Search results: Ultra processed foods

What are healthy diets? Joint statement by the Food and Agriculture Organization of the United Nations and the World Health Organization

What this is about:

Healthy diets promote health, growth and development, support active lifestyles, prevent nutrient deficiencies and excesses, communicable and noncommunicable diseases, foodborne diseases and promote wellbeing. The exact make-up of a diet will vary depending on individual characteristics, preferences and beliefs, cultural context, locally available foods and dietary customs. However, the basic principles of what constitutes healthy diets remain the same.

The guiding principles: Adequate, Balanced, Moderate, Diverse.

Here’s what they mean by Balance:

The actual guidelines are discussed under the Moderate principle.

• Sodium: restrict to 2 grams/d (5 g table salt)
• Sugars: restrict to 10% or less of daily calories.
• Saturated fat: restrict to 10% of calories, with no more than 1% from trans fat

FAO and WHO duck making a clear statement about the next two issues, although their implications are clear.

• Red and processed meat: even low levels may have negative health consequences
• Ultra-processed foods: these have negative health consequences

I wish they had stated these recommendations more clearly.  Yes they are controversial with big industries lobbying against any suggestion to eat less of these foods, but these agencies, or at least WHO, should put public health first.

I recognize that these agencies have constituencies of nearly 200 countries, many with strong meat and ultra-processed food industries.  I also recognize that the agencies have no power other than leadership to get any of those countries to do anything.

They at least stated what they thought.  It’s up to country governments to take action.  I hope they do.

Charlotte Bilekoff.  Real Food, Real Facts: Processed Food and the Politics of Knowledge.  University of California Press, 2024.  267 pages.

Food processing is a big issue these days (witness RFK Jr’s pledge to get ultra-processed foods out of school meals) and I was interested to see what food studies scholar Charlotte Biltekoff had to say about it.

Her thesis: When people say they want to eat “real food” rather than highly processed food, the food industry responds with “real facts,” science-based discussions of the benefits of food processing (“food scientism”).

The industry’s response is based on the idea that if you could only correct public ignorance and misperceptions, you could sell your products more easily.

But public concerns are about politics, not science.  And food scientism is a form of antipolitics.

She cites as an example, the FDA’s ongoing inability to define the term “natural.”

Concerned about health, sustainability, and risk and wanting change in the food system, the public sought to act on its values and aspirations in the marketplace.  Narrowly reframing those concerns as demands that could be met through product reformulations and new approaches to marketing—but without serious, systemic engagement with the broader issues they reflected—the food industry produced products that appeared to be more natural, less processed, and therefore better…articles in the industry press and comments to the FDA show that many perceived the consumers of “real food” as irrational and misinformed.  Seen through the lens of food scientism of the Real Facts frame, consumer perceptions of processing and what “natural” meant, or should mean, were further proof that the public lacked the skills and understanding to meaningfully participate in the regulatory processess, let alone act as knowledgeable participants in the governance of technology and the shaping of the food system. (p. 143)

What Biltekoff has done here is to translate the classic two-culture risk communication problem to food.

Her book made me go back and look at what I wrote about the two-culture problem in Safe Food: The Politics of Food Safety.  The book contrasts the differing perceptions of industry and the public about the potential harm of microbial foodborne illness versus GMOs.

These differences in approaching questions of risk were understood long before anyone invented the techniques for genetically modifying foods. In 1959, for example, the scientist and writer C. P. Snow characterized the ways in which people trained in science tend to think about the world—as opposed to those without such training—as representing two distinct cultures separated from one another by a “gulf of mutual incomprehension” [1]. Much more recently, the anthropologist Clifford Geertz wrote, “The ways in which we try to understand and deal with the physical world and those in which we try to understand and deal with the social one are not altogether the same. The methods of research, the aims of inquiry, and the standards of judgment all differ, and nothing but confusion, scorn, and accusation—relativism! Platonism! reductionism! verbalism!—results from failing to see this” [2].  [1. Snow CP. Two Cultures and the Scientific Revolution: The Rede Lecture. London: Cambridge University Press, 1959; 2. Geertz C. Empowering Aristotle (book review). Science 2001;293:53].

Science-based approaches to food safety, I pointed out, count cases and estimate costs, whereas what I called “value-based” approaches, are about feelings of dread and outrage.

Biltekoff’s analysis applies the two-culture framework to public responses to food processing and to the ways the food industry deals with those responses.

Her analysis explains much about the current pushback against the concept of ultra-processed foods from the food industry and some nutritionists.  If you want to understand why the Dietary Guidelines Advisory Committee has chosen not to recommend reducing intake of ulra-processed foods, read this book.

And, amazingly, the book is available as open source.  Read the book online here.

Read Charlotte Biltekoff’s interview with UC Press here.

The 2025-2030 Dietary Guidelines Advisory Committee (DGAC) report is well underway.   The committee either has submitted or is about to submit its report to HHS and USDA;.  The report has not yet been posted, but presumably will be posted soon.

But understand: the scientific advisory committee is just that: advisory.

The agencies, HHS and USDA, are responsible for writing the actual guidelines.  They choose an internal committee to do that work.  That new committee can pick, choose, add, or subtract from the advisory committee’s report.

So yes, the new Secretaries of HHS and USDA can have a lot of input (and veto power) into the new guidelines.

As I’m fond of repeating, the guidelines process was quite different when I was on the DGAC in 1995.  Then, our committee chose the research topics, reviewed the research, wrote the advisory committee report, and wrote the actual dietary guidelines.  The agencies made only minor tweakings.

The agencies have written the guidelines since 2005, making the process much more subject to politics.

The DGAC, for example, viewed the evidence on ultra-processed foods as too limited to take a stand, yet RFK, Jr says ultra-processed foods are killing us.

The development of the 2025-2030 guidelines will be most interesting to watch.  Stay tuned.

I spent a lot of time last week responding to reporters’ questions about Trump’s appointing Robert F. Kennedy, Jr to head the Department of Health and Human Services.

Here’s what the president-elect said about the appointment on Twitter (X):

For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health…HHS will play a big role in helping ensure that everybody will be protected from harmful chemicals, pollutants, pesticides, pharmaceutical products, and food additives that have contributed to the overwhelming Health Crisis in this Country. Mr. Kennedy will restore these Agencies to the traditions of Gold Standard Scientific Research, and beacons of Transparency, to end the Chronic Disease epidemic, and to Make America Great and Healthy Again!

Trump has instructed Mr. Kennedy to end chronic disease and “Go wild on food.”

In various statements, Mr. Kennedy has said he wants to get rid of “poisons”

• Ultra-processed foods in schools
• Artificial colors in cereals
• Chemicals, pollutants, pesticides
• Mercury in fish
• Fast food

He also wants to

• Restrict sodas on SNAP
• Promote sustainable, regenerative farming by small farmers
• End conflicts of interest between government agencies and corporations: Corporate capture is the biggest threat to democracy.

These are the kinds of things I’ve been saying and writing about for decades!

[He also is pushing for some things that are much less well grounded in science: getting rid of grains for kids, seed oils, and fluoride in drinking water; deregulating raw milk; and firing all nutrition scientists on day 1].

If he really does do what he’s promising here, it means taking on the food industry, in a way that no government has ever done, and Trump showed no signs of doing in his first term.

What can we expect?  I have no idea, but thist sure will be interesting to watch.

Mother Jones calls Kennedy’s appointment “a genuine catastrophe.”

For charges of hypocrisy, click here.

Civil Eats asked a bunch of people to predict “The Path Forward for Food and Ag.”  Here’s what I said.

I wish I had a crystal ball to say how food and agriculture issues would play out over the next four years, but all I have to go on is what Trump and his followers say. If we take them at their word, then we must expect them to implement their Project 2025 plan, which replaces one deep state with another that favors conservative business interests and ideology. This calls for replacing staff in federal agencies with Trump loyalists and dismantling them, stopping the USDA from doing anything to prevent climate change, reforming farm subsidies (unclear how), splitting the farm bill to deal separately with agricultural supports and SNAP, reducing SNAP participation by reinstating work requirements and reducing the Thrifty Food Plan, and making it more difficult for kids to participate in school meals.

On the other hand, some of the plans make sense: eliminating checkoff programs and repealing the sugar program, for example. So do some of Robert F. Kennedy, Jr.’s goals: Make America Healthy Again by focusing on chronic disease prevention, getting harmful chemicals out of kids’ foods, and getting rid of conflicts of interest among researchers and agency staff. It’s too early to know how much of this is just talk, but I’m planning to do what I can to oppose measures I view as harmful, but to strongly support the ones I think will be good for public health.

Ashley N. Gearhardt, Kelly D. Brownell, Mark S. Gold, and Marc N. Potenza, editors.  Food & Addiction: A Comprehensive Handbook, Second Edition.  Oxford University Press, 2024.  570 pages.

This is the second edition of a book I wrote about in 2012.

At the time, I said:

Brownell and Gold have produced an instant classic.  Food and Addiction presents a comprehensive, authoritative, and compelling case for considering whether food is addictive.  Its chapters raise serious questions about our current laissez-faire attitude toward food marketing, especially to children.  This book is a must read for everyone who cares about the causes and consequences of obesity and the need for food policies that better promote health.  It is a game changer.  Readers will never look at food the same way again.

Much has happened since then to focus greater attention on the ways food triggers addictive-like eating behavior.

• Michael Moss’s books, Salt, Sugar, Fat, and Hooked.  These document how food companies deliberately formulate products to make them irresistible (“you can’t eat just one”).
• The emergence of the concept of ultra-processed foods as a researchable category.
• Kevin Hall et al’s demonstration that ultra-processed foods encourage people to eat more calories but not realize it.
• The increase in research using the Yale Food Addiction Scale, and
• The research described and reviewed in this book.

All of this makes an increasingly convincing case that the word “addiction” applies to food as well as to other addictive substances, and that similar proportions of people (10% to 15%) meet criteria for addiction; everyone eats, but not everyone meets those criteria.

The editors’ introductory and concluding chapters lay out the diagnostic and policy issues.

The short chapters address biological, behavioral, clinical, and legal correlates of food addiction.

They are written by a authors who address these issues from enormously different , but highly critical, perspectives ranging from the exceedingly personal to the big-picture political.

Is anything missing here?  As with any multi-authored book, this one undoubtedly took years to produce.  That makes it a few years out of date in fast-moving areas.  It does not cover recent research on ultra-processed foods, Kevin Hall’s experiment, the concept of food “noise,” or the way the new GLP-1 drugs might interact with addictive behavior.

But, this is the resource of food addiction, a great gift to the addiction-perplexed and an enormous public service at a time when it is badly needed.

The House of Lords Food, Diet and Obesity Committee has a lengthy (179 pages) new report ‘Recipe for health: a plan to fix our broken food system’.

Key finding: Obesity and diet-related disease are public health emergencies costing society billions in healthcare costs and lost productivity.

Key recommendation: The Government should develop a comprehensive, integrated long-term new strategy to fix our food system, underpinned by a new legislative framework.

Key actions (selected):

• Require large food businesses to report on the healthfulness of their products
• Exclude businesses making unhealthful products from policy discussions on food, diet and obesity prevention.
• Tax products high in salt and sugar; use revenues to make healthy food cheaper.
• Ban the advertising of less healthy food across all media.

No recommendation on reducing intake of ultra-processed foods?  Despite finding the link between ultra-processed foods and poor health outcome “alarming,” the report ducked the issue and recommended only to fund more research.

It also advised reviewing dietary guidelines with ultra-processed foods in mind.

Still, the recommendation to keep food businesses out of public policy discussions is a good one, not to mention taxes and advertising bans.

This, mind you, is the House of Lords.  Impressive.

LINKS

• Full report
• News story
• Shorthand version of the report
• Video
• Audio (Baroness Walmsley)

The FDA has announced its 2025  Priority Deliverables for the Human Food Program.

These cover the microbial and chemical safety of foods, but I am especially interested in what the FDA is and is not doing about nutrition and chronic disease prevention—something mentioned by FDA Commissioner Robert Califf as a priority for American public health.

Based on FDA’s Nutrition Initiatives, the deliverables begin with:

FDA’s Role in Empowering Consumers to Build Nutritious Diets that Support Health and Wellness

Using a risk management approach, we focus our efforts in FY 2025 on labeling and other initiatives to help consumers make more informed choices about the food they eat, and, for those who rely on certain critical foods, such as infant formula, as their sole source of nutrition, we work to make sure those products are safe, properly labeled, and nutritionally sound.

As for the Human Food Program’s priority policy initiatives:

• Update FDA’s Nutrient Content Claim “Healthy”
• Propose Front-of-Package Nutrition Labeling:
• Support Reductions in Sodium in the Food Supply
• Increase the Resiliency of the U.S Infant Formula Market

The deliverables do mention diet-related chronic disease in the contexts of sodium and research.

• We will also collaborate with our federal partners and engage with key stakeholders to enhance sodium-related data sharing and learnings, as part of these efforts to help reduce diet-related chronic diseases and deaths associated with high sodium intake, such as hypertension and stroke.
• We will continue to collaborate with other federal agencies on developing and advancing a nutrition research agenda, including accelerating high-quality research to better understand the mechanisms between ultra-processed foods and poor health outcomes.

Despite Commissioner Califf’s statements, it looks like the Human Food Program is not particularly interested in chronic disease prevention or policy approaches to improving the environment of food choice.

Instead, its policies put the burden of responsibility on you as an individual to make healthier choices—not to find ways to counter the food industry’s marketing imperatives.

The FDA’s Human Food Program is all about empowering consumers.  Good luck with that.

Yes, the FDA is grossly underfunded and handicapped in what it can do, and yes, addressing environmental determinants of chronic disease would encounter opposition from vested interests.

But the FDA is an agency of the Public Health Service.  It needs to do better.

The Human Food Program should be taking the lead in addressing Commissioner Califf’s stated concerns

• The big issue is chronic disease, on which we are “doing terribly.”
• We have to deal with the marketing of ultra-processed foods designed to make you hungry for more.

These issues are consistent with the new administration’s Make America Healthy Again campaign.  Let’s hope that works.

The current Dietary Guidelines Advisory Committee has produced its draft recommendations.  These, as I discuss tomorrow, are mostly banal, much the same as all guidelines since 1980.

But this year there are two rather shocking exceptions, both having to do with what is not recommended.

Incredible non-recommendation #1.  Reduce the focus of the Dietary Guidelines on reduction of chronic disease risk.

What???  The entire purpose of the Dietary Guidelines is to reduce the risk of diet-related disease.  Chronic diseases—obesity, type-2 diabetes, heart disease, cancer, etc—are the leading causes of death and disability among U.S. adults.

Maybe this was a typo?  Surely this committee means to say “Recommend increasing the focus of the Dietary Guidelines on chronic disease risk reduction.

The current wording is a travesty.  I’m not the only one who thinks so.  See Jerry Mande’s Tweet (X).

Update: I gather the uproar over this did some good and the committee is changing the wording.

Incredible non-recommendation #2.  Say nothing about ultra-processed foods.

The committee made it clear that they were not going to say a word about ultra-processed foods.  At least not now.  Why not?

Scientific experts tasked with advising federal officials drafting the 2025-2030 Dietary Guidelines for Americans said the data were far too limited to draw conclusions…Ultra-processed foods don’t have a recognized definition or a robust body of scientific literature that has studied them, they said, so guidelines would be premature.

Another travesty.  An overwhelming body of observational research suggests harm from diets high in ultra-processed foods.  OK, these studies only demonstrate association, not causation.

But—not one, but two well-controlled clinical trials demonstrate that ultra-processed foods induce people to consume more calories than they would otherwise: 500 more in one trial and more than 800 in the second.  These are enormous differences.

Yes, it would be great to know why, exactly.  And yes, the definition of ultra-processed can be fuzzy with respect to a few—remarkably few—foods.

But what more do you need to know?  Isn’t this enough to tell people that if they want to keep caloric intake under control, a good way to do that would be to limit consumption of ultra-processed foods?

But this committee chose to ignore the controlled trials because they didn’t last long enough.

As I explain in that link, the committee’s hands are tied by having to make “science-based” recommendations.  But in nutrition, most of the science is observational, which is why those controlled trials, short in duration as they are, matter so much.

The committee needs to revisit this decision.  If the guidelines do not include a recommendation to limit intake of ultra-processed foods, they will be ignoring the science and will be behind the times.

Worse, the guidelines will not help Americans reduce their risks for chronic disease.

See: Stat News:  5 questions about the next U.S. dietary guidelines, and the ‘impossible restriction’ on them: Difficulty of nutrition research leaves problems like ultra-processed foods largely unaddressed. 

Tomorrow: the banality of the latest recommendations.