Ultra-Processed People

Yuzo Makitani -

The Book in 3 Sentences

  1. Ultra-processed foods are prevalent in our modern day diet (up to 60% in US and UK) due to profit-motivated corporations and a lack of governance on the chemistry of food.
  2. These ultra-processed foods include substances which promote over-consumption of calories, damage gut bacteria, and alter our metabolism and appetite - leading to health issues, mainly obesity.
  3. There needs to be separation between government/research and food corporations, with the former policing rather than cooperating with the latter; on an individual level, people should avoid eating foods with ingredients which are not found in a typical kitchen.

Impressions

Overall I liked the message of the book and found it rich in information. I easily spent a whole day reading half the book.

I generally believe in the author’s key takeaway that ultra-processed foods are unhealthy. I also appreciate the substantive amount of citation and interviews which went into this book. However, I disliked the Van Tulleken’s writing style and thought it sometimes undermined his thesis:

  • Van Tulleken doesn’t come across as an expert, because he relies heavily on the credibility and research of others. His own research is an N=1 study on himself eating ultra-processed food, which does not count as credible research.
  • His paragraph structure does not start with the main point. I found myself frequently searching for the key takeaway in the paragraphs. He also does not end chapters with a summary of what he said, instead ending in a long block of footnotes.
  • I also found the structure of the book confusing. He devotes three whole chapters to why obesity isn’t due to sugar, exercise, or willpower. He only starts to explain why UPF is the root cause of obesity halfway into the book. This roundabout approach makes him take too long to get to the main point.
  • Van Tulleken fails to show a mechanism for how man-made substances found in ultra-processed foods actually damage gut bacteria and alter our metabolism. This may be because science has not yet found the mechanisms, but if this is the case he needs careful in showing causation about something we don't understand how it happens.
  • He undermines his own credibility by focusing on conflicts of interest first. He attacks the credibility of researchers by showing their connections to the food industry. This is important, but he should focus on questioning the underlying methodologies of the study, then drawn connections to be more convincing. Again, like my last point he draws too much on peripheral observations which weakens the credibility of the core premise.

How I Discovered It

The book was referenced in an Economist article I read in August. When I saw it was a bestseller I decided to pick it up.

Who Should Read It?

The book is useful for anybody, but I think it is especially useful for parents with infants or young children. The young are most vulnerable to the effects of bad diets.

How the Book Changed Me

  • The book made me more mindful about the food I eat, and staying away from fast food and pre-packaged food
  • I now look at ingredients lists more carefully to screen them for non-kitchen ingredients, whereas before I really only looked at the nutritional information like trans fats, sodium, sugar, and carbs as percentage of daily recommended intake
  • The dangers of ultra-processed food serves as motivation to cook more often

My Top 3 Quotes

  • “UPF now makes up as much as 60 per cent of the average diet in the UK and the USA.”
  • “Additionally, people who eat UPF and don’t gain weight have increased risks of dementia and inflammatory bowel disease, but we don’t tend to blame patients for having these problems.”
  • “Most of the humans in the UK and the US have entered what I call ‘the third age of eating’, in which most of our calories come from food products containing novel, synthetic molecules, never found in nature.”

Summary + Notes

Here is an excerpt from the book which summarizes the key scientific findings better than I can:

  • The destruction of the food matrix by physical, chemical and thermal processing means that UPF is, in general, soft. This means you eat it fast, which means you eat far more calories per minute and don’t feel full until long after you’ve finished. It also potentially reduces facial bone size and bone density, leading to dental problems.
  • UPF typically has a very high calorie density because it’s dry, and high in fat and sugar and low in fibre, so you get more calories per mouthful.
  • It displaces diverse whole foods from the diet, especially among low-income groups. And UPF itself is often micronutrient-deficient, which may also contribute to excess consumption.
  • The mismatch between the taste signals from the mouth and the nutrition content in some UPF alters metabolism and appetite in ways that we are only beginning to understand, but that seem to drive excess consumption.
  • UPF is addictive, meaning that for some people binges are unavoidable.
  • The emulsifiers, preservatives, modified starches and other additives damage the microbiome, which could allow inflammatory bacteria to flourish and cause the gut to leak.
  • The convenience, price and marketing of UPF urge us to eat constantly and without thought, which leads to more snacking, less chewing, faster eating, increased consumption and tooth decay.
  • The additives and physical processing mean that UPF affects our satiety system directly. Other additives may affect brain and endocrine function, and plastics from the packaging might affect fertility.
  • The production methods used to make UPF require expensive subsidy and drive environmental destruction, carbon emissions and plastic pollution, which harm us all.”

Below is the crucial study that serves as the basis that UPFs contribute to obesity:

“Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain…” conducted by Hall of the National Institute of Health (NIH)

“The experiment he devised was appealingly simple: he’d put two different diets head-to-head.3 One would comprise 80 per cent NOVA group I food (stuff like milk, fruit, vegetables and so on), with some foods from NOVA groups 2 (kitchen ingredients like oil and vinegar) and 3 (processed foods including tinned goods, butter and cheese) but no UPF (NOVA group 4). The other diet would consist of at least 80 per cent NOVA group 4 foods – i.e. 80 per cent UPF. Crucially, the diets would be matched with each other exactly in terms of salt, sugar, fat and fibre content, and the participants would be able to eat as much of the food as they wanted.”

“When the results came in, Hall was shocked. He had proved himself wrong and Monteiro right. On the grey, tinned, ultra-processed diet, people ate an average of 500 calories more per day than those on the unprocessed diet, and they gained weight in line with that. Perhaps even more surprisingly, participants actually lost weight when they were on the unprocessed diet, even though they could eat as much of it as they liked. As already mentioned, it wasn’t that the UPF was more delicious, either. There was some other quality beyond ‘deliciousness’ that was driving the UPF group to overeat.”

Excerpt from Ultra-Processed People: The Science Behind Food That Isn't Food