Avoidable personal choices are now being blamed as the root cause of the unhealthy American, with diet a prime culprit. Ultra Processed Foods (UPF) are the dietary scourge of choice, although new food groups are competing for the title, based on hype, flawed science, greed, and ignorant politicians sure to Keep America Grossly Unhealthy - Again.
Without precise, reliable, and valid scientific evidence, denial of medical benefits for food-related diseases and legal attacks on UPF manufacturers are likely. All while the plaintiffs’ bar is enriched to the detriment of our health and pocketbooks. Vigilance and precise, honestly reported science must be demanded. [1]
Initially, UPFs were targeted as the prime cause of an unholy trinity of diseases: obesity, diabetes, and fatty liver disease. We were cheered for attacking “Big Foods,” like Nestle and General Foods, as major malefactors. Secretary Kennedy focuses on seed oils as drivers of obesity, claiming we are being “unknowingly poisoned” by the likes of canola, sunflower, safflower, and soybean oils. To the consternation of nutritionists and physicians, he is also touting using beef tallow instead of vegetable oils for frying, to the consternation of nutritionists and physicians.
Among other concerns is the Health Secretary’s idea of penalizing lifestyle choices with which he disagrees by limiting medical benefits. Even as he proclaims he won’t deprive those who consume donuts – often fried in “lethal” seed oils, he raises the consideration that society shouldn’t pay for those who “predictably get very sick” from consuming sugary beverages and fried donuts and the like.
While there may be a charm in denying medical coverage to those consuming cigarettes, where health harms are clearly established and acknowledged, the idea of attacking certain foods based on insufficiently researched studies and often contradictory data seems, at best, premature, no matter how popular a culprit UPF is.
Sloppy Research Generates Sloppy Responses
Inarticulate causal hypotheses between foods and disease complicate nutritional research and obfuscate conclusions. It’s unclear exactly what causes these food-related “predictable sickness,” research is not constructed to discern which of the many ills leveled against these products may be responsible. Is it over-consumption, ultra-processing, or chemical additives, like colorants and preservatives? Perhaps hyper-palatability-induced food addictions, added sugars, fats, or refined carbs might be the cause. Or something unrelated to food, like sedentary lifestyles exacerbated by social-media addiction.
Further, the outcomes are generally lumped together in current research. While obesity may be indirectly causally related to diabetes and fatty liver in some cases, it also may be confounding for lack of exercise or other metabolic malfunctions unrelated to food intake. The question of whether one health outcome is tied to multiple food-related issues or whether multiple diseases are tied to one problem is not even raised, let alone resolved
Most studies are opaque, confusing and fail to account for, or even identify, possible confounders, alternate, synergistic causes. Nevertheless, the widespread anti-UPF vitriol is propelling lawsuits against Big Food, sure to raise prices if plaintiffs prevail – possibly without any demonstrable benefit.
In the lawsuit against UPF manufacturers filed in January that I discussed here, teenager Bryce Martinez claims that compared to other healthful diets, like the “Mediterranean diet,” the American UPF-rich diet is unsafe. As a result, he “developed fatty liver disease and type-2 diabetes at the age of 16.…”
The Myth of the Mediterranean Diet:
But emerging evidence disputes many of Martinez’s claims, including the merits of the Mediterranean in preventing fatty liver disease in children. Researchers in Israel, a Mediterranean diet country with perhaps the lowest rate of diet-related deaths, reported a rising incidence of fatty liver disease in children.
"I never saw this in my early career. Now, it’s common [in Israel] — even in children without excess weight. Among obese children, up to 40% develop fatty liver disease. … It used to be rare to diagnose a 15-year-old with fatty liver disease, but today it's routine."
- Dr Orly Ishach-Adiv, Head Pediatric Gastroenterology: Hillel Yaffe Hospital
The Diabetes Debacle and Other Hallucinations
Among other “proofs” (or rather correlations) allegedly establishing the association between UPF and diet-related illness is an increased prevalence of Type 2 diabetes. Alas, depending on the statistical modality used to report disease, diabetes is not on the rise. Rather, the supposed increase is a function of an aging population, better health care, and more accurate, simplified diagnoses.
Among the secular trends unrelated to diet that account for an increase in Type 2 diabetes in children include increased sedentariness, red meat consumption (including beef tallow), low birth weight or pre-term birth (associated with increased IVF), and gestational diabetes, where a mother develops diabetes during pregnancy. [2]
It tastes sooo good.
Sugar-sweetened beverages have borne the brunt of the UPF attack, with a prevailing concern of addiction as the underlying cause. In response, Big Food manufactured beverages with artificial sweeteners; artificially sweetened drinks are preferable to sugary ones. Not necessarily so. A new report implicated certain artificial sucralose in stimulating addiction-like behaviors that increase appetite! Could it be artificial rather than sugar-sweetened, causing obesity?
"Sucralose activates the area in the brain that regulates hunger, and that activation, in turn, is linked to greater ratings of hunger…. people who drank water withsucralose said their appetite increased by nearly 20% compared with drinking water with table sugar.” [emphasis added]
- Dr. Katie Page, Director Diabetes and Obesity Research Institute USC Keck School of Medicine.
In addition to finding that sucralose-containing drinks increased “hunger pangs” by about 17%, Dr. Page found increased connections to parts of the brain responsible for controlling motivation, appearing to hijack the brain in the very same addictive manner now leveled against UPF:
"Sucralose appears to affect your decision-making skills. For example, we found increased brain connectivity between the hypothalamus and the anterior cingulate cortex, which controls the risks and rewards of a decision."
Nevertheless, manufacturers are riding on the blessings of the popular anti-sugar and “wellness” “industry,” entrenching the vilification of sugar in favor of its artificial analog.
Some experts argue that the current popular view is overly simplistic. Lauri Wright, Professor of Nutrition at the University of South Florida, writes:
“It is popular to demonize one particular food. ….I think we need to … focus on the overall diet patterns and what truly are the cause and effect versus these inaccurate correlations.”
The Time Line.
From my vantage point, the correlation between UPF consumption and the rise in obesity is illusory. Per the Martinez complaint, UPF “poisoning” began in the 1980s, ostensibly increasing unchecked. One would therefore expect the obesity epidemic to have begun and then grow in tandem. Not so. Obesity prevalence spiked in 1994, remained constant for the decade before 2013 as UPF consumption continued to grow, and began rising again in 2018 in concert with COVID. Not even a gross correlation with UPF exists for adults. [3]
No apparent correlation exists for children either. The obesity growth spurt began in the 1970s, spiking in 2003-2004, leveled off, and began growing again around 2013. Again, the pattern does not track UPF consumption when the obesity incident is tracked by age group, although the patterns differ. Indeed, different results between genders and among ages is a signal that
Evidence be damned, plaintiffs attorneys are prowling for UPF litigants. While more food regulation (and increased costs) might be proper if there were a real association, lambasting the products and their producers in the light of recent and existing evidence serves only to enrich plaintiff attorneys’ pockets at the expense of the rest of us, without provided clear evidence of benefit.
It’s time for objective, dispassionate, and transparent science, with attention to potential confounders and appreciation of the complex intricacies of the lifestyle-genetics-exposure interface. In other words, it’s time for those versed in science to make policy- not those (wired to sue big companies), who euphemistically might be called “Ministers of Health” in a 1984-type world.
[1] At this writing, it appears that data debunking the addiction theory of UPF is being squelched.
[2] Interestingly, gestational diabetes rates rose significantly between 2016 and 2021 in conjunction with increasing maternal age. The rate for mothers aged ≥40 years (15.6%) was nearly six times as high as the rate for mothers aged <20 years.
[3] Peter W Huber, The Cure in the Code: How 20th Century Law is Undermining 21st Century Medicine
