Ultraprocessed Foods & Cardiometabolic Disease
Ultraprocessed Foods & Cardiometabolic Disease
How modern gastronomy contributes to declining global health.
Ultraprocessed foods are a group of foods that have undergone extensive processing. They’re formulations of cheap calories and additives that make them energy-dense, hyperpalatable, and devoid of beneficial nutrients. The consumption of ultraprocessed foods is increasing worldwide, and damning evidence implicates these “foods” in the diseases of civilization — type 2 diabetes, obesity, and cardiovascular disease. Mounting evidence also indicates that specific ingredients in ultraprocessed foods and byproducts of their manufacturing may directly cause harm to cardiometabolic health. Is junk food the new smoking?
There’s no denying it — diet quality worldwide has declined dramatically in the last few decades.
The main culprit: ultraprocessed foods (UPF) — otherwise known as “junk food.”
UPF is one of four categories of food based on the Nova classification system, which recognizes four “food groups”: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and UPF.
UPF aren’t modified foods, but rather formulations of cheap energy sources, some nutrients, and other additives cobbled together through “ultraprocessing.” UPF are energy-dense (high in calories); comprise unhealthy fats, refined starches, sodium, and added sugars; and are poor sources of protein fiber, vitamins, and minerals.
Another insidious aspect of UPF is their hyperpalatability. The Lay’s “bet you can’t eat just one” slogan isn’t just a catchphrase — it’s an innate feature of their product. Legions of food scientists have worked tirelessly to make sure you “can’t eat just one.”
The other qualities of UPF including their ease of consumption, attractive packaging, and low cost contribute to their overconsumption. Some public health experts have gone so far as to conclude that “the ever-increasing production and consumption of these products is a world crisis, to be confronted, checked, and reversed…” as part of public health initiatives.
Some examples of UPF include soft drinks, packaged snacks, processed meats, and pre-prepared frozen meals, cereal and bread, and many sauces, spreads, and condiments.
In contrast to UPF, unprocessed and minimally processed foods are those traditionally found in diets around the world — the “whole foods” we often consider to be healthy and associated with wellness and longevity. Ingredients you’d cook with around the house.
Eating an “evolutionarily discordant” diet
You don’t need to “go paleo” to be healthy. In fact, we probably don’t have the foggiest idea of how or what our ancestors ate.
But it sure as hell wasn’t anything closely resembling UPF.
Modern-day humans (that’s us) are genetically adapted to the environment — both the physical and the food environment — of our ancestors. This probably included a LOT of low-intensity physical activity and a method of obtaining food that involved agriculture and animal husbandry. Diets were comprised of whole foods that underwent little to no processing.
The rapid change in our food environment and lifestyle conditions occurred too recently on an evolutionary timescale for our genomes to adapt. We’re stuck with hunter-gatherer DNA in a world designed for desk jockeys. This discordance between genes and environment has manifested itself as an increase in the so-called “diseases of civilization.”
UPF consumption around the world and dietary decline
Nearly all countries and regions of the world have increased their UPF consumption, but “high-income” countries such as Australia, Canada, the United Kingdom, and the United States are the worst offenders — UPF comprises 40%–60% of the diet in these areas. However, In Asia, the Middle East, and Africa, UPF sales (and thus consumption) are also rising as they adopt Western ways of life.
Eating more UPF is bad, but it’s the fact that UPF are replacing healthier, less-processed or unprocessed foods that’s the real problem. It’s not as if people are just adding a bit more UPF to their already healthy diets — there’s a substitution going on, and it’s a bad tradeoff.
What does a reduction in “diet quality” mean?
As UPF intake goes up, dietary energy density does too. Energy density is the amount of energy (calories) in a particular weight of food and is generally presented as the number of calories in a gram. Foods with a lower energy density provide fewer calories per gram than foods with a higher energy density. For example, vegetables have a low energy density (you can eat a high volume for a low caloric cost), while UPF (think of a bag of oily potato chips) has a high energy density.
Higher UPF intakes also increase the amount of free (added) sugar and saturated/trans fats in the diet and reduce the amount of fiber, protein, potassium, and important micronutrients like zinc, magnesium, and vitamins A, C, D, E, B12, and niacin, among others.
UPF and cardiometabolic health
Overwhelming evidence links UPF consumption to disease.
Meta-analyses on the issue have indicated that eating a diet high in UPF raises the risk for type 2 diabetes by 40%, cardiovascular events by 35%, all-cause mortality by 29%, overweight and obesity by 36%–55%, metabolic syndrome by 81%, and cardiovascular mortality by 50%–66%.
How might UPF elevate one’s risk for cardiometabolic disease?
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