Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / Ultra-Processed Foods: What they are and whether we should worry

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Ultra-Processed Foods: What they are and whether we should worry · Wellness, Actually with Emily Oster & Perry Wilson, MD

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  Speaker 1: This is parent Data. I'm Emily Oster today on parent Data.
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  Speaker 1: We're trying something new, which is actually something old. I'm
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  Speaker 1: going to read you an article that we published in
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  Speaker 1: the parenta newsletter everyone loves being read to, so you
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  Speaker 1: can consider this your parent Data audiobook. And I chose
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  Speaker 1: this article to start with because ultraprocessed.
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  Speaker 2: Foods are everywhere.
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  Speaker 1: They're everywhere in our diets, but they're also everywhere in
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  Speaker 1: the popular discourse. What we want to do is to
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  Speaker 1: look at how food processing impacts your health.
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  Speaker 3: We know they are not the healthiest, but ultraprocessed foods
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  Speaker 3: are quick, easy, and tasty.
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  Speaker 1: Ultra process foods include those that are high in sugars
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  Speaker 1: and fatsye, candy bars and ice cream and potato chips.
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  Speaker 2: Oh my, ultra processed foods one of my favorites. Maybe
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  Speaker 2: as addictive as smoking.
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  Speaker 3: Americans are among the biggest consumer of ultraprocessed foods in
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  Speaker 3: the world. In fact, ultra processed foods make up more
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  Speaker 3: than half of an adult's diet and two thirds of
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  Speaker 3: a child's diet.
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  Speaker 1: It's a place where I do a lot of research,
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  Speaker 1: I do a lot of thinking, and I think a
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  Speaker 1: lot of our discourse gets really confused, and we need
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  Speaker 1: a dose of reality and a dose of understanding to
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  Speaker 1: be able to process all of the many, many panic
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  Speaker 1: headlines that you're probably seeing. So without further ado ultraprocessed foods,
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  Speaker 1: what they are and whether we should worry. There is
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  Speaker 1: nothing in the world of nutrition more confusing than ultraprocessed foods.
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  Speaker 1: Seemingly every week there is a new headline about the
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  Speaker 1: dangers of ultra processed foods, and there are links to
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  Speaker 1: things like heart disease, dementia, and death. Articles ask things
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  Speaker 1: like how can I spot an ultra processed food? On
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  Speaker 1: the flip side, there are plenty of people who will
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  Speaker 1: claim this is blown. A recent podcast episode in My
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  Speaker 1: feed was entitled why ultra processed foods save family dinners?
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  Speaker 1: Making this more confusing, there are foods that seemed designed
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  Speaker 1: for health that fall in this category. For example, protein powder.
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  Speaker 1: Getting enough protein is all the rage these days. People
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  Speaker 1: are trying to hit one hundred grams of protein a
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  Speaker 1: day or more. This is actually not that easy to do.
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  Speaker 1: It is made a lot easier with protein powder. As
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  Speaker 1: a result, you see many people who appear quite healthy
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  Speaker 1: consuming these products daily, but these are ultra processed, so
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  Speaker 1: maybe you should avoid them, But then how exactly are
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  Speaker 1: you going to get those hundred grams of protein? This
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  Speaker 1: brings up the more general question what exactly is the
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  Speaker 1: concern here? Is the processing itself a problem or the
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  Speaker 1: nutrient profile? The whole discourse is a mess, and is
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  Speaker 1: especially problematic for parents, since case a lot of the
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  Speaker 1: foods our kids love, nuggets, mac and cheese are in
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  Speaker 1: this category. Are we ruining them? This whole thing is
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  Speaker 1: much much more understandable with information and data, So let's
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  Speaker 1: take a look.
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  Speaker 2: What is an multrassed food?
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  Speaker 1: The idea of ultra processed foods comes from a system
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  Speaker 1: called the Nova classification, developed in two thousand and nine
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  Speaker 1: by researchers in Brazil. This group proposed that foods be
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  Speaker 1: classified in four categories. One unprocessed or minimally processed Foods
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  Speaker 1: that are either unprocessed or have undergone only minimal processing
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  Speaker 1: like crushing or freezing, think eggs, milk, plain fruits and vegetables,
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  Speaker 1: plain yogurt, spices. Two processed culinary ingredients foods derived from
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  Speaker 1: group one. Foods through simple processes olive, oil, salt, sugar.
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  Speaker 1: This group is mostly seasonings.
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  Speaker 2: Three processed foods.
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  Speaker 1: Simple food products made by combining group one and two ingredients,
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  Speaker 1: things like cheese and bread, salted nuts, dried fish. Four
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  Speaker 1: Ultra processed foods foods that are made with industrial processing techniques,
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  Speaker 1: often involving the addition of products that are not in
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  Speaker 1: groups one or two or have no particular nutritional value.
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  Speaker 1: What group any individual food is in is not always obvious.
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  Speaker 1: In writing this, I got curious about whether my favorite snack,
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  Speaker 1: chomps turkey sticks are considered ultra processed. I wasn't able
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  Speaker 1: to get a straight answer. Reddit seems to think no,
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  Speaker 1: but there was some confusion. In general, you cannot find
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  Speaker 1: a list of these foods. When researchers classify foods into categories,
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  Speaker 1: they do it by hand or with some machine learning approaches.
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  Speaker 1: What is it about ultraprocessing? Visiting this is a core question.
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  Speaker 1: Why are we focused on ultraprocessing? In particular? The idea
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  Speaker 1: for the classification came out of observations by the researchers
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  Speaker 1: that there was a link between health and eating patterns
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  Speaker 1: in Brazil, and in particular, a diet heavy in foods
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  Speaker 1: that were highly processed appeared to be linked with.
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  Speaker 2: Worse health outcomes.
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  Speaker 1: The researchers wanted a way to summarize these dietary patterns
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  Speaker 1: that would be amenable to analysis, so they came up
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  Speaker 1: with this system. This classification has been widely used for research,
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  Speaker 1: probably because it's fairly simple to understand and because some
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  Speaker 1: kind of classification like this is necessary to do research
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  Speaker 1: on diet. There is a lot of interest in linking
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  Speaker 1: dietary patterns to health outcomes. If you want to do
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  Speaker 1: research on that topic, you need a way to define
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  Speaker 1: healthy versus unhealthy diets. The problem is that healthy diets
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  Speaker 1: can be a bit like what a Supreme Court justice
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  Speaker 1: once said about pornography, I know it when I see it.
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  Speaker 1: In other words, if I showed you two diets, you
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  Speaker 1: could probably tell me which is the one you thought
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  Speaker 1: was healthy, But actually translating.
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  Speaker 2: That to data is tough. There are a lot of.
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  Speaker 1: Ways to do this, and what researchers really like is
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  Speaker 1: a way that other people have also used, because then
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  Speaker 1: it's easy to defend your own use. This NOVA classification
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  Speaker 1: started getting used, and then it became the classification. The
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  Speaker 1: reality is that this grouping is one of various approaches
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  Speaker 1: that might have been roughly equivalent the share of a
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  Speaker 1: diet that is made up of ultraprocessed foods is positively
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  Speaker 1: correlated with sugar and fat in the diet and negatively
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  Speaker 1: correlated with vegetable and fruit consumption. There are nutrient based indices,
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  Speaker 1: like the USDA's Healthy Eating Index that are also.
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  Speaker 2: Very highly correlated.
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  Speaker 1: The fact that the index that has become popular is
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  Speaker 1: focused on the processing nature of the food is almost accidental.
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  Speaker 1: You could have focused on sugar content or the amount
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  Speaker 1: of vegetables in the diet and classified individuals in almost
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  Speaker 1: exactly the same groups. In fact, there may be nothing
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  Speaker 1: special about the processing part of the ultra processing. If
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  Speaker 1: the classification had been organized differently, we might be more
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  Speaker 1: focused on sugar or something else. Way correlations in the area.
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  Speaker 1: There is a tremendous amount of correlational evidence that the
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  Speaker 1: share of the diet made up of ultra processed foods
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  Speaker 1: is associated with poor health outcomes. There are many meta
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  Speaker 1: analyzes you can see at least one linked in the
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  Speaker 1: article on parentata dot org. These meta analyzes are of
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  Speaker 1: studies that compare health for people who eat more versus
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  Speaker 1: less ultraprocessed food Higher consumption of ultraprocessed foods is associated
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  Speaker 1: with obesity, cardiovascular disease, dementia, mental health, and mortality, among
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  Speaker 1: other things.
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  Speaker 2: Pretty much any bad health.
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  Speaker 1: Outcome you can identify, it's more common if you eat
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  Speaker 1: more ultraprocessed foods. There are two core issues in interpreting
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  Speaker 1: these data. First, going back to the discussion before, there
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  Speaker 1: is really no reason to think that the problem is
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  Speaker 1: necessarily processing. You'd see these correlations with different ways to
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  Speaker 1: measure a healthy diet. Second, it is difficult or impossible
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  Speaker 1: to separate out correlation and causation. Consumption of a higher
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  Speaker 1: share of ultraprocessed food is associated with lower income, less education,
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  Speaker 1: less exercise, more smoking, etc. It is difficult or impossible
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  Speaker 1: to separate these other factors from food. In fact, the
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  Speaker 1: motivation for developing the NOVA classification was an observation about
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  Speaker 1: differences in diet and in health between socioeconomic.
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  Speaker 2: Groups in Brazil.
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  Speaker 1: My bottom line is that I really do not think
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  Speaker 1: we can learn anything either worrisome or reassuring from these studies.
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  Speaker 1: Randomize evidence often sus Although most of the literature on
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  Speaker 1: ultraprocessed foods is not good, there is one study that
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  Speaker 1: I would call out as extremely informative, which I think
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  Speaker 1: is key to understanding a lot of the data. The
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  Speaker 1: study is entitled Ultra Processed Diets Cause Excess Calorie Intake
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  Speaker 1: and Weight Gain and Inpatient Randomized Control Trial of ad
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  Speaker 1: Libidium food ding WHEW. This is a randomized study of
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  Speaker 1: twenty individuals who were brought into an inpatient board. They
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  Speaker 1: were randomized into one of two diets, one that was
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  Speaker 1: focused on ultra processed foods and one that was focused
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  Speaker 1: on less processed foods. All meals were provided and the
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  Speaker 1: total calories and macronutrients were matched, meaning the two groups
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  Speaker 1: were each provided with the same number of calories per
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  Speaker 1: day with a similar mix of carbohydrates, fat, and protein.
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  Speaker 1: The researchers measured how many calories they actually consumed. If
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  Speaker 1: you're curious, you can see pictures of the diets in
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  Speaker 1: the paper. To give you an example, on day two
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  Speaker 1: in the ultra Processed diet, dinner is a chicken salad
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  Speaker 1: sandwich made with canned chicken pickle, relish, mayonnaise, and white bread,
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  Speaker 1: peaches canned in heavy syrup, cookies, fig newtons, and five
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  Speaker 1: cups of diet Crystal Light lemonade with neutro source fiber.
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  Speaker 1: Some of these are so gross, like this, it's really.
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  Speaker 2: The like lemonade that gets you in the unprocessed menu.
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  Speaker 1: On day three, dinner is a beef roast with couscous,
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  Speaker 1: fresh squeeze, lemon juice, garlic and olive oil, green beans,
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  Speaker 1: a beautiful side salad with green leaf, lettuce, cucumber and tomatoes,
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  Speaker 1: a vinaigrette with olive oil, and a black bean hummus
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  Speaker 1: cooked from dried beans, garlic, sweet peppers, olive oil, lemon juice, cumin,
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  Speaker 1: chili powder, and baby carrots. Looking them over, probably the
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  Speaker 1: most notable thing is the enormous difference in vegetables and fruit,
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  Speaker 1: which are more or less completely absent from the ultra
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  Speaker 1: processed diet, minus some sad canned green beans. Also, the
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  Speaker 1: ultraprocessed diet has an enormous amount of diet crystal light
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  Speaker 1: with added fiber of to five cups per meal, which
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  Speaker 1: I'm not sure what to make of this.
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  Speaker 2: The images are.
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  Speaker 1: Actually a good illustration of one of the points above.
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  Speaker 1: If you looked at these meals, you'd find many many
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  Speaker 1: ways to categorize their differences, processing being only one of them.
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  Speaker 1: The core finding of the study is that people consume
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  Speaker 1: more calories an average of five hundred and eight more
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  Speaker 1: per day on the ultraprocessed diet. That is an enormous difference,
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  Speaker 1: enough that they gained a notable amount of weight in
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  Speaker 1: the two week study. It is not completely clear why,
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  Speaker 1: but there are at least two reasonable theories. One is
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  Speaker 1: that many ultraprocessed foods are literally designed to make you
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  Speaker 1: want to eat more of them, so people may overeat.
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  Speaker 1: The second is that fruits and vegetables make you feel
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  Speaker 1: fuller because they contain a lot of fiber. Most of
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  Speaker 1: the ultraprocessed fiber was in that diet lemonade, which people
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  Speaker 1: might not have consumed much of. The additional data on
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  Speaker 1: hunger and fullness suggests that both groups felt similarly satisfied,
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  Speaker 1: which may be more consistent with the second story than
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  Speaker 1: with the over eating idea. Regardless of the reason, this
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  Speaker 1: paper leads us to a very simple conclusion. To the
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  Speaker 1: degree that there is a causal link with health, the
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  Speaker 1: problem seems to be that these foods encourage people to
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  Speaker 1: eat excessive calories. That excessive consumption of calories puts people
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  Speaker 1: at risk for cardiovascular disease and other health complications. This
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  Speaker 1: is the sense in which this category of food is problematic.
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  Speaker 2: The bottom line and how to ultra process new information.
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  Speaker 2: Some facts.
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  Speaker 1: First, ultra process is really just one way to capture
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  Speaker 1: and characterize a particular dietary pattern, one that is, among
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  Speaker 1: other things, low in fruits and vegetables. Second, to a
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  Speaker 1: large extent, the correlations between these dietary patterns and health
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  Speaker 1: are probably driven by other differences across people, including exercise, smoking.
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  Speaker 2: And health resources. Third, there is causal.
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  Speaker 1: Evidence that these foods encourage consumption of more calories and
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  Speaker 1: therefore could contribute to obesity and related metabolic disease. From
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  Speaker 1: these I see two bottom line action items. First, let's
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  Speaker 1: think about your own dietary perspective and your kids. There
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  Speaker 1: is no issue per se with food that has been processed.
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  Speaker 2: If you want to consider it at.
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  Speaker 1: All, perhaps remember that when you open a large bag
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  Speaker 1: of Doritos, they are designed to have you eat them all.
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  Speaker 1: Another point, fiber found in fruits and vegetables mostly is
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  Speaker 1: good for you and your kids. As much as it
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  Speaker 1: is possible to incorporate them in your meals. Do it. Second,
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  Speaker 1: how to process new headlines. My advice don't I promise
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  Speaker 1: within the next two weeks you will see a headline
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  Speaker 1: saying ultra processed foods have been linked to something bad.
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  Speaker 2: You do not need to read that article.
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  Speaker 1: You know everything you need to now go about your
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  Speaker 1: day in peace.