Ultra-Processed Vibes

By: Helena Bottemiller Evich

You’ve no doubt seen the panicked headlines: Ultra-processed foods are slowly killing us.

There’s been an astonishing amount of press attention on ultra-processed foods as of late, in no small part due to a popular new book, “Ultra-Processed People” by Chris van Tulleken. Just this week, CNN did a deep dive about how we’re essentially eating “predigested food.” The Washington Post recently explained how to spot and avoid ultra-processed foods, the Globe and Mail ran a headline about how food scientists have “tricked our brains into craving ultra processed foods” and Cosmopolitan dished up whole-foods recipes to help its readers cut back on the super processed stuff. Just about every week in Food Fix, I include a new feature or news story on ultra-processed foods – known as UPFs for short – and it’s usually not particularly positive.

Until this week, however, UPFs have not been a discussion point among top food and health officials, at least not publicly. That’s starting to change. During an appearance on Wednesday, at the first-ever Department of Health and Human Services Food is Medicine Summit (a packed event, by the way), FDA Commissioner Robert Califf brought up UPFs unprompted.

“We’ve got to understand ultra-processed foods,” Califf said. “It’s one of the most complex things I’ve ever dealt with. Drugs are easy – you know the dose of what you’re taking. Ultra-processed food is a complex combination of things that we’ve got to figure out.”

He later added: “It may even be the case, as we’re learning with ultra-processed foods, that the more you eat, the more you want … just think about potato chips – ever tried to eat one? We’ve got to understand the connection between what’s in the food and what’s in this gut-brain axis that the GLPs are now uncovering is a biological phenomenon. It’s not just willpower.” (Note: GLPs refers to the class of drugs (glucagon-like peptide-1) being used for weight loss like Ozempic, Wegovy and Mounjaro.)

It was the first time the commissioner – and likely any sitting FDA commissioner – has commented publicly on ultra-processed foods. And he wasn’t done for the day.

Where is the research? After his appearance at the summit, Califf told me and two other reporters backstage that he is watching the science on UPFs closely and again emphasized that it’s a difficult issue due to some pretty serious research gaps. Quite a bit of observational research has found associations or correlations between UPF consumption and risk of obesity and cardiovascular diseases, but we have very, very few highly controlled trials that might help explain why or how UPFs could be driving disease.

“There’s a lot of data showing an association between ultra-processed food and negative health outcomes,” Califf told reporters. “There’s not the definitive causal inference – that’s very difficult in food,” he said, arguing that more research is needed.

“FDA can’t really act until there’s a scientific consensus,” Califf added.

A few hours later, the commissioner teed off on UPFs again during a fireside chat hosted by the Alliance for a Stronger FDA, driving home the same points about the association between these products and “a lot of bad health outcomes.” But also cautioned: “Before FDA can do anything with that, we’re going to need a lot more research.”

(Also of note: Califf was not the only government voice to take issue with UPFs this week. Both Rep. Chellie Pingree (D-Maine) and Sen. Cory Booker (D-NJ) – who sit on the House and Senate agriculture committees, respectively – came out swinging against UPFs and soaring health care costs in their remarks at the HHS summit.)

Will the government do anything? The comments from Califf and others this week are interesting – and certainly put the food industry on notice – but will the Biden administration actually do anything about UPFs? That’s the big question.

The Dietary Guidelines Advisory Committee – a little-known expert panel that helps HHS and USDA update federal nutrition advice – is currently reviewing the evidence related to UPF intake and risk of obesity, but so far this has been a fairly wonky, behind-the-scenes thing – though it certainly has plenty of food-industry leaders quietly melting down about the potential consequences. If the next round of federal nutrition advice (due in 2025) were to recommend Americans cut-back on UPFs to improve public health – a very big IF – it could be quite bad for business.

Food industry groups, for their part, argue that focusing on processing is completely misguided and confusing for consumers, as it can lump “healthy” foods like yogurt and whole-grain breads in with frozen pizza and packaged cookies. More than half of calories consumed by Americans now come from UPFs, but figuring out what is ultra-processed vs. not is complicated and some surveys suggest consumers are already quite confused.

FDA is also moving quickly to release a mandatory front-of-pack labeling proposal by June – requiring nutrition information to appear on the front of food packages – but this policy isn’t expected to target the degree to which foods are processed. The agency is also working on an update to the definition of “healthy,” but as I’ve written before, the marketing term is already used so infrequently on foods that an update likely won’t have much of an impact in the marketplace.

We don’t yet know what, if anything, agencies like FDA and USDA might do to target UPFs now or in the future, especially if evidence mounts that they are as harmful as some observational studies suggest. (The federal government has invested shockingly few resources in nutrition research, which certainly doesn’t add clarity.) For now, though, this is a major vibe shift in Washington.

Food Fix! Newsletter, Helena Bottemiller Evich, 2/2/2024

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