Eddy Edson
Well-Known Member
- Relationship to Diabetes
- Type 2
Eliminate or reformulate ultra-processed foods? Biological mechanisms matter
Increased ultra-processed foods (UPFs) in the food supply have plausibly caused the rise in obesity prevalence and related chronic diseases. To addres…
www.sciencedirect.com
A paper just published by Kevin Hall et al. It's dumb to target UPF's as a broad category without knowing why they promote obesity, which we don't. Let's try to find out and see if we can reformulate some UPF types to make them healthier while retaining their attractive qualities. Trying to eliminate the entire category (a) won't work and (b) is profoundly regressive.
The potential harm of UPFs has encouraged many proponents of the NOVA system to recommend avoiding UPFs entirely and to call for policies aimed at removing UPFs from the food supply. However, uniformly reducing all UPFs—the heterogeneous food category that now represents 67% of total kcal per day for US children—may not ultimately be an appropriate public health goal and may even have unintended harms. Drastically reducing or eliminating the availability of all categories of UPFs without simultaneous consideration and efforts to replace them with better, affordable, and practical alternatives should be scrutinized. Eliminating UPFs that deliver on many desirable properties (inexpensive, microbiological safety, nutrient fortification, extended shelf-life, and convenience) may only worsen the existing disparities in food insecurity.
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In fact, consumption of ready-to-eat or heat UPFs has more than doubled in US children in recent years (Wang et al., 2021), while over the same period the average diet quality of US children has actually modestly improved, according to the American Heart Association diet score and the Healthy Eating Index (Liu et al., 2021). Further, the increased popularity of ready-to-eat or heat UPFs also reflects important changes in food utilization and home economics. Rather than eliminating such foods, we should acknowledge their utility and consider that their reformulation, rather than elimination, might have a more meaningful impact on improving the nutritional quality and health on a population level.
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Reformulating UPFs while retaining their desired properties will require knowledge of the precise components or features that elicit unhealthful effects, which will make these substitutions more effective and precise. However, at this time, mechanisms by which UPFs encourage excess energy intake and deleterious health outcomes are largely unknown—but hypotheses abound. Perhaps the sensory attributes of UPFs make them easier to chew and swallow, resulting in faster eating (Forde et al., 2020), such that overconsumption occurs before gut-brain signals have time to communicate satiation. UPFs may lead to overconsumption of calories because they are often high in sugar and fat while being low in protein. Industrial food processing can result in substantial water losses, thereby increasing their energy density, which may also result in overconsumption. It is also conceivable that the absence of a natural food matrix and the low insoluble fiber content of UPFs might disrupt interactions with microbiota or abnormal absorption and signaling from the gastrointestinal tract. Or perhaps UPFs are industrially engineered to be hyper-palatable, with ingredients that disrupt the flavor-nutrient feedback relationships that evolved over millennia (Small and DiFeliceantonio, 2019). It certainly could also be any combination of these mechanisms and more. More research is clearly required to understand precisely how UPFs contribute to overconsumption, obesity, and associated diseases.
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Industrial food processing is an established and ubiquitous part of our food system, reflected by the fact that UPFs provide more than half of calories consumed in many countries. While some UPF categories (e.g., SSBs) should be targeted for reduction, policies targeting elimination of UPFs as a broad category ignore the substantial time, skill, expense, access, and effort required to safely procure enjoyable meals without UPFs—resources that are already in short supply across large swaths of the population. Alternatively, many common UPF products may be amenable to effective reformulation. More mechanistic UPF research is urgently needed to identify the precise attributes of UPFs that elicit harm and optimize effective reformulation strategies to improve human health.