The latest thing in food health is ultra-processed foods. The Lancet has a special on it, the editorial is free but the others are email-walled. The first is available here at time of writing, and I am reading it.
This is the intro, and I agree with it:
This rise in ultra-processed foods is driven by powerful global corporations who employ sophisticated political tactics to protect and maximise profits. Education and relying on behaviour change by individuals is insufficient. Deteriorating diets are an urgent public health threat that requires coordinated policies and advocacy to regulate and reduce ultra-processed foods and improve access to fresh and minimally processed foods. The Series provides a different vision for the food system with emphasis on local food producers, preserving cultural foods transitions and economic benefits for communities.
Where I have never been quite convinced is that the primary problem with modern megacorp food is what it has got in it, rather than what it has not. The thesis, as I understand it is that these foods have many different harmful chemicals, many underinvestigated and perhaps more undiscovered. The evidence provided is that the more of this food you eat the less healthy you are.
There is good mechanistic reasons why some of this stuff is bad for you, in particular the emulsifiers seem a bad idea to me, there is a not a hard line between an emulsifier and a detergent and detergents are bad for everything with cell membranes. I am sure there are plenty of other things that are bad for you in them.
However the previous conventional thought would be that a diet dominated by megacorp food and lacking in fresh fruits and vegetables would be bad because of what it is missing, rather than what it has.
The gold standard test to distinguish causality from correlation is a randomised controlled trial (RCT). The criticism that the hypothesis has not been subjected to RCTs is addressed in the first paper:
Few randomised controlled trials (RCTs)
Criticism: Most existing evidence on the adverse health effects of UPFs is observational and cannot definitively establish causality. More research is needed, especially from RCTs.
Response: Short-term RCTs (eg, those by the US NIH 56 and Tokyo Hospital 58) have shown consistent and biologically plausible effects of ultra-processed diets on precursors of obesity, including excessive total energy intake and increases in bodyweight and fat mass. These experiments support the plausibility of associations with the incidence of obesity observed in long-term prospective cohorts.
I looked at those two papers, in particular they both have a photo of all the meals in the supplementary info (US pdf here, Japanese PPT here, neither are small). I include the snacks of each in the spoiler below, and while this is not completely representative of the diets it gives a pretty good idea. If this is the best they can come up with, this does not seems to me to be evidence agaisnt the "fresh food is good for you" thesis. Also I would much rather be on the Japanese trial than the US one, the US UPF pictures just look brutal to me.
I think they should do a real double blind trial. Give some groups of poor people a breadmaker and a premixed bread mix, and tell them to use that as much as possible and avoid UPFs. Give one group bread mix with UPFs and another one without.
What do you think?
This is the intro, and I agree with it:
This rise in ultra-processed foods is driven by powerful global corporations who employ sophisticated political tactics to protect and maximise profits. Education and relying on behaviour change by individuals is insufficient. Deteriorating diets are an urgent public health threat that requires coordinated policies and advocacy to regulate and reduce ultra-processed foods and improve access to fresh and minimally processed foods. The Series provides a different vision for the food system with emphasis on local food producers, preserving cultural foods transitions and economic benefits for communities.
Where I have never been quite convinced is that the primary problem with modern megacorp food is what it has got in it, rather than what it has not. The thesis, as I understand it is that these foods have many different harmful chemicals, many underinvestigated and perhaps more undiscovered. The evidence provided is that the more of this food you eat the less healthy you are.
There is good mechanistic reasons why some of this stuff is bad for you, in particular the emulsifiers seem a bad idea to me, there is a not a hard line between an emulsifier and a detergent and detergents are bad for everything with cell membranes. I am sure there are plenty of other things that are bad for you in them.
However the previous conventional thought would be that a diet dominated by megacorp food and lacking in fresh fruits and vegetables would be bad because of what it is missing, rather than what it has.
The gold standard test to distinguish causality from correlation is a randomised controlled trial (RCT). The criticism that the hypothesis has not been subjected to RCTs is addressed in the first paper:
Few randomised controlled trials (RCTs)
Criticism: Most existing evidence on the adverse health effects of UPFs is observational and cannot definitively establish causality. More research is needed, especially from RCTs.
Response: Short-term RCTs (eg, those by the US NIH 56 and Tokyo Hospital 58) have shown consistent and biologically plausible effects of ultra-processed diets on precursors of obesity, including excessive total energy intake and increases in bodyweight and fat mass. These experiments support the plausibility of associations with the incidence of obesity observed in long-term prospective cohorts.
I looked at those two papers, in particular they both have a photo of all the meals in the supplementary info (US pdf here, Japanese PPT here, neither are small). I include the snacks of each in the spoiler below, and while this is not completely representative of the diets it gives a pretty good idea. If this is the best they can come up with, this does not seems to me to be evidence agaisnt the "fresh food is good for you" thesis. Also I would much rather be on the Japanese trial than the US one, the US UPF pictures just look brutal to me.
I think they should do a real double blind trial. Give some groups of poor people a breadmaker and a premixed bread mix, and tell them to use that as much as possible and avoid UPFs. Give one group bread mix with UPFs and another one without.
What do you think?
Spoiler Snacks :
