{"id":2587,"date":"2024-11-23T15:20:48","date_gmt":"2024-11-23T15:20:48","guid":{"rendered":"https:\/\/healthyretirementnews.com\/index.php\/2024\/11\/23\/theyre-up-to-70-of-the-american-diet-but-the-us-has-no-policy-on-ultraprocessed-foods\/"},"modified":"2024-11-23T15:20:48","modified_gmt":"2024-11-23T15:20:48","slug":"theyre-up-to-70-of-the-american-diet-but-the-us-has-no-policy-on-ultraprocessed-foods","status":"publish","type":"post","link":"https:\/\/healthyretirementnews.com\/index.php\/2024\/11\/23\/theyre-up-to-70-of-the-american-diet-but-the-us-has-no-policy-on-ultraprocessed-foods\/","title":{"rendered":"They\u2019re up to 70% of the American diet. But the US has no policy on ultraprocessed foods"},"content":{"rendered":"

Twenty-year-old Sam Srisatta is giving a month of his life to science \u2014 research that could help shape the future of US nutritional and regulatory guidance about the ultraprocessed foods that make up <\/strong>nearly 70% of the nation\u2019s food supply. <\/p>\n

By 7 a.m. each day in his hospital room, nurses record Srisatta\u2019s weight and vitals. Bowel movement samples are captured for analysis. Some mornings, blood is drawn to test how his body reacts to the different types of foods he consumes. Other days, he lies in a bubble that measures his oxygen and carbon dioxide output to determine how many calories he burns while at rest. <\/p>\n

After each morning\u2019s battery of tests is complete, Srisatta has 15 minutes to eat his breakfast before the food is removed, weighed and recorded. At lunch and dinner, he has a full hour to eat as much or little as he likes before the leftovers are whisked away to be measured, and additional vitals are captured. Then he is free to read, play video games, exercise with supervision or fall asleep. <\/p>\n

It\u2019s a routine he and 35 other volunteers repeat for four weeks as they live inside the Metabolic Clinical Research Unit of the National Institutes of Health Clinical Center in Bethesda, Maryland \u2014 part of a unique randomized clinical trial designed to tease out the health impact of different types of ultraprocessed foods. <\/p>\n

\u201cThese are industrially manufactured formulations from refined ingredients and additives that you typically don\u2019t find in your home kitchen or restaurant,\u201d said Kevin Hall, a senior investigator with the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, who is leading the study. <\/p>\n

Ultraprocessed foods typically contain combinations of sugar, salt and fats designed to maximize the \u201cbliss point\u201d of a food, making it potentially irresistible \u2014 much like the 1960s Lay\u2019s potato chip ads starring actor Bert Lahr, famed for playing the Cowardly Lion in \u201cThe Wizard of Oz,\u201d who said, \u201cBetcha can\u2019t eat just one.\u201d <\/p>\n

Potential pitfalls of ultraprocessed foods<\/h3>\n

Advances in food science over the decades since have created even more artificial flavors, smells and textures that experts say home-cooked meals can no longer replicate. These additives, along with high levels of sugar, salt and fat, help create the overwhelming lure of ultraprocessed foods. <\/p>\n

Numerous studies find higher amounts of ultraprocessed food raise the risk of obesity and the development of chronic conditions including cancer, cardiovascular disease, obesity, type 2 diabetes and depression. Such foods may even shorten life. <\/p>\n

\u201cThese and other diet-related conditions account for at least half of all US deaths, disproportionately impacting Black, indigenous, low income and rural Americans, and contribute to $4.5 trillion in annual health care costs,\u201d top officials for the US Food and Drug Administration wrote in a mid-November editorial on the dangers of ultraprocessed foods. <\/p>\n

But do all overly processed foods cause the same harm? The question is puzzling scientists and slowing down regulatory action, critics say. <\/p>\n

\u201cThere\u2019s a lot of debate about whether or not all ultraprocessed foods are bad for you,\u201d Hall said. \u201cProbably not, so what are the mechanisms in this big, broad category of ultraprocessed foods \u2014 which make up somewhere between 50% and 70% of the calories available in our food supply \u2014 what are the mechanisms that drive poor health? <\/p>\n

\u201cIf we can figure that out, then we can provide our colleagues at the FDA and regulators with information about how they might want to label foods, for example, or policymakers on how they may want to change policies,\u201d Hall said. <\/p>\n

An extra 500 calories per day<\/h3>\n

Hall and his team have previously researched the appeal of ultraprocessed foods. A prior study, published in July 2019, sequestered healthy volunteers from the outside world for a month, feeding them ultraprocessed food, including sugary cereals and blueberry muffins, for two weeks and minimally processed foods, such as Greek yogurt with fresh fruit and nuts, for another two weeks. Participants were able to eat as much or little of each diet as they liked. <\/p>\n

Both diets contained the same number of total calories, sugars, fiber, fat, salt and carbohydrates, so Hall expected the food and drink to have a similar impact on the bodies of the 20 volunteers \u2014 but that\u2019s not what happened. <\/p>\n

\u201cWhat we saw in that previous study was that people tended to overeat the ultraprocessed foods diet by about 500 calories per day more than when the same people were exposed to the environment with zero ultraprocessed foods,\u201d Hall said. <\/p>\n

A recent, much smaller randomized clinical trial in Japan, which fed nine sequestered volunteers a week of ultraprocessed and a week of minimally processed food, found a much larger result \u2014 people on the ultraprocessed diet ate an additional 813 calories per day. <\/p>\n

\u201cIn Hall\u2019s study, these people were in a locked ward. They couldn\u2019t lie, they couldn\u2019t cheat, they couldn\u2019t do anything except to eat what they were given,\u201d said molecular biologist and nutrition scientist Marion Nestle, who is the Paulette Goddard Professor of Nutrition, Food Studies and Public Health, Emerita at New York University. <\/p>\n

\u201cThey could eat as much of what they were given as they wanted to and they got this amazing result, which has now been repeated in Japan,\u201d said Nestle, who was not involved in either study. <\/p>\n

The extra 500 calories a day in the July 2019 study led to an average weight gain of 2 pounds <\/strong>(0.9 kilogram) <\/strong>for each week on the ultraprocessed diet \u2014 and a similar loss of weight each week on the minimally processed diet, Hall said. <\/p>\n

\u201cNow the question is, why did that happen?\u201d he asked. \u201cWhat we\u2019ve done in this new study is reformulate ultraprocessed diets so that they vary in certain aspects that we think are probably likely to have driven the excess calorie intake.\u201d <\/p>\n

A first for ultraprocessed foods<\/h3>\n

Obesity is a worldwide epidemic, according to the World Health Organization, which estimates more than half the world will be overweight or obese by 2035. In the United States alone, it\u2019s estimated nearly 260 million Americans will be overweight or obese by 2050 unless policy makers take immediate action. <\/p>\n

For the first time in history, the potential role of ultraprocessed foods in the US obesity epidemic is being investigated as part of the new 2025-2030 US Dietary Guidelines, slated to be published by the end of 2025. <\/p>\n

Once those guidelines are finalized, they will form the basis of federal nutrition policy for the next five years. <\/p>\n

\u201cUltraprocessed foods are fabulously important, in fact the most important concept to come in nutrition since vitamins,\u201d Nestle said. \u201cIt\u2019s backed up by the addiction literature. It\u2019s backed up by Hall\u2019s controlled clinical trial and observational studies. How much more do you need?\u201d <\/p>\n

\n
<\/div>\n
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A stash of ultraprocessed foods in the metabolic unit\u2019s kitchen includes candies, cookies and chips, as well as mayonnaise, cereals, crackers and breads with additives.<\/span> <\/div>
Sandee LaMotte\/CNN<\/figcaption><\/div>\n<\/p>\n<\/div>\n

Starting in 2023, a group of well-known nutritional experts chosen for the 2025 Dietary Guidelines Advisory Committee, or DGAC, began examining the latest science on ways in which ultraprocessed foods affect health. Those findings will be delivered to staff at the US Department of Agriculture and the US Department of Health and Human Services, who will write the final guidelines. <\/p>\n

While discussions on the impact of ultraprocessed foods on heart disease, diabetes and other health issues occurred during the years of work, the committee limited its scientific analysis to only one question: How does ultraprocessed food impact growth, weight gain and obesity across the lifespan? <\/p>\n

How ultraprocessed studies were excluded<\/h3>\n

The advisory committee also set a high standard for research it included in the analysis, excluding studies of less than 12 weeks and fewer than 30 people and prioritizing studies that were based in the United States. <\/p>\n

\u201cWe have learned the hard way from the low-fat clinical trials that weight control trials need to last about 1 year or more because weight loss was greater with low fat for about 6 months, but then this reversed,\u201d said leading nutrition researcher Dr. Walter Willett, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health in Boston, who is not part of the advisory committee or involved with Hall\u2019s research. <\/p>\n

\u201cThus trials of only a few months were worse than no trials at all because they were misleading,\u201d Willett said in an email. \u201cFor this reason, the standard of design for weight control trials is now that they should last for about one year at a minimum.\u201d <\/p>\n

However, experts say such studies are rare due to the expense, the overall lack of funding for nutritional research in the US, and the difficulty in controlling what people actually eat versus what they say they eat. <\/p>\n

\u201cIf you just ask people how many calories they\u2019re eating, people tend to dramatically underestimate that baseline,\u201d Hall said. \u201cThey also tend to believe that they\u2019re sticking to a very low calorie amount throughout the entire dietary period \u2014 they actually end up consuming gradually more and more calories over time.\u201d <\/p>\n

The committee standards also excluded studies that were not clear on how foods were considered ultraprocessed \u2014 a common occurrence due to ongoing controversy among nutritionists as to how to define ultraprocessed foods. <\/p>\n

A punt on ultraprocessed food<\/h3>\n

While the final advisory report won\u2019t be delivered to government stakeholders for a few months, a May meeting of the advisory committee discussed the scientific findings. <\/p>\n

Amid the research the committee members considered, they could only find \u201climited\u201d evidence to suggest that ultraprocessed foods could lead to weight gain and obesity in children, adolescents and adults of all ages. <\/p>\n

Hall\u2019s 2019 randomized controlled clinical trial, however, was not included in the analysis because it was less than 12 weeks and fewer than 30 people, according to a spokesperson from the Office of Disease Prevention and Health Promotion, which supports the committee\u2019s work. <\/p>\n

\u201cThere was wide variance in what was considered ultraprocessed and some serious concerns with studies,\u201d said advisory committee member Dr. Fatima Cody Stanford, an obesity scientist and associate professor of medicine at Harvard Medical School and Massachusetts General Hospital in Boston. <\/p>\n

\u201cAnd there were serious concerns with the applicability of ultraprocessed foods to the US population given global differences in food supply. So this is how we got to a grade of \u2018Limited,\u2019\u201d <\/strong>Stanford said during the May meeting. <\/p>\n

There was also insufficient data to show ultraprocessed foods might be detrimental to pregnant women and infants and toddlers, the committee said. Recent research has shown a newborn\u2019s fat mass at birth is associated with obesity as a preschooler, while other studies have shown the risk of major birth defects increases with an expectant mother\u2019s weight. <\/p>\n

Due to the limitations of the studies considered in the analysis, members of the ultraprocessed advisory subcommittee said they would not be recommending any action on ultraprocessed foods \u2014 leaving that up to the advisory committee for the 2030-2035 US Dietary Guidelines. <\/p>\n

\u201cIn five years, hopefully this isn\u2019t sort of punted again for another five,\u201d said committee member Deirdre Tobias, an obesity and nutritional epidemiologist and assistant professor of nutrition and medicine at Brigham and Women\u2019s Hospital and Harvard Medical School. <\/p>\n

\u201cResearch is going to explode, so revisiting it will probably be, if anything, even more of a priority,\u201d Tobias said in May. <\/p>\n

Since the committee is only advisory, it is possible the new guidelines issued in 2025 could address ultraprocessed foods if federal nutrition scientists who write the final document consider other data and public comments. Robert F. Kennedy Jr., President-elect Donald Trump\u2019s pick for secretary of the US Department of Health and Human Services, has made it clear he wants to regulate chemicals in food. Kennedy also wants to limit access to soda and ultraprocessed foods in school lunches and the Supplemental Nutrition Assistance Program, or SNAP. <\/p>\n

Bonnie Liebman, director of nutrition for the Center for Science in the Public Interest, a nonprofit food safety and nutrition advocacy organization, agreed with the advisory committee\u2019s decision, saying the committee had \u201ctoo little evidence\u201d to issue advice. <\/p>\n

\u201cWe have an obligation to get the best scientific evidence, and frankly, we need more research,\u201d said Liebman, who was not on the committee or involved in Hall\u2019s studies. \u201cIt\u2019s just too early to know what it is about ultraprocessed foods that explains why they\u2019ve been linked to a higher risk of some health problems.\u201d <\/p>\n

It\u2019s not just weight loss<\/h3>\n

Nestle, who has authored, coauthored or edited 15 books on food safety and the politics of nutrition, says the sheer number of studies linking ultraprocessed foods to a myriad of health concerns should tip the balance. <\/p>\n

\u201cThere have been literally hundreds of observational studies that show a connection between ultraprocessed foods and adverse health outcomes \u2014 nearly all show harm,\u201d Nestle said. \u201cObservational studies don\u2019t prove causation, but Kevin Hall\u2019s experiment, which I think is one of the most important experiments ever done in nutrition, is a randomized clinical trial.\u201d <\/p>\n

Randomized clinical trials are considered the gold standard of research because they control variables such as sneaking a sweet or forgetting what food was eaten \u2014 factors plaguing studies that often rely on a subject\u2019s memory or willingness to share. <\/p>\n

\u201cCan you imagine locking somebody up for 20 or 30 weeks or even a year in a metabolic ward? Who will pay for that?\u201d Nestle asked. \u201cWe already know that these foods make people eat more calories than they otherwise would, and they don\u2019t realize they\u2019re eating more. What else do we need to know in order to make public health recommendations? Reduce intake of ultraprocessed foods \u2014 it\u2019s really that simple.\u201d <\/p>\n

Unfortunately, advisory committees are instructed to make recommendations using only the strictest science, Nestle added. <\/p>\n

\u201cNutrition science is largely uncontrolled and indefinite. Without methods for studying diet and health that do not now exist, recommendations can never be science-based enough to satisfy critics,\u201d she said. <\/p>\n

\u201cThis ties the hands of the DGAC and explains why the committee has to be hesitant about suggesting eating less of ultraprocessed foods, despite all the studies indicating harm.\u201d <\/p>\n

Testing two theories of overeating<\/h3>\n

On a fall day during his second week in the metabolic unit, Srisatta\u2019s breakfast is a huge bowl of oatmeal, a side of yogurt and an extra-large helping of scrambled eggs with spinach \u2014 all part of the 6,000 calories he is offered each day. <\/p>\n

\u201cUsually they give out a four-person serving and I can eat as much or little as I want. Most of the time, it\u2019s definitely more than I can eat,\u201d Srisatta said. \u201cI don\u2019t get snacks, but I can have as much water as I like.\u201d <\/p>\n

Today, he is required to eat the entire meal, which occurs only once a week. The meal looks homemade and delicious, and Srisatta finishes all of it well within his 15-minute window. Down in the kitchen where the food is prepared, however, it becomes clear some of his breakfast that day was ultraprocessed. <\/p>\n

\u201cThe eggs we used in that omelet were a liquid egg product that has ingredients in it that make it ultraprocessed,\u201d said Sara Turner, a metabolic clinical research dietitian on Hall\u2019s team at NIH Clinical Center. <\/p>\n

\u201cThe pancake syrup <\/strong>that was in the yogurt has ultraprocessed ingredients in terms of added flavors and added sweeteners, and the same with the apple and cinnamon oatmeal,\u201d Turner said. <\/p>\n

In his new study, Hall and his team of nutritionists are throwing some curveballs in the matchup between minimally and ultraprocessed foods. The goal: Alter meals in two of the four weeks in order to test top theories as to why ultraprocessed foods may cause overeating. <\/p>\n

One of those is energy density, or the number of calories in each gram of food. Packing a lot of calories into a small portion, which often occurs with ultraprocessed foods, can be a reason for weight gain, Hall said. <\/p>\n

The other theory is the food\u2019s ability to excite the taste buds, or its \u201chyperpalatability,\u201d which boosts the desire to eat, said Tera Fazzino, an assistant professor of psychology at the University of Kansas. <\/p>\n

\u201cTypically that means manipulating one or more of three clusters of nutrients \u2014 the amount of salt and fat, fat and simple sugars and carbs and salt \u2014 until they send a message to the brain\u2019s reward center triggering the desire to eat more, even when full,\u201d said Fazzino, who developed the definition of hyperpalatable food and assisted Hall with the study\u2019s development. <\/p>\n

Hall and his team hope to be able to completely reverse the impact of the two variables by testing diets with 80% of calories from ultraprocessed foods that are low in energy density and relatively low in hyperpalatable foods. <\/p>\n

\u201cIf we can really understand the mechanisms, then maybe we can remove that harmful effect of a highly ultraprocessed diet,\u201d Hall said. <\/p>\n

A picture that says it all<\/h3>\n

Sam Srisatta\u2019s lunch and dinner that day are enormous \u2014 a large bowl of broccoli and two hefty salads filled with a rainbow of vegetables and fruits. To reach the goal of including 80% ultraprocessed foods, the salads are mixed with additive-laden deli meat, turkey sausage, a ready-to-prepare boxed rice mix and store-bought salad dressing. <\/p>\n

Next to those meals in the kitchen, however, is dinner for the next day, when Srisatta will begin a week of ultraprocessed meals that are energy-dense and hyperpalatable. That meal contains no minimally processed foods at all \u2014 just ultraprocessed turkey and American cheese sandwiches on white bread, potato chips, and peaches canned in heavy syrup. <\/p>\n

Meals for both days contain the same maximum number of calories, yet the difference is visually striking. It takes two overflowing trays of a mix of minimal and ultraprocessed foods to match the same energy density as one trayful of ultraprocessed foods. <\/p>\n

How all these different diets impact Srisatta and the other volunteers won\u2019t be revealed until the study publishes in a few years, well past the publication of the federal 2025-2030 dietary guidelines. In the meantime, more studies are needed to answer the scientific question of how ultraprocessed foods impact the body, Hall said. <\/p>\n

\u201cBy understanding how the food environment actually does shape our metabolic health, we hope to basically improve the food supply in the future,\u201d Hall said. \u201cEach study adds a small piece to that puzzle of understanding. We\u2019re doing our small piece and we think we could do more. There\u2019s many other people who are very interested in doing this research. We need the resources to do more.\u201d <\/p>\n<\/p>\n

This post appeared first on cnn.com<\/div>\n

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