By Wayne Persky
Ultra-processed foods have received a lot of bad press, lately.
Over the past few years, we've seen the publication of numerous research articles concluding that ultra-processed foods in general, are-harmful for our health.. Some countries have already modified their dietary guidelines to recommend eating less ultra-processed foods and they have policies in place regarding the use of ultra-processed foods in school lunch programs, but to date, the US has made precious few changes in their policies regarding the use of ultra-processed foods (Pomeranz, Mande, and Mozaffarian, 2023).1
US citizens are beginning to choose healthier food products.
Americans have begun seeking out commercially processed foods that contain fewer preservatives and unnecessary additives, whenever alternatives are available. And they've begun to rediscover that eating healthy, whole foods, and reducing their intake of grains, and ultra-processed foods in general, conveys valuable health benefits that lead to a reduction in health problems such as obesity, diabetes, hypertension, and cardiovascular issues. So now that Americans are gradually beginning to get their diets back on track, what does the United States Department of Agriculture (USDA) do?
USDA scientists suggest we eat more ultra-processed foods.
In a recently published study, researchers associated with the Agricultural Research Service (ARS) of the USDA used their own guidelines, based on their current "MyPyramid" concept of dietary guidelines to "prove/imply" that a diet that includes ultra-processed foods (that provide 91% of the total calories), can be considered to be a healthy diet (Hess, et al., 2023).2 And the justifications for this claim, as pointed out by Julie Hess, a "research nutritionist" at the Grand Forks Human Nutrition Research Center, in an ARS online article, was based on the following statement (Agricultural Research Service. 2023, July 11):3
According to current dietary recommendations, the nutrient content of a food and its place in a food group are more important than the extent to which a food was processed.
Really? Where's the scientific evidence for that claim?
A search of the scientific literature on the Internet will not locate any current research that justifies this claim. The claim appears to be simply a rephrasing of their existing position on nutrition, suggesting that it's primarily an attempt to use smoke and mirrors to validate their claim.
In fact, a search of the literature reveals the absurdity of that claim.
A search of the Internet uncovers numerous research projects that resulted in the opposite conclusion. Every legitimate study out there appears to verify that eating whole foods provides more health benefits than eating ultra-processed foods, taking supplements, or using any other method to maintain long-term health.'
Specifically, USDA scientists claim that ultra-processed foods can be used to build a healthy diet.
Should we believe them? Our position is (and has always been) that whole foods are always a more
healthful choice than processed foods, and they're especially a more healthful choice than highly
processed foods. As microscopic colitis (MC) patients, we've learned by experience that whole, safe,
foods are by far the best selections we can make when choosing a diet to recover from this disease. Is it time to reconsider that policy, and modify our diet, based on USDA's new recommendation?
For over 100 years,
the USDA has been making dietary recommendations for Americans. And for decades, the earlier
recommendations were pretty simple, seemingly logical guidelines. But in January of 1977, the
McGovern committee (officially known as the United States Senate Select Committee on Nutrition and
Human Needs) issued their recommendations, and those recommendations changed the course of
USDA dietary guidelines.
So USDA went back to the drawing board.
In February of 1980, USDA, and the US Department of Health and Human Services (HHS)
collaborated to issue guidelines based on those recommendations. The new guidelines were named
Nutrition and Your Health: Dietary Guidelines for Americans. The McGovern committee's
recommendations were specifically designed to combat health issues such as atherosclerosis, certain
cancers, diabetes, heart disease, hypertension, obesity, and stroke. So presumably, the new USDA
guidelines were designed to implement those recommendations, and improve the general health of
the US population.
How well has that worked?
Over four decades have passed since the USDA issued those guidelines, and not only have those
health issues not been resolved, but virtually all of them have become worse. And some of them have
reached extremely worrisome levels. It's painfully obvious that USDA's dietary recommendations are
not resolving the health problems of US citizens, as per the McGovern committee's recommendations.
And these health problems exist worldwide, not just in the US.
For example , based on a huge worldwide study, a recent article in the Lancet shows that in 2021, there were 529 million people (worldwide) living with diabetes (GBD 2021 Diabetes Collaborators, 2023).4 The highest rates of diabetes can be found in the Mideast and North Africa, and in the central and south Pacific island area, including Australia and New Zealand. The study projects that by 2050, 1.31 billion people will be living with diabetes.
Numerous research articles dispute the ARS researchers' claim.
An article published on Medical Xpress, based on information from New York University, contains the
following quoted information, which specifically disputes the claim made by Hess in the ARS article,
claiming that the extent of processing doesn't matter (New York University, 2023, July 20):5
After decades of focusing on single nutrients such as protein, fat, and carbohydrates in nutrition science and food policy, a growing body of evidence shows that there is more to dietary quality than nutrients. "It's clear that the extent of processing of a food can influence its health effects, independent of its food ingredients or nutrient contents. Ultra-processed foods generally contain 'acellular nutrients' — nutrients lacking any of the natural intact food structure of the source ingredient—and other industrial ingredients and additives that together can increase risk of weight gain, diabetes, and other chronic diseases," said study co-author Dariush Mozaffarian, the Jean Mayer Professor of Nutrition at the Friedman School of Nutrition Science and Policy at Tufts.
Ultra-processed foods are known to increase cancer risk.
In a recent online article published on Medical Xpress, Dr. Dawn Mussallem, of the Mayo Clinic points
out that the average American's diet includes at least 63% ultra-processed foods (Mayo Clinic, 2023,
July 26).6 That's probably a much higher percentage than most people realize. Furthermore, she points out that research shows that ultra-processed foods are associated with colorectal, ovarian, and breast cancer. She also points out that not only do ultra-processed foods increase the risk of developing cancer, but studies show that after cancer is diagnosed, ultra-processed foods increase the mortality risk associated with those malignancies.
And ultra-processed foods increase the risk of developing diabetes.
In a study conducted in Italy that included 1,065 individuals who had type II diabetes, subjects were
studied up to 11.6 years (Bonaccio, et al., 2023).7 Diet was determined based on a 188 item food
frequency questionnaire. Researchers determined that higher ultra-processed food consumption was
associated with reduced survival, and higher mortality due to cardiovascular issues, and these results
were independent of diet quality. In other words, it didn't matter whether an individuals diet was
healthy, or unhealthy, the percentage of ultra-processed foods in the diet had the same effect (reduced survival, and increased mortality risk due to cardiovascular issues.
The average consumption of ultra-processed foods in the study cohort's diets was only 7.4%
(compared with the 63% rate for Americans). Of those in the highest quartile, females ate 10.5% or
more of ultra-processed food, and males ate 9% or more. Females in the lowest quartile ate less than
4.7% of ultra-processed foods and males ate less than 3.7%. Compared with the lowest quartile, those in the highest quartile had a hazard rate ratio of 1.70 for all cause mortality and 2.64 for cardiovascular associated mortality. The researchers noted that there was a linear dose-response relationship between ultra processed food intake, and both all cause mortality, and cardiovascular associated mortality.
Ultra-processed foods are associated with cognitive decline.
In a study published in JAMA Neurology, 10,775 individuals with a mean age (at the beginning of the
data collection) were followed for 6 to 10 years (Gonçalves, et al. 2023).8 The subjects of the study were divided into four groups, depending upon their consumption level of ultra-processed foods. Those in the top category had a 28% increased rate of global cognitive decline, and a 25% increased rate of executive function decline, when compared with those in the lowest category.
Why is eating whole foods so beneficial for good health?
According to published research, whole foods contain a combination of various nutrients, including
vitamins, minerals, fiber, and phytochemicals, which work together synergistically to provide
optimum health benefits. Several studies have shown that nutrients obtained from whole foods have
greater bioavailability, are more effectively absorbed, and better utilized by the body, compared with
ingesting isolated nutrients (as in the case of supplements or additives in highly processed foods).
A study published in the Journal of nutrition, for example, found that eating whole apples had a
stronger antioxidant effect than taking an equivalent amount of isolated antioxidants from
supplemental sources (or additives in processed foods). Whole fruits and vegetables contain
phytochemicals which have been associated with reduced risk of chronic diseases such as cancer and
heart disease. Many of these nutrients are partially (and in some cases totally) destroyed when foods
are highly processed. Manufacturers may attempt to add them back in the form of supplemental
additives, but as noted above, this tends to be far inferior to eating whole foods.
Why eating whole foods is a much better choice than drinking the same foods in smoothies.
For decades, smoothies have been promoted by most fitness experts and various other self-appointed health authorities as a way to boost our nutritional intake with a quick and convenient nutrient-dense meal or snack. And as microscopic colitis (MC) patients, many of us have used smoothies because we were convinced that they're an easier way to digest various foods, while boosting our nutrient intake. Because of the processing, we believed that all that fiber in fruit and vegetables would be less likely to irritate our digestive systems. And to some extent, it probably is, because the processing eliminates any problems due to inadequate chewing.
Is it just me?
There seems to be an endless parade of research proving that what we once thought was good for us, is actually bad for us, and what we thought was bad for us, is not so bad after all. And although some of these research projects involve long-held medical beliefs, many are associated with nutrition and health.
Alas, research evidence shows that smoothies are not nearly as healthful as we were led to believe.
According to a recent Medical Express article, a research study published in Food and Function in
2019 specifically addressed the question of whether eating fruits, vegetables, nuts, and seeds in a
smoothie is as healthful and nutritious as eating them. (Intermill, 2023, August 13).9 In this study,
researchers had subjects in the study ingest foods in three different forms, solid, semisolid, and liquid. All three forms had identical nutrient content. Then the researchers utilized specific blood tests on the human subjects to determine how each form affected digestion.
The liquid form caused elevated blood triglycerides.
Interestingly, they found that when compared with eating whole foods, the liquid form caused
elevated triglycerides in the study subjects' blood (which is undesirable, obviously). They also found
that the liquid food caused reduced feelings of fullness and satisfaction. And as the article points out,
previous studies have shown that peanut butter (ground peanuts) have been shown to cause elevated triglycerides when compared with eating whole peanuts.
As most of us are aware,
elevated triglyceride levels can trigger inflammation, and they've been associated with increased
cardiovascular risks, and increased risk of developing type II diabetes. And as MC patients, none of us
needs any increase in our inflammation level. And although the fiber in smoothies may be somewhat
easier to digest than fiber in whole foods, it's still there, so the overall advantage may be slight.
Is the recent increase in early-onset cancers merely a coincidence?
In a study of 562,145 people with early-onset cancer in the U.S., from 2010 to 2019, researchers found that the incidence of early-onset cancers increased substantially, and gastrointestinal cancers showed the greatest increase in early-onset cancers (Koh, et al., 2023).10 The researchers determined that the annual percentage change (APC) in early-onset cancer, between the years of 2010 to 2019, was 0.28%. During the same time period, the age standardized incidence rate of cancer for individuals who were50 years old and older, actually decreased at an APC rate of 0.87%. Could this trend be due to the fact that consumption of ultra-processed foods decreases with age, so that younger people are more likely to include larger amounts of ultra-processed foods in their diet (Baraldi, Martinez Steele, Canella, and Monteiro, (2918)?11
Inadequate protein intake leads to obesity.
As already noted, ultra-processed-foods tend to provide fewer beneficial nutrients for the human
body, relative to their listed nutrient content, when compared with whole foods. And importantly,
because they are primarily plant-based, ultra-processed foods in general don't provide adequate
protein for good health. This is especially true for gluten-free foods, because by eliminating wheat and most legumes from the options, the main plant-based sources of protein are also eliminated.
An Australian study shows how inadequate protein causes increased hunger.
The World Health Organization (WHO) has declared that the biggest threat faced by humanity is obesity. Recent research at the University of Sydney in Australia has shown that when protein intake is inadequate, the body compensates by expressing a need for additional food intake (University of Sydney, 2023, September 3).12 And in the case of ultra-processed-foods, that additional food primarily leans toward fats and carbohydrates, so it's no wonder that obesity is at epidemic levels today.
Most American men overestimate their health.
A recent survey by the Cleveland Clinic showed that although 81% of American men believe that
they're leading a healthy lifestyle, only 51% said that they eat a healthy diet, and 27% admit to spending more than 5 hours each day watching TV, on the average (Thompson, 2023, September 7).13 Thatmight be representative of many other people in the world today.
A significant number of research studies regarding the adverse health consequences of eating ultraprocessed foods have been published. And additional research shows that in recent decades, earlyfonset cancer, especially gastrointestinal cancer, is increasing. The general health of the citizens of the U. S. (and most developed countries) appears to be in a downward trend.
In view of this, and especially the generally declining health of Americans, there doesn't seem to be
any valid evidence in USDA's recommendations to eat more ultra-processed foods. To the contrary,
their position appears to be tenuous, at best, and disingenuous, at worst, because it clearly contradicts virtually all other published research regarding the healthfulness of eating ultra-processed foods.
Ultra-processed foods are definitely contraindicated for MC patients.
Ultra-processed foods in general contain far too many ingredients, far too many synthetically-produced ingredients (many of which are inherently risky), combined with over-processing. So as MC
patients, we certainly wouldn't want to alter our dietary selections to incorporate USDA scientists'
recommendations to add any ultra-processed foods to our diet.
What were they thinking?
One can't help but wonder — after such generally poor health performance of consumers who have
followed USDA's dietary guidelines over recent decades, and with the preponderance of evidence
revealing the health risks associated with eating ultra-processed foods, why would USDA publish
such a controversial article recommending that U.S. citizens eat more highly processed foods?
1 Pomeranz, J. L., Mande, J. R., And Mozaffarian, D. (2023). U.S. Policies Addressing Ultra-processed
Foods, 1980-2022. American Journal of Preventive Medicine (AJPM), Retrieved from
2 Hess, J. M., Comeau, M. E., Casperson, S., Slavin, J. L., Johnson, G. H., Messina, M., . . . Palmer, D.
G. (2023). Dietary Guidelines Meet NOVA: Developing a Menu for A Healthy Dietary Pattern Using
Ultra-Processed Foods. The Journal of Nutrition, Retrieved from
3 Agricultural Research Service. (2023, July 11). Scientists Build a Healthy Dietary Pattern Using
Ultra-Processed Foods. Retrieved from https://www.ars.usda.gov/news-events/news/researchnews/
4 GBD 2021 Diabetes Collaborators. (2023). Global, regional, and national burden of diabetes from
1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of
Disease Study 2021. The Lancet, Retrieved from
5 New York University. (2023, July 20). Ultra-processed foods largely missing from US food policy.
Medical Xpress, Retrieved from https://medicalxpress.com/news/2023-07-ultra-processed-foodslargely-
6 Mayo Clinic (2023, July 26). Is there a connection between ultra processed food and cancer? Medical
Xpress, Retrieved from https://medicalxpress.com/news/2023-07-ultraprocessed-food-cancer.html?
7 Bonaccio, M., Di Castelnuovo, A., Costanzo, S., Ruggiero, E., Esposito, S., Persichillo, M., . . . Licia
Iacoviello, L. (2023). Ultraprocessed food consumption is associated with all-cause and
cardiovascular mortality in participants with type 2 diabetes independent of diet quality: a
prospective observational cohort study. The American Journal of Clinical Nutrition, ISSN 0002-9165.
Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0002916523660253?via
8 Gonçalves, N. G., Ferreira, N. V., Khandpur, N., Steele, E. M., Levy, R. B., Lotufo, P. A., . . . Suemoto,
C. K. (2023). Association Between Consumption of Ultraprocessed Foods and Cognitive Decline.,
JAMA Neurology, 80(2), pp 142–150. Retrieved from
9 Intermill, B. (2023, August 13). On Nutrition: The form of food we eat may have more impact than
we think. Medical Xpress, Retrieved from https://medicalxpress.com/news/2023-08-nutrition-foodimpact.
10 Koh, B., et al. (2023). Patterns in Cancer Incidence Among People Younger Than 50 Years in the US,
2010 to 2019. JAMA Network Open, 6(8):e2328171. Retrieved from
11 Baraldi, L. G., Martinez Steele, E., Canella, D.S., and Monteiro, C. A. (2918). Consumption of ultraprocessed
foods and associated sociodemographic factors in the USA between 2007 and 2012:
evidence from a nationally representative cross-sectional study. BMJ Open, 8, e020574. Retrieved
12 University of Sydney. (2023, September 3). Growing evidence su
pports the protein leverage
hypothesis as a significant mechanism driving obesity, study finds. Medical Xpress, Retrieved from
13 Thompson, D. (2023, September 7). Survey shows American men are less healthy than they believe.
Medical Xpress, Retrieved from https://medicalxpress.com/news/2023-09-survey-american-menhealthy.