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

“We’ve started eating substances constructed from novel molecules and using processes never previously encountered in our evolutionary history.”

Van Tulleken introduces the UPF concept and puts it in an evolutionary context. Namely, UPF involves ingesting chemicals that our bodies have not had time to adapt to. As such, eating UPF involves significant risk for humans, as we do not know that our bodies will be able to safely cope with them.

“Surely it would be simpler and cheaper to use fewer ingredients?”

Van Tulleken examines a paradigmatic example of UPF, mass-produced ice cream. He notes the huge list of ingredients and wonders if having so many would not involve more expense. He quickly discovers, though, that the UPF ingredients in fact save money. This is because the modified starches and oils used can replace more expensive conventional ingredients such as eggs and butter. At the same time, other UPF ingredients like emulsifiers and gums save costs by allowing the product to be transported over longer distances and stored in more diverse conditions.

“To work out if a food is healthy, most of us ask how much saturated fat, salt, sugar, fibre, vitamins and minerals it contains.”

Van Tulleken sums up the nutritional philosophy known as nutritionism. This suggests that whether a food is “good” or “bad” for us depends on the various micro- and macronutrients in the food. He argues that this philosophy and approach has been very effective at curing diseases of deficiency, such as scurvy, but has been unable to explain the huge rise in obesity since the 1980s. One of the main problems of nutritionism, suggests van Tulleken, is that it leads to very confusing and complicated advice on what is healthy or unhealthy and on what constitutes a healthy diet.

“He saw what he called a ‘nutritional transformation,’ a confusing rise in obesity among the poorest communities as obesity rates in more affluent areas were beginning to fall.”

Van Tulleken describes how Monteiro was led to posit a link between UPF and obesity. Monteiro first noticed an apparent paradox in the dietary patterns of Brazilians. Namely, he observed that poorer Brazilians were eating more of what was considered healthy food, according to conventional knowledge of macronutrients, but gaining weight. He managed to resolve this contradiction by identifying a factor independent of macronutrients in the diet of lower-income Brazilians: new, industrially processed foodstuffs.

“The idea that humans might have an internal system […] that allows us to self-regulate and balance our diets seems unlikely considering how little we are trusted by the authorities to eat without guidance.”

Van Tulleken comments on how alien the concept of an internal regulatory system for food intake is within our current health and food culture. He bases this point on the fact that governments feel the need to tell their citizens what they are supposed to eat to be healthy. Van Tulleken argues that something has gone deeply wrong within our culture. In earlier eras, humans, like all other animals, were able to eat according to instinct.

“[F]ood had generally been hard to get hold of.”

This is part of the abundance hypothesis. It argues that obesity is a result of the mismatch between our bodies, which evolved for scarcity, the common condition throughout most of human evolutionary history, and the contemporary abundance and reliability of the food supply. As such, it is inevitable that humans put on weight in the current epoch; the historical scarcity of food means that we are hardwired to consume as much as we can.

“It may feel like it’s under your conscious control and indeed you can choose to have or delay a drink.”

Van Tulleken examines how our internal regulatory system for food intake works and the absurdity of saying that nutritional intake is under our conscious control. In making this argument, he uses the analogy of hydration levels. At any given moment, we can choose to forgo a drink. However, control only exists in the moment and is an illusion in the long run. In the long run, our bodies strictly regulate our levels of hydration and use thirst to push us to drink when we need more water. Similarly, with food intake, we can ignore hunger and exercise “will” at a given moment. However, in the long term, it’s impossible to ignore the body’s signals to make us eat what it needs.

“[N]ot simply that UPF is delicious and so creates ‘hedonistic overdrive,’ where we enjoy eating more than we hate being full.”

One theory of why UPF might lead to overeating is that we have two conflicting hormonal impulses when it comes to food—one, the pleasure in eating food, and, second, the discomfort in feeling “full.” UPF has been made so appealing that our pleasure from eating unnaturally and excessively overrides our disgust at being full. However, van Tulleken argues that there is something else driving overeating with UPF that is only indirectly related to its “deliciousness.”

“[T]he problem, common to all diets, is that we don’t really choose what to eat […] You can avoid carbs in the same way you can hold your breath.”

Van Tulleken explains why he thinks that all diets, including the currently fashionable low-carbohydrate ones, ultimately fail. Diets commit the error of supposing that what and how much we eat is within our conscious control. Van Tulleken argues that because of our internal regulatory system for food intake, this control does not exist on a deeper level. While we may be able to exercise “willpower” and stick to a diet for a few weeks or months, in the end, we will be driven to eat the foods dictated by our nutritional regulatory system.

“We’re doing a lot less than we used to throughout the industrialized world.”

This embodies the “sedentary lifestyle” explanation of obesity. This hypothesis holds that obesity is the result of humans doing a lot less physical activity in the home and at work than they used to due to mechanization and the predominance of nonmanual service sector jobs. As such, humans are burning fewer calories and inevitably putting on weight. Van Tulleken finds this thesis erroneous, as experiments show that contemporary humans are not in fact burning fewer calories than their hunter-gatherer ancestors. This is because we possess an internal regulatory system for ensuring a consistent expenditure of calories, which downregulates nonessential bodily systems if we do more exercise.

“The swamp isn’t just the density of restaurants. It’s also the total immersion in marketing.”

Van Tulleken explains why certain people are more prone to eating UPF and becoming overweight as a result. This has little to do with choice but is about the “food environment” they find themselves in. “Food swamps” are food environments where UPF is so pervasive that it is difficult to find non-UPF, whole food. Further, UPF dominates because UPF marketing and advertising are ubiquitous.

“We know that low-income households tend to eat more UPF, for often many sensible reasons.”

Van Tulleken notes how there is a correlation between consumption of UPF and lower income. However, he argues, the main reason for this is not ignorance of what constitutes healthy food. Rather, what drives consumption is the cheapness, speed of preparation, and availability of UPF relative to non-UPF for people with scarce time and money. This suggests that the answer to obesity and UPF consumption is not punitive taxation on UPF but measures to make non-UPF more accessible and the alleviation of poverty.

“[D]rug addiction and food addiction share risk factors like family history of addiction, trauma and depression.”

Van Tulleken explains how UPF is similar to addictive drugs. Like drug addiction, addiction to UPF food is strongly linked to negative life experiences that lead one to seek relief or escape. At the same time, addiction to UPF, like alcohol or drug addiction, is transmitted across generations and within families. This is perhaps because children normalize the excessive eating of UPF and excess eating as a coping mechanism when they are brought up in a household where parents or older siblings consume UPF.

“We consume addictive products for the sensory hit, and we know that increasing the speed of any drug being delivered […] is a crucial aspect of making a substance addictive.”

This partly explains why UPF leads people to overeat and suggests another way that UPF is analogous to an addictive substance. The softness of UPF means that we typically consume UPF much more quickly than ordinary food. Combined with its caloric density, UPF provides a spike in blood sugar and calorific “rush” that one would not get with non-UPF. This sensory rush leads consumers to seek out UPF again, and in greater quantities, to get the same feeling. It also makes non-UPF seem unexciting.

“But this added flavor won’t contain any of those lost nutrients that it should signal.”

This is another reason UPF has addictive potential. Because the intensive processing of UPF destroys most of the micronutrients in the foods processed, as well as their smell and taste signatures, manufacturers must use artificial flavors to make food appetizing. However, artificial flavors still trigger an anticipation of nutrients. When these are not found, consumers eat more UPF to chase those missing nutrients.

“[A] physiological confusion that barely makes it to the surface of our conscious experience, we find ourselves reaching for another.”

Van Tulleken expands on the addictive character of UPF and its similarity to addictive drugs. The packaging, marketing, smell, and taste of UPF are all designed to create the illusion that we will be getting an authentic and enjoyable experience from the food. This is something that UPF can never deliver on, sowing confusion between the senses and the actual content of the food. This sensory confusion is a hallmark of other addictive drugs, which disrupt the body’s natural ability to distinguish pleasure from desire and wanting from needing or liking.

“Whether an additive causes issues that are detectable only after years of exposure—depression, increased suicidality […] weight gain […] is difficult to discern.”

Van Tulleken highlights another problem with UPF—the difficulty of testing for its long-term effects. It may be possible to identify substances that are immediately and obviously toxic. However, this is much harder with long-term and subtle effects. There are multiple, complex factors in the real world that could cause similar long-term health conditions and from which it is difficult to extricate the role of UPF. Even when serious attempts are made to test for the impact of new chemicals on health, safety will remain at best uncertain.

“At a time when […] growth is more subdued in established economies […] a strong emerging market posture is going to be a winning position.”

This comment was made in 2016 by Mark Schneider, who was then the chief executive of Nestle. Schneider reveals a common issue facing UPF firms—namely, that UPF firms seek constant growth but find that Western markets are saturated. As such, these firms inevitably turn their attention to promoting consumption of UPF in developing and poorer nations. Communities in poorer nations do not have the healthcare or social infrastructure to deal with the effects of UPF, meaning that UPF’s impact on these communities will be even more severe.

“None of the UPF snacks and discretionary products are necessary for the human diet.”

This is one of the reasons why UPF is bad for the environment. Many UPF products require vast energy to produce. Yet they are unnecessary in dietary terms and serve no other purpose than to generate revenue. UPF companies have a vested interest in creating more of these unnecessary products to deal with the problem of saturated markets for existing products.

“[I]f you look at the corporate websites, you might believe that these companies are not food companies at all but rather charities committed to improving the environment.”

Van Tulleken highlights how many UPF firms have engaged in extensive public relations and marketing campaigns to present themselves as “green” and sustainable. However, this belies the reality, which is that UPF firms, and the industrial farming on which they depend, are among the largest contributors to greenhouse gas emissions and possible catastrophic climate change. This is because the processing of whole foods and the supply chains required for multiple stages of production are energy intensive relative to simply growing whole foods.

“If the food’s too soft, add more gum. If it’s too dense in energy, add artificial sweeteners.”

Van Tulleken discusses one of the UPF industry’s responses to claims that their food adversely affects health. Namely, UPF firms have responded by proposing to process UPF still further to correct the problems van Tulleken identifies regarding its softness and energy density. He argues, though, that such “hyper-processing” can never work because UPF firms are ultimately driven to create products that sell and are consumed more. Second, hyper-processing risks introducing into the human diet a whole new raft of chemicals and processes with unknown health effects.

“[A]lmost homeopathic quantities of milk are administered too often leading to starvation and death.”

This is one of the many tragic consequences of Nestle’s aggressive marketing of baby formula to mothers in the developing world in the 1970s. Nestle gave formula to these mothers for free or at low prices until they stopped lactating and were dependent on it and then hiked up the price. Many mothers with limited financial resources watered down the formula to make it last longer, leading their babies to die of malnutrition. This highlights the dangers of allowing UPF firms to act without proper scrutiny and regulation. It also highlights how devastating predatory corporate practices can be when combined with existing poverty.

“Removing industry from the table will require a cultural shift before any shift in legislation.”

According to van Tulleken, the UPF industry is too involved in determining policies surrounding regulation. He argues that policy makers, activist groups, researchers, and charities need to adopt a more adversarial and non-collaborative approach with UPF companies if meaningful change is going to take place. Van Tulleken states that this will require a shift in culture and in attitudes toward industry collaboration more broadly. He gives little indication of how such a change in culture is likely to come about.