classification and front of package traffic light labelling. British Journal of Nutrition. Published online, 1-14. Retrieved from https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/nutrients-or-processing-an-analysis-of-food-and-drink-items-from-the-uk-national-diet-and-nutrition-survey-based-on-nutrient-content-the-nova-classification-and-front-of-package-traffic-light-labelling/30C871960D54E76E292BC1DE97FC3A00
3. British Medical Journal. (2024, February 28). Consistent evidence links ultra-processed food to over 30 damaging health outcomes. Medical Xpress, Retrieved from https://medicalxpress.com/news/2024-02-evidence-links-ultra-food-health.html?utm_source=nwletter&utm_medium=email&utm_campaign=daily-nwletter
4. Fang, Z., Rossato, S. L., Hang, D., Khandpur, N., Wang, K., Lo, C., . . . Song, M. (2024). Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study. British Medical Journal, Retrieved from https://www.bmj.com/content/385/bmj-2023-078476
5. Duquenne, P., Capperella, J., Fezeu, L. K., Srour, B., Benasi, G., Hercberg, S., . . . St-Onge, M-P. (2024). The association between ultra-processed food consumption and chronic insomnia in the NutriNet-Santé Study. Journal of the Academy of Nutrition and Dietetics, Retrieved from https://www.jandonline.org/article/S2212-2672(24)00094-7/fulltext#%20
