Currently browsing posts about: Ultraprocessed

I don’t like writing about the dietary guidelines process while it is still ongoing because so much can change between now and the time the advisory committee submits its report, and USDA and HHS issue the actual guidelines.

But this Dietary Guidelines Advisory Committee is dealing with the concept of ultra-processed foods and is tied in knots over it.

So I will devote this week to the guidelines.

• Today: Why knots?
• Wednesday: Why isn’t NIH funding more rigorous nutrition research?
• Thursday:  Why all the fuss when guidelines always say the same things?

OK.  Let’s get to it.

Why do I think the Dietary Guidelines Advisory Committee (DGAC) is tied in knots over ultra-processed foods (UPF)?

1. It  is required to make evidence-based recommendations.  This is impossible with observational evidence.
2. It is required to exclude the one existing controlled clinical trial from consideration (because it was too short).

Therefore, it had to conclude: ““Limited evidence suggests that dietary patterns with higher amounts of foods classified as UPF consumed by adults and older adults are associated with greater adiposity (fat mass, waist circumference, BMI) and risk of obesity/overweight. Evidence Grade: Limited.”

The DGAC is in an impossible position, and doing the best it can under the circumstances.

I need to say a word about evidence-based recommendations.  How I wish they could be.   If all you have is observational studies, you need to interpret them carefully.  Interpretation is subject to bias.

When I was a DGAC member (1995 guidelines), the agencies recognized what we were up against.  They instructed us to review the available research and give the best advice we possibly could based on it.

All of this raises a philosophical question: Should government agencies issue advice based on incomplete and inadequately controlled observational research?  Or should they say nothing?

This committee, apparently, is considering saying nothing about ultra-processed foods: “It would be hugely problematic to tell people to avoid 60% of the food supply without having something good to replace it.”

Really?  Plenty of “something good” is available.  It’s called food: fruits, vegetables, grains, meat, fish, dairy, eggs.

These—unprocessed and minimally processred—can be delicious, nutritious, and satisfying, and at reasonable cost.

—–

Tomorrow: Why don’t we have more rigorous research?

Addition:  The video of the meeting.  The discussion of ultra-processed foods starts at 3:51:45 .

If you are still confused about ultra-processed foods and the current status of this truly important dietary concept, here is a great place to start: The Financial Times of all things: “Deny, denounce, delay”: The battle over the risk of ultra-processed foods.

Why important?  The message is clear: eat less of them.  Hence, the article’s subtitle: “Big Food is trying to dampen fears about the effects of industrially formulated substances.”

This piece is totally worth reading.

It is clear that the public is now much more aware of UPFs, and concerned about them. Two-thirds of Europeans now believe that ultra-processed foods are unhealthy and will cause health problems in later life, according to a February survey of 10,000 people in 17 countries, and 40 percent do not trust that the authorities are regulating them well enough. Research by Mintel in the UK has found that 70 percent of UK adults try to avoid ultra-processed foods.

“I don’t think even Carlos Monteiro in his wildest dreams expected the public discourse to get so attuned,” says Lang at City University. “The public is running with it. The genie is out of the bottle.”

Every now and then a headline makes me gasp:

Deena Shankar’s article in Bloomberg News begins:

It’s been just about a year since the US government slashed additional pandemic-related food-stamp benefits, and some of the companies that make and sell food are seeing that hit their sales.

As she explains,

Enhanced benefits for the Supplemental Nutrition Assistance Program, or SNAP, ended last February, meaning families and individuals saw monthly cuts of $95 to $250 or more in what they received. Families with kids lost at the high end of the spectrum, according to the Center on Budget and Policy Priorities, a nonpartisan research and policy institute.

Never mind the effects of reduced benefits on low-income families.

packaged-food giant Kraft Heinz Co. cited the reduction in benefits as a major headwind that the company and the industry faced in 2023. “We saw some challenges in our mac-and-cheese business,” Chief Executive Officer Carlos Abrams-Rivera said on an earnings call. “Frankly, it’s a business that is driven disproportionately by our SNAP exposure.”

How’s that for a gasp-inducing statement.  SNAP recipients are the core customers for this product.

If you want to know about inequities in the US food system, start here.

Kraft Mac & Cheese exemplifies cheap ultra-processed food.

Walmart sells five boxes for $4.88, less than a dollar a box.

For that, you are supposed to get three servings per box, but the whole box adds up to:

• 750 calories
• 1680 mg sodium,(4.2 grams of salt)
• 27 grams sugars

And what’s in this?

ENRICHED MACARONI (WHEAT FLOUR, DURUM FLOUR, NIACIN, FERROUS SULFATE [IRON], THIAMIN MONONITRATE [VITAMIN B1], RIBOFLAVIN [VITAMIN B2], FOLIC ACID), CHEESE SAUCE MIX (WHEY, MILKFAT, SALT, MILK PROTEIN CONCENTRATE, SODIUM TRIPHOSPHATE, CONTAINS LESS THAN 2% OF TAPIOCA FLOUR, CITRIC ACID, LACTIC ACID, SODIUM PHOSPHATE, CALCIUM PHOSPHATE, WITH PAPRIKA, TURMERIC, AND ANNATTO ADDED FOR COLOR, ENZYMES, CHEESE CULTURE).

Walmart sells a pound of carrots for $1.38.

There is something seriously wrong with a food system that makes a 750-calorie Mac and Cheese product so much cheaper than a pound of carrots.

I learned about this one from Beverage Daily:

Unexpected and bold: The iconic nacho cheese taste of Doritos imbued into a first-of-its-kind spiritThe Frito-Lay brand has collaborated with Danish flavour innovator Empirical to launch Doritos Nacho Cheese Spirit – a limited edition, multi-sensorial experience that really tastes like nacho cheese…. Read more

Limited edition bottles will be available in select New York and California markets for $65 for a 750ml bottle.

Now you get to have your ultra-processed snack and 42% alcohol by volume—all at once!

Oh no!  According to the company, the product is sold out.

You can’t make this stuff up.

Let’s start the new year with some good news.

I was excited to read in The Lancet that Colombia has enacted a tax on junk foods.

The new tax was included in a wider reform that passed into law in December, 2022, seeking to reduce the
burden of obesity and other diseases on Colombia’s health system, while also bringing in revenue in a country that manages a fiscal deficit.

This is a tax on ultra-processed foods!

The tax is being implemented gradually, beginning at 10%, before rising to 15% in 2024 and 20% in 2025, and targets foods are high in salt and saturated fat, as well as industrially manufactured prepackaged foods.

Colombia already has warning labels.  Here’s who else has them.

The warning label movement!

Now, if we only could get these in the U.S….

But note: not everyone loves the tax.  The Guardian reports charges that it is unfair to the poor.  But so is type 2 diabetes.

Lots of people are uncomfortable about the concept of ultra-processed foods, the category of processed foods made mainly of industrially extracted ingredients, containing little or no recognizable food, and able to reproduced in home kitchens only if you have the ingredeients and the equipment.

Here is an example: The Guardian headline: “Ultra-processed foods are not more appealing, study finds”

The Study: Evidence that carbohydrate-to-fat ratio and taste, but not energy density or NOVA level of processing, are determinants of food liking and food reward.  Appetite, Volume 193, 2024, 107124, https://doi.org/10.1016/j.appet.2023.107124.

• Purpose: “This virtual (online) study [highlighted so you won’t miss this point] tested the common but largely untested assumptions that food energy density, level of processing (NOVA categories), and carbohydrate-to-fat (CF) ratio are key determinants of food reward.”
• Method: “Individual participants (224 women and men, mean age 35 y, 53% with healthy weight, 43% with overweight or obesity) were randomised to one of three, within-subjects, study arms: energy density (32 foods), or level of processing (24 foods), or CF ratio (24 foods). They rated the foods for taste pleasantness (liking), desire to eat (food reward), and sweetness, saltiness, and flavour intensity (for analysis averaged as taste intensity).”
• Results: Against our hypotheses, there was not a positive relationship between liking or food reward and either energy density or level of processing. As hypothesised, foods combining more equal energy amounts of carbohydrate and fat (combo foods), and foods tasting more intense, scored higher on both liking and food reward. Further results were that CF ratio, taste intensity, and food fibre content (negatively), independent of energy density, accounted for 56% and 43% of the variance in liking and food reward, respectively. We interpret the results for CF ratio and fibre in terms of food energy-to-satiety ratio (ESR), where ESR for combo foods is high, and ESR for high-fibre foods is low.”
• Conclusion: “We suggest that the metric of ESR should be considered when designing future studies of effects of food composition on food reward, preference, and intake.”I ca

Comment

I can’t say this any better than Stuart Gillespie, who posted:

https://twitter.com/stuartgillesp16/status/1729061409202618512?s=51&t=BTlnSTTeO7_vUXAOw5KNXg

Or Tamar Haspel (@Tamar Haspel) who points out:

Want to find out what properties of food drive consumption?

Is it fat/carb ratio, degree of processing, sweetness?

I’m gonna say asking a self-selected group of internet randos to rate a bunch of really unappetizing photographs isn’t the way.

If nutrition and food scientists want to shoot down the concept of ultra-processed foods, they are going to have to refute hundreds of studies linking such foods to poor health outcome, as well as the carefully controlled clinical trial demonstrating that ultra-processed foods encourage overeating.

If

The International Fund for Agricultural Development (IFAD), as part of its IFAD Research Series, released a report, Overweight and obesity in LMICs in rural development and food systems, along with a literature review.

The report finds obesity rates across developing countries to be approaching levels found in high-income countries.

The study attributes the rise to:

• Food Prices: The price gap between healthy foods (expensive) and unhealthy foods (inexpensive) is greater in developing countries than in rich developed countries.
• Diet: Sugar-sweetened beverage consumption is on the rise in developing countries and the global sales of highly processed foods rose from 67.7kg per capita in 2005 to 76.9kg in 2017.
• Culture: In some developing countries, childhood fatness is associated with health and wealth and consumption of unhealthy foods carries prestige.
• Gender: Women are more likely to be overweight or obese than men in nearly all developing countries.

One strength of this study is its consideration of the need for interventions across the entire food system:

The study results show that food system-related interventions are not overweight or obesity specific. Instead, they tap into the wider field of making diets more healthy and nutritious, and emerge as necessary strategies to set the scene for creating non-obesogenic food supply chains. The identified intervention strategies cut across different food system domains: there were production strategies for improved dietary diversity, strategies for processing (which involved food package labelling or price mechanisms), strategies for changing the food environment and strategies to address consumer behaviour.

I’m always surprised when the nutrition community opposes evidence for the association of ultra-processed foods with poor health outcomes.

I read an article about such opposition from the British Nutrition Foundation.

Bridget Benelam, a BNF spokesperson, explained: For many of us when we get home after a busy day, foods like baked beans, wholemeal toast, fish fingers or ready-made pasta sauces are an affordable way to get a balanced meal on the table quickly. These may be classed as ultra-processed but can still be part of a healthy diet.

I looked up the position statement of the British Nutrition Foundation.

At present, the British Nutrition Foundation believes that due to the lack of agreed definition, the need for better understanding of mechanisms involved and concern about its usefulness as a tool to identify healthier products, the concept of UPF does not warrant inclusion within policy (e.g. national dietary guidelines).

I also looked up its “Why trust us?” statement.

Our funding comes from: membership subscriptions; donations and project grants from food producers and manufacturers, retailers and food service companies; contracts with government departments; conferences, publications and training; overseas projects; funding from grant providing bodies, trusts and other charities.  Our corporate members and committee membership are listed on our website and in our annual reports.

With some diligent searching, I did indeed manage to find the list of corporate members.

Front group anyone?  Take a look.

Aldi Stores Ltd https://www.aldi.co.uk/corporate-responsibility

Associated British Foods www.abf.co.uk

Arla www.arlafoods.co.uk

ASDA Stores Ltd www.asda.com

British Sugar plc www.britishsugar.co.uk

Cargill Inc www.cargill.com/

Coca Cola www.coca-cola.co.uk

Costa Coffee www.costa.co.uk

Danone Ltd www.danone.com/en

Ferrero www.ferrero.co.uk

General Mills www.generalmills.co.uk

Greggs plc www.greggs.co.uk

Innocent Drinks Ltd http://www.innocentdrinks.co.uk/

International Flavors & Fragrances Inc. www.iff.com

J Sainsbury Plc www.sainsburys.co.uk

Kellogg Europe Trading Ltd www.kelloggs.co.uk

Kerry Taste & Nutrition www.kerrygroup.com

KP Snacks Limited www.kpsnacks.com

Lidl GB www.lidl.co.uk

LoSalt www.losalt.com/uk

Marks and Spencer plc www.marksandspencer.com

Mars UK Ltd www.mars.com

McDonald’s Restaurants Ltd www.mcdonalds.co.uk

Mitchells & Butlers www.mbplc.com

Mondelez International www.mondelezinternational.com

National Farmers’ Union Trust Company Ltd www.nfuonline.com/home

Nestlé UK Ltd www.nestle.co.uk

Nestlé Nutrition www.smahcp.co.uk

Nomad Foods Europe www.iglo.com

PepsiCo UK Ltd  www.pepsico.co.uk

Pladis www.pladisglobal.com

Premier Foods www.premierfoods.co.uk

Quorn www.quorn.com

Slimming World www.slimmingworld.co.uk

Sodexo https://uk.sodexo.com

Starbucks www.starbucks.co.uk

Subway UK & Ireland https://www.subway.com/en-GB

Tata Global Beverages Ltd www.tataglobalbeverages.com

Tate & Lyle www.tate&lyle.com

Tesco Plc www.tesco.com

The Co-operative Group Ltd www.co-operative.coop

Uber Eats www.ubereats.com/gb

UK Flour Millers www.ukflourmillers.org

Waitrose & Partners www.waitrose.com

Weetabix www.weetabix.co.uk

Whitbread www.whitbread.co.uk

Wm Morrisons Supermarkets plc www.morrisons.co.uk

Yakult www.yakult.co.uk 

 

Sustaining Members

Agriculture and Horticulture Development Board www.ahdb.org.uk

ASDA Stores Ltd www.asda.com

Associated British Foods www.abf.co.uk

Coca-Cola Great Britain and Ireland www.coke.com

Danone UK Ltd www.danone.co.uk www.h4hinitiative.com

International Flavors & Fragrances Inc. www.iff.com

J Sainsbury plc www.sainsburys.co.uk

Kellogg Europe www.kelloggs.co.uk

Marks and Spencer plc www.marksandspencer.com

Mondelez International www.mondelezinternational.com

Nestlé UK Ltd www.nestle.com

PepsiCo UK Ltd www.pepsico.com www.walkers.co.uk www.quakeroats.co.uk www.tropicana.co.uk

Tate & Lyle www.tateandlyle.co.uk

Tesco www.tesco.com

Sustaining members agree to provide a donation to the British Nutrition Foundation for at least three years to support our wider charitable work focussing on consumer education, and engagement with the media, government, schools and health professionals.