“What is real? How do you define ‘real’? If you’re talking about what you can feel, what you can smell, what you can taste and see, then ‘real’ is simply electrical signals interpreted by your brain.”
— Morpheus, The Matrix.
With the MAHA movement placing a target on ultraprocessed foods (UPFs), the response from industry interests has been predictable. What has been troublesome, although not unexpected, is the response from within the corridors of the institutions that have presided over the debacle that has been the food-health recommendations and guidelines of the last 50 years. These same corridors connect in byzantine and labyrinthine ways to both the producers of these comestibles and the halls of power that aim to regulate them. A recent editorial in the New York Times, penned by a registered dietitian at a renowned university, lamented that labeling foods as ultra-processed is “so broad it borders on useless…. It lumps store-bought whole-grain bread and hummus in with cookies, potato chips, and soda.”
And therein lies the problem.
A quick review of several of the ingredient labels of popular whole-grain breads reveals that they contain various combinations of added sugars, soy oil, lecithin, monoglycerides, dough conditioners, potassium sorbate, emulsifiers, and DATEM. DATEM stands for diacetyl tartaric acid esters of mono- and diglycerides and is an emulsifier and dough conditioner used to improve the elasticity, handling, and shelf life of the product.
This stark contrast, as discussed in the aforementioned ingredients between what goes into an ultra-processed food (NOVA Classification Group 4), does not include the differences in how the breads are made. An industrial loaf of bread often includes extra sugars, along with significant amounts of extra yeast, to shorten the proofing time, so that a single loaf is done in under three hours, from flour to packaging, from start to finish. That’s less than the proofing time alone for a traditional, artisanal loaf made from flour, salt, yeast, and water. A sourdough loaf proofs even longer.
Simply because the manufacturer labels something as a ‘whole-grain bread’ (in accordance with extant laws) doesn’t make it legitimately so any more than Henry VII’s paid-for genealogy proves he was descended from King Arthur. In fact, a closer examination of the ingredient list for whole-grain bread reveals that it is remarkably similar to that for manufactured cookies. Pepperidge Farm Whole Grain Honey Wheat Bread shares an ingredient list with Chips Ahoy! Original Chocolate Chip Cookies that include wheat flour, sugar, soybean/canola oil, and soy lecithin. A quick perusal of the list of ingredients in some hummus preparations reveals the ever-present soybean/canola oil, sugar, cellulose, modified cornstarch, potassium sorbate, and soy lecithin. It’s an ingredient list that has more in common with that bag of Chips Ahoy! than it does with any recipe from Chef Ottolenghi.
And once again, the ingredient list doesn’t even tell the whole story. The way these industrial foods are manufactured, particularly when the process involves additives, preservatives, and flavor compounds, often requires the destruction of the native food matrix before it is recombined with the industrial components. As some of the latest research indicates, this appears to fundamentally alter the relationship between the nutrients and other elements within these ultra-processed offerings, making UPFs a unique modern creation rather than simply a natural extension of the authentic foods that inspired them.
A simple example of the impact of the natural food matrix is to examine the difference between traditional mozzarella and halloumi cheese. The ingredient list is exactly the same. The cheeses are not, as anyone who has had a traditional Napolitano pizza topped with buffalo mozzarella and grilled halloumi on the BBQ can attest. The matrix is why consuming whole raw blueberries – with a glycemic index of 53 – doesn’t send someone with type II diabetes into a diabetic coma, and in fact, over time, positively improves their health. A glass of blueberry juice – with a glycemic index of 65 – does the opposite.
This week’s Study Spotlight examines the review article from Nature, The Role of Ultra-Processed Food in Obesity.
- The article highlights the temporal correlation between the rise in obesity and the consumption of ultraprocessed foods (UPFs), as defined by the NOVA 4 Group Classification.
- The construction of UPFs involves altering the native food matrix to produce a soft texture, and the addition of exogenous salt, fats, and sugars results in increased energy density and hyperpalatability.
- This affects ingested behaviors, satiety signaling, and food reward systems.
- Beyond just ingredient composition, there are physiologic mechanisms by which the obesogenic effects of UPF characteristics, e.g., emulsifiers, non-nutritive sweeteners, acellular nutrients, and contaminants from processing and packaging, may manifest, including altered absorption kinetics, glycemic response, and effects on the gut microbiome.
The Caveat:
At the current rate, by 2035, there will be over 4 billion obese people (as defined by a BMI ≥ 30 kg/m2), which is estimated to be greater than 50% of the global population. That includes 20% of boys and 18% of girls aged 15 to 19 years. Based on current trends, the most significant proportion of people affected will be from low- and middle-income countries. The trajectory of obesity over time is practically superimposable upon the curve of UPF consumption.
Over just the last decade, there have been multiple prospective cohort studies linking UPF intake to the likelihood of obesity and chronic disease.[1] Despite these studies, the current push back against reining in the ubiquitous consumption of UPFs focuses on the lack of a clearly singular, causal pathway as a reason to withhold intervention. Further complicating the issue is the likelihood that the effects of UPFs are mediated through multiple physiological mechanisms. Among those are the effects of ultraprocessing on the native food matrix. This is a consideration that is consistently overlooked by those who offer only ingredient-based arguments or purposefully ignored by those with a vested interest in continued Nutritionism.
The food matrix encompasses the complex assembly of nutrients and non-nutrient food components, as well as their physical and chemical interactions. These factors influence the release, accessibility, digestibility, and stability of nutrients and other compounds in foods.[2] In other words, there are adverse effects from the consumption of ultraprocessed food from factors beyond what you can find on the ingredient label. This being true, a simple reformulation, such as replacing an artificial red dye with a natural derivative, will have a minimal impact on stemming the rise of obesity attributable to the consumption of ultraprocessed foods.
Reformulation is a solution welcomed by the UPF industry. Instead of an approach to decrease consumption, such as the movement to reduce cigarette smoking, reformulation allows for the preservation of the core business model. This will enable companies to keep their existing product lines, manufacturing infrastructure, and distribution networks largely intact. It maintains the convenience-focused value proposition that drives UPF sales and protects market share in high-margin ultra-processed food categories. It allows manufacturers of ultra-processed food to continue selling the same familiar products in the same grocery store aisles.
It avoids the education of consumers and avoids the introduction of new eating patterns or food preparation that excludes or minimizes the inclusion of UPFs. The current purchase triggers, convenience, hypepalatability, taste profiles, and shelf life remain in place. All the while, it allows the companies a positive PR spin: “We’re listening and responding to consumer concerns.” Voluntary reformulations also make it difficult to institute governmental regulations and boundaries when companies are “voluntarily improving.”
Industry cooperation enables the coordinated movement of entire sectors (e.g., as seen during the removal of trans fats from UPFs). Trade groups and multistakeholder institutions can create industry-wide talking points about “continuous improvement” and “innovation,” allowing the ultraprocessed food industry to control both the narrative and the timeline. It is time for us, the consumer, to claim our seat at the table.
[1] (Lane, 2024)
[2] (Aguilera, 2019)
The Study:
Additional references:
