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This is “The Opinions,” a show that brings you a mix of voices from New York Times Opinion. You’ve heard the news. Here’s what to make of it.
My name is Nicola Guess. I am a registered dietitian. And today, we’re going to be talking about ultra processed food.
Ready meals, chocolate biscuits, sausages, fizzy drinks.
Chicken nuggets, burgers, and hot dogs.
Well, we know they may be delicious, but new research finds eating them too often could be taking years off your life.
Scientists now say these foods should be regulated with tobacco style warnings and advertising bans.
It’s been an issue that’s been bubbling for a number of years, and I think really has come to the fore, particularly in the US. And this is the time of year when people are thinking, how am I going to get healthy for the new year? Like, what am I going to do? Should I be eating this or that?
And I think ultra processed food has now become the dominant question in nutrition. And that really concerns me because I feel like five years ago, we would be thinking, is this food healthy or not?
That’s not what’s happening now. Patients are now asking, is this an ultra processed food? And I’m going to be making the case that I don’t yet think it is a useful way of describing whether a food is healthy or not.
It’s difficult to eliminate ultra processed foods from our diet completely. We need to think about what the risks or benefits might be when we’re raising this conversation of ultra processing.
In America, 75 percent of ultra processed food is high fat, high sugar, or high salt food. But what is the grade, that other 25 percent? And that is things like breads and cereals and yogurt products, most of which are probably neutral or actually good for us. And some of those ultra processed foods have benefits, whether it’s providing micronutrients.
So in the UK, for example, I think about a third of folate, folic acid intake, comes from things like bread and breakfast cereals. Do we really want to be warning people off products that give us a micronutrient that young women are lacking?
Shelf stability isn’t a bad thing. It helps reduce food waste. It makes food more affordable. Is that a bad thing? And then you have the environmental question.
I’ve consulted for food companies, including Beyond Meat, which makes ultra processed alternatives that I think are better for the planet, and I would die of shock if soy milk were unhealthier than regular milk. But it is unquestionably better for the planet.
So do we want to be frightening people off ultra processed foods, which will include things like soy milk, which we are probably going to need to for example, reduce carbon emissions? And I think these are all trade offs that we’re not considering because people are frightened of ultra processed foods.
So historically, we’ve always thought about food in very, very simple terms, whether it’s high sugar, high fat, high calorie. For the last 10 years, there’s been academic research, reframing it and saying, well, let’s look at foods by the degree of processing.
And lots of that data showed that when people have lots of their calories from ultra processed food, they get negative health outcomes. So they become overweight, they develop type 2 diabetes, they develop, in some cases, diseases like dementia. So there was a huge concern.
But most people thought, well, this is probably just that we are looking at cookies and cakes and fast food. But Kevin Hall did a really great landmark study at the NIH where he said, well, OK then let’s compare an ultra processed diet with an unprocessed diet, but we’ll match it for those usual suspect ingredients.
So we’ll make sure they’ve both got the same amount of fat. We’ll make sure they’ve both got the same amount of salt. They’ve both got the same amount of sugar. And let’s see what happens.
And what he found was that people on the ultra processed diet ate more, and they gained more weight in a very short period of time compared to the unprocessed diet. And that really made us recognize, well, it’s not just then this salt and the sugar and the fat. There’s something else going on.
So it caused a lot of excitement and then I think people thinking, a ha! We’ve really got to look more closely at this ultra processed issue. But think about what you do when you’re not having any unprocessed food.
That means you’re not having any whole fruits and veg. And to me, this is a big limitation of that study, is that yes, the diets were matched for sugar and salt and things like that, but they weren’t for fruits and vegetables.
What we know is that when we consume meals with lots of particularly vegetables, we spontaneously consume fewer calories. So to me, although Kevin’s study was a breakthrough in understanding, OK, what does processing do, there is still an unanswered question about what would happen if people consumed, yes, some ultra processed foods, but the rest of their diet was high in fruit and veg.
Processing means lots of things and there are lots of questions that we still need to answer. What is it about processing in general that might cause us to overeat? There is also a question about whether there is something about these additives that might be interfering with the way our brain processes energy.
So they might be tricking us into thinking we’re not eating many calories and actually we are, or they might be triggering what we call this hedonic response, that it’s a pleasurable thing when we eat. We don’t know the answers to any of that yet.
And so my concern is what we should be doing is, in terms of advising people about what is healthy, is go with what we are certain about. So we do not need more research to understand that donuts, fast food, burgers, sugary drinks are unhealthy for us.
And in my opinion, we should be acting on that rather than getting carried away by, does this jar of hummus or pasta sauce have an emulsifier in it, or whether it’s got an ingredient you don’t recognize on the label.
So the way to stop people consuming all of this unhealthy stuff is basically availability and price. It’s not like you go to the movie theater and oh, here’s a bag of dried fruit, or here’s some fruit and nuts.
In America, about a third of people have fast food every day. About 30 percent of people are having fast food probably three times or more a week. In the US, one in six kids is having fast food maybe twice a day, is having potato chips and an energy drink on the bus in the morning for school.
So wherever we are, we are exposed to, can we call it crappy food? I mean, all of us know it’s not good for us, but it’s right there, it’s convenient. And that’s our problem that we need to fix, in my opinion, is changing the food environment so it’s not so available.
The best proposal I’ve seen is that you put a tax on these foods, or so a levy on those foods, and use that to subsidize healthier foods. So for example, vegetables. And I think that’s a useful, pragmatic way forward. And even it could be easier in institutions.
So for example, lots of college campuses, lots of health institutions are large enough that if they implemented some of these changes, they could have a real effect locally. The food industry aren’t going to like that, but what we don’t want is companies to make profit out of stuff that’s making us unhealthy.
For example, the big soda companies are not going to any proposal to remove their products from school. So this has to be driven by the public supporting their government to enact these changes.
In terms of bang for our buck, I cannot believe in 2025, the nutrition conversation is now about supermarket bought bread and high fiber cereals, and not about fast food and donuts and sugary, sweetened beverages and the lack of fruit and veg in our diets. I cannot believe and I think this is what the ultra processed lens has done, is we are focusing on the wrong thing.
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