Tag: Sugar

From Watts Up With That?

Guest Essay by Kip Hansen

Prologue:  This will be the last entry to a series of five parts which have discussed the ongoing scientific controversy surround the issue of Ultra-Processed Foods – UPFs.

The previous essays were:

What Junk Nutrition Science Looks Like

Modern Scientific Controversies: The War on Food: Part 1

Modern Scientific Controversies: The War on Food: Part 2, What are UPFs?

Modern Scientific Controversies: The War on Food: Part 3 — UPFs: What Are They Measuring?

The typical news media article on Ultra-Processed Foods usually starts with something like this, used in a New York Times piece, titled “How Bad Are Ultraprocessed Foods, Really? “ by Alice Callahan:

“Are ultraprocessed foods harmful?

“Most research linking UPFs to poor health is based on observational studies, in which researchers ask people about their diets and then track their health over many years. In a large review of studies that was published in 2024, scientists reported that consuming UPFs was associated with 32 health problems, with the most convincing evidence for heart disease-related deaths, Type 2 diabetes and common mental health issues like anxiety and depression.”

And it is true, consumption of UPFs have been “associated” with a lot of health problems – through the kind offices of epidemiology.  Remember:

World-class statistician, William “Matt” Briggs, author of the book “Uncertainty: The Soul of Modeling, Probability & Statistics”, tells us, in no uncertain terms, that: “Epidemiology is the field which officially mistakes correlations for causations.”

And that is the most basic statement we can make about the faddish battle against Ultraprocessed Foods.

Let’s first make a basic assumption:

The basics of a “Good Diet” are a) Adequate, meaning enough, protein, carbohydrates, fats and essential vitamins and minerals.  b) Not too much of any one thing, especially too much sugar (of all types), too many fats (of all types), too many proteins (of all types), and for some people, too much salt.  c)  Defining ‘too much’ and ‘adequate, enough’ is tricky, but you get the idea.   d)   Lots of variety including whole grains, fruits and vegetables of all types.

Feel free to have some objections to that assumption, nearly everyone can find something not to like, but what we know of the science of diet supports that very basic assumption.

What does this have to do with Ultraprocessed Foods?

Almost nothing.  Ultraprocessed Foods (UPFs hereafter) are a category of foods based solely on “the extent and purpose of food processing”.   Biologically, nutrition is the purpose of eating. Yet, nutritional values are not part of the defining characteristics of UPFs. 

Remember, UPFs does not mean “junk food”.  UPFs does not mean sugary sodas, hamburgers, French fries, candy and snacks.  Those are a concern in modern societies, but, while they are often included in UPFs, they are not the core of UPFs. 

What is the core of UPFs?  “Almost everything on the shelves, in the aisles, of your grocery store and in the cupboards and refrigerators of your home.”

Another viewpoint:

In a NY Times piece (“How Bad Are Ultraprocessed Foods, Really?“), the journalist, Alice Callahan, quotes Dr. Lauren O’Connor [a nutrition scientist and epidemiologist who researched this topic as a former USDA and NIH employee] as saying:

“It’s true that there is a correlation between these foods and chronic diseases, she said, but that doesn’t mean that UPFs directly cause poor health.”….”Dr. O’Connor questioned whether it’s helpful to group such “starkly different” foods — like Twinkies and breakfast cereals — into one category. Certain types of ultraprocessed foods, like sodas and processed meats, are more clearly harmful than others.”

That quote seemed just a little too “on purpose” to me, so I wrote to Dr. O’Connor and asked her “Did you really say “are clearly more harmful”?  (which implies that UPFs themselves are harmful, some more than others.)  or is that the opinion of the journalist?”

Dr. O’Connor was kind enough to supply an expanded and more nuanced clarification, re-written as below, after acknowledging that “to Alice’s [Alice Callahan] credit, we spoke for almost an hour so I may have gotten sloppy with my language”: 

“It’s true that there is a correlation between these foods and chronic diseases, she said, but that doesn’t mean that foods classified as ultra-processed directly cause poor health. Correlation does not equal causation. We need more randomized controlled trials in which cause-and-effect can be determined. Currently, there are only a couple small RCTs published but several more are in the works.” (you can find them registered at clinicaltrials.gov or on NIH’s reporter website)

Dr. O’Connor questions the utility of grouping such “starkly different” foods into one category. The quintessential image of ultra-processed foods (google it!) is an image of hot dogs, candy, and sugar-sweetened beverages. However, this image is misleading because the group of ultra-processed foods in the US is highly variable and also includes many fortified whole-grain products and plant-based proteins (as well as infant formula). This is problematic for developing dietary guidance on ultra-processed foods and communicating to the public because processed meats and sugar-sweetened beverages, for example, are foods that we recommend consuming in small to moderate amounts. However, there is consistent encouragement to the public to increase whole grains and plant-based proteins to improve their health.”

Those who have read the entire series will know that the ONLY solid evidence for any detrimental effect of so-called UPFs are restricted to the results for two sub-classes of UPFs, as shown yet again in Cordova et al. (2023) “Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study”:

Even those effects are small and may not amount to minimal clinically important differences (MCID) for most people.  

Bottom Lines:

1.  There is no evidence that the category “Ultraprocessed Foods” is a valid concern for any consideration regarding human diets.  It is far too broad and encompassing ‘nearly everything’ without regard for nutritional value.

2.   Avoidance of UPFs can lead to nutritional deficiencies particularly for those with fewer resources and limited access to a wide variety of affordable foods  –  not only for poor and marginalized populations, but even for middle class families.

3.  This does not negate the evidence that suggests that extreme amounts of sugars in an individual’s diet can harm health, particularly if it leads, or has led, to obesity or is in combination with either type of diabetes.

4.  The evidence for harmful effects of animal based foods (meats) is controversial [and here]  and should be considered separately.

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Author’s Comment:

The whole UPFs issue is, in summary, just another run-away food fad, albeit blended in an odd way with anti-corporatism, anti-globalization, aspects of the ‘health food movement’ and Luddite-ism.  It is worrying that governmental agencies have hopped on the anti-UPFs band-wagon.  

There is no need to avoid UPFs – other than your personal preferences about foods and your personal degree of concern about such issues as “food additives” (which is a different but related issue).

For a second opinion, try: Ultraprocessed Foods Have a Terrible Reputation. They Don’t Deserve It, by Jessica Wilson at Slate.

Obsessing about foods and diet is an amusement for those lucky segments of humanity that have a real choice about what to include in their diets.  This has led to a dietary supplement industry earning over 53 Billion dollars in the United States alone.  While the best evidence shows that there is little to no benefit gained from supplementary vitamins, minerals or other diet supplements.

My Opinion:  Eat a wide variety of foods, not too much, across all the food groups, including plenty and varied vegetables and fruits (fresh if possible), legumes, and grains.    Get some exercise, 20-30 minutes a day most days, anything that includes moving around counts.

And for your own sake, quit obsessing about food.

Thanks for reading.

Comments meant for me personally should begin with “Kip – “

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