From soft drinks to cereals and packaged snacks to processed meat, ultra-processed foods are full of additives. Oil, fat, sugar, starch and sodium, as well as emulsifiers such as carrageenan, mono- and diglycerides, carboxymethyl cellulose, polysorbate and soy lecithin, continue to strip foods of healthy nutrients, while which introduce other ingredients that could also be harmful to human health.
Hundreds of new ingredients never encountered by human physiology are now found in nearly 60 percent of the diet of the average adult and in nearly 70 percent of the diet of children in the United States.
While obesity and lack of physical activity are recognized as contributing to preventable morbidity and mortality in the US, another emerging danger is the unprecedented consumption of these ultra-processed foods in the standard American diet. This may be the new “silent” killer, as unrecognized high blood pressure was in previous decades.
Doctors at Florida Atlantic University's Schmidt College of Medicine explored this hypothesis and provide important information to healthcare providers in a battle where the entertainment industry, the food industry and public policy do not align with the needs of their patients. Their findings are published in a comment on The American Journal of Medicine.
“Those of us who practice medicine in the U.S. today find ourselves in an ignominious and unique position: We are the first group of healthcare professionals to have presided over a decline in life expectancy in 100 years,” said Dawn H. Sherling, MD. , corresponding author, associate director of the internal medicine residency program and associate professor of medicine at the FAU Schmidt College of Medicine. “Our life expectancy is lower than that of other economically comparable countries. When we look at the increasing rates of non-communicable diseases in less developed nations, we can see a trace of this increase along with the increase in the consumption of ultra-processed foods in their diets.
Although professional organizations like the American College of Cardiology warn patients to “choose minimally processed foods over ultra-processed foods” in their 2021 dietary guidelines, there is a warning that “there is no commonly accepted definition for ultra-processed foods, and Some healthy foods may exist within the category of ultra-processed foods.”
“When the components of a food are contained within a natural whole food matrix, they are digested more slowly and more inefficiently, resulting in lower calorie extraction, lower overall glycemic loads, and lower increases in lipoproteins.” high in triglycerides after eating, which could lead to atherosclerotic plaque,” said Allison H. Ferris, MD, senior author, associate professor and chair of the Department of Medicine and director of the internal medicine residency program at the FAU Schmidt College of Medicine. . “Therefore, even if problematic additives were removed from ultra-processed foods, there would still be concerns that excessive consumption of these products could lead to obesity, diabetes and heart disease.”
The authors add that public health organizations are increasingly using the NOVA classification system, which divides foods into four categories: whole foods, culinary ingredients (items such as butter, oil and salt), traditionally processed foods (such as bread and yogurt made with few ingredients), and ultra-processed foods, or those that are manufactured industrially and use ingredients that are not normally found in a home kitchen.
According to the authors, a plausible mechanism to explain the dangers is that ultra-processed foods contain emulsifiers and other additives that are mostly not digested by the mammalian gastrointestinal tract. They may act as a food source for our microbiota and, as such, may be creating a dysbiotic microbiome that, in the right host, can promote disease.
“Additives, such as maltodextrin, may promote a mucous layer that is friendly to certain species of bacteria that are found in greater abundance in patients with inflammatory bowel disease,” Sherling said. “When the mucosal layer is not adequately maintained, the epithelial cell layer can become vulnerable to injury, as has been shown in feeding studies using carrageenan in humans and other studies in mouse models, using polysorbate-80 and cellulose gum. , which triggers immune responses in the host.”
The authors add that there have been marked increases in colorectal cancer in the US, especially among younger adults. They believe that increased consumption of ultra-processed foods may contribute, in addition to other gastrointestinal diseases.
“Finding out whether ultra-processed foods contribute to our rising rates of non-communicable diseases requires direct testing in analytical studies designed a priori to do so,” said Charles H. Hennekens, MD, FACPM, co-author of First Sir Richard Doll. Professor of Medicine and senior academic advisor at the FAU Schmidt College of Medicine. “In the meantime, we believe it is incumbent upon all healthcare professionals to discuss with their patients the benefits of increasing consumption of whole foods and reducing consumption of ultra-processed foods.”
The authors also opine that just as the dangers of tobacco began to emerge in the middle of the previous century, it took decades before the preponderance of evidence and the efforts of forward-thinking health officials prompted policy changes to discourage use. of cigarettes. They say there is likely a similar path for ultra-processed foods.
“Multinational companies that produce ultra-processed foods are as powerful, if not more, than tobacco companies were in the last century, and it is unlikely that governments will be able to quickly adopt policies that promote whole foods and discourage the consumption of ultra-processed foods. “said Sherling. “Importantly, healthcare providers must also be aware of the difficulties many of our patients have in affording and finding healthier options, which requires a broader public health response.”