ultraprocessed foods

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In trial, people lost twice as much weight by ditching ultraprocessed food

diet, health, nutrition, obesity, trial, ultraprocessed foods, weight / /

In a small randomized controlled trial, people lost twice as much weight when their diet was limited to minimally processed food compared to when they switched to a diet that included ultraprocessed versions of foods but was otherwise nutritionally matched.

The trial, published in Nature Medicine by researchers at University College London, adds to a growing body of evidence that food processing, in addition to simple nutrition content, influences our weight and health. Ultraprocessed foods have already been vilified for their link to obesity—largely through weaker observational studies—but researchers have struggled to shore up the connection with high-quality studies and understand their impact on health.

The ultraprocessed foods researchers provided in the new trial were relatively healthy ones—as ultraprocessed foods go. They included things like multigrain breakfast cereal, packaged granola bars, flavored yogurt cups, fruit snacks, commercially premade chicken sandwiches, instant noodles, and ready-made lasagna. But, in the minimally processed trial diet, participants received meals from a caterer rather than ones from a grocery store aisle. The diet included overnight oats with fresh fruit, plain yogurt with toasted oats and fruit, handmade fruit and nut bars, freshly made chicken salad, and from-scratch stir fry and spaghetti Bolognese.

While the level of processing differed between the diets, the large-scale nutrition content—fat, protein, carbohydrates, fiber—were similar, as was the proportions of fruits, vegetables, dairy, and starchy food. Overall, both diets adhered to the dietary guidance from the UK government, called the Eatwell Guide (EWG).

Diet processing

The trial had a crossover design, meaning that participants were randomly split to start out on either the ultraprocessed food (UPF) diet or the minimally processed food (MPF) diet. They stayed on their starter diet for eight weeks, then took a break, and switched to the other diet. For both diets, food was delivered directly to the participants’ homes. Participants ate what they wanted and, mostly, didn’t seem to cheat by sneaking other food, based on food diaries and reported adherence.

Fifty participants completed at least one diet, while 43 completed both diets. The participants were mostly women, with a mean age of 43, and all had a body mass index categorized as overweight or obesity. At the start of the trial, ultraprocessed foods made up, on average, nearly 70 percent of the participants’ standard diets, and they were not adhering to the EWG recommendations.

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“Deny, denounce, delay”: The battle over the risk of ultra-processed foods

health, Science, syndication, ultraprocessed foods / /
A shopping cart by a store shelf in a supermarket

When the Brazilian nutritional scientist Carlos Monteiro coined the term “ultra-processed foods” 15 years ago, he established what he calls a “new paradigm” for assessing the impact of diet on health.

Monteiro had noticed that although Brazilian households were spending less on sugar and oil, obesity rates were going up. The paradox could be explained by increased consumption of food that had undergone high levels of processing, such as the addition of preservatives and flavorings or the removal or addition of nutrients.

But health authorities and food companies resisted the link, Monteiro tells the FT. “[These are] people who spent their whole life thinking that the only link between diet and health is the nutrient content of foods … Food is more than nutrients.”

Monteiro’s food classification system, “Nova,” assessed not only the nutritional content of foods but also the processes they undergo before reaching our plates. The system laid the groundwork for two decades of scientific research linking the consumption of UPFs to obesity, cancer, and diabetes.

Studies of UPFs show that these processes create food—from snack bars to breakfast cereals to ready meals—that encourages overeating but may leave the eater undernourished. A recipe might, for example, contain a level of carbohydrate and fat that triggers the brain’s reward system, meaning you have to consume more to sustain the pleasure of eating it.

In 2019, American metabolic scientist Kevin Hall carried out a randomized study comparing people who ate an unprocessed diet with those who followed a UPF diet over two weeks. Hall found that the subjects who ate the ultra-processed diet consumed around 500 more calories per day, more fat and carbohydrates, less protein—and gained weight.

The rising concern about the health impact of UPFs has recast the debate around food and public health, giving rise to books, policy campaigns, and academic papers. It also presents the most concrete challenge yet to the business model of the food industry, for whom UPFs are extremely profitable.

The industry has responded with a ferocious campaign against regulation. In part it has used the same lobbying playbook as its fight against labeling and taxation of “junk food” high in calories: big spending to influence policymakers.

FT analysis of US lobbying data from non-profit Open Secrets found that food and soft drinks-related companies spent $106 million on lobbying in 2023, almost twice as much as the tobacco and alcohol industries combined. Last year’s spend was 21 percent higher than in 2020, with the increase driven largely by lobbying relating to food processing as well as sugar.

In an echo of tactics employed by cigarette companies, the food industry has also attempted to stave off regulation by casting doubt on the research of scientists like Monteiro.

“The strategy I see the food industry using is deny, denounce, and delay,” says Barry Smith, director of the Institute of Philosophy at the University of London and a consultant for companies on the multisensory experience of food and drink.

So far the strategy has proved successful. Just a handful of countries, including Belgium, Israel, and Brazil, currently refer to UPFs in their dietary guidelines. But as the weight of evidence about UPFs grows, public health experts say the only question now is how, if at all, it is translated into regulation.

“There’s scientific agreement on the science,” says Jean Adams, professor of dietary public health at the MRC Epidemiology Unit at the University of Cambridge. “It’s how to interpret that to make a policy that people aren’t sure of.”

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