Last night I got back from work late and, stressed and tired, I raided the kitchen cupboards and scavenged a bowl of Coco Pops, two slices of toast and all the Tunnock’s Milk Chocolate Caramel Wafers in the cookie tin.
I knew what I was eating was highly processed and unhealthy, but the temptation of the short-term hit was too great to worry about the health consequences.
As a doctor, I always give advice about eating this or that, exercising, quitting smoking, drinking less and the like. I give this advice to my patients, my family and in this column.
But following the advice is so much harder than giving it.
I’d be lying if I said those caramel cookies weren’t delicious — but as delicious as they are, we all really need to make a bigger effort when it comes to ultra-processed foods (UPFs).
Essentially, these are processed foods packed with sugar and fat, with lots of additives, such as artificial sweeteners, emulsifiers and similar additives.
In recent years, the noise about UPFs has become much louder. But I was never sure how much was hype and how much was factual.
But unlike my previous evenings of mocking, this time I’m more concerned about it. Last week, a study published in the BMJ by leading epidemiologists from across continents changed everything.
The article, published in the BMJ, convincingly showed that people who ate the most ultra-processed foods had a 21 percent higher risk of death from any cause (stock image)
In the future, it will be seen as one of those groundbreaking studies that changes the advice we give to patients. It confirms once and for all the truth about the risks of ultra-processed food: it is literally killing us.
This article conclusively showed that people who ate the most ultra-processed foods had a 21 percent higher risk of dying from any cause, a 66 percent higher risk of dying from heart disease, and a 12 percent higher risk of developing cancer.
There were also increased risks of obesity – 36 percent – and type 2 diabetes – 40 percent.
But the biggest impact was on mental health – with a 48 percent higher risk of anxiety and a 22 percent higher risk of depression over the study period.
Previous research has shown there may be a link, but this review of studies brought together many smaller studies with data from more than nine million patients. With these figures, the link between UPF and poor health could be proven beyond doubt and with near statistical certainty.
And working in the emergency department, I see the impact of UPFs. I estimate that more than 50 percent of patients would not have gotten sick without a diet full of UPFs; strokes, cancers, heart attacks and diabetes complications are much more common in those who have more UPFs in their bodies. their diet.
Groundbreaking, groundbreaking, groundbreaking, whatever we call this article, you can be sure the food manufacturers won’t pass this up.
This industry is a multi-billion dollar business and companies with vested interests will do everything they can to delay the reforms we need.
We only have to look at the history of smoking to see the script of what will happen.
Many doctors a hundred years ago were in favor of smoking and even claimed that it was beneficial. They were paid handsomely to participate in tobacco marketing campaigns.
However, in the 1950s, two now famous British epidemiologists, Sir Richard Doll and Sir Austin Bradford Hill, published a groundbreaking study showing that smoking was linked to cancer.
The tobacco industry spent the next fifty years questioning the validity of the study, saying it was not evidence and that being “associated” with cancer does not mean it causes it. The manufacturers argued that the only way to answer the question of whether smoking was dangerous was a randomized, controlled trial. Half of the trial volunteers smoked cigarettes and the other half did not – research that was clearly unethical and also impracticable.
The effect was to delay the introduction of public health measures such as smoking bans in the workplace and elsewhere. Meanwhile, tobacco companies continued to make profits while millions of people around the world died from smoking-related diseases.
I see similar arguments about the research on ultra-processed foods. For example, people who eat UPFs die younger and get more cancer, but there are also other factors, such as lack of exercise.
Just because something is marketed as healthy doesn’t mean it is (stock image)
But as their tobacco research showed, there were other ways to prove that smoking caused cancer – crucially by showing a strong statistical link. in the case of UPFs, researchers found a 12 percent increased risk of cancer, demonstrating beyond any doubt that UPFs directly impact health.
There must also be a ‘biological gradient’ – in other words, the more UPFs you eat, the sicker you become.
The new study also showed this: For example, for every 10 percent increase in UPF consumption, there was a 12 percent increase in the risk of developing type 2 diabetes.
There also needs to be consistency in the results, which there was with the results of more than nine million people from multiple studies, all of which yielded the same results: UPFs are linked to poor health. But, crucially, to prove cause, there must be a scientific explanation for the findings. And we have it now.
It won’t surprise you that ultra-processed foods are low in nutrients but high in added sugars and unhealthy (but tasty) fats. Due to a lack of protein, they often don’t fill you up, causing you to eat more calories. But that’s only half the problem.
The foods often contain what are essentially edible chemicals, the likes of which our bodies have never experienced before in human evolution.
Studies have shown that chemicals, such as emulsifiers and artificial flavors, can cause inflammation that causes a range of adverse effects. These include increasing damage to DNA that can lead to cancer and helping to create plaques in arteries that lead to heart attacks.
But it is the disruption of gut bacteria that I think is most concerning and could explain the effects on mental health.
The gut-brain axis is a two-way communication system between the brain and the gut. Changes in bacteria in our gut, caused by UPFs, disrupt signals from the gut to the brain via the vagus nerve (as well as changing hormones produced by the vagus nerve). intestine). Here’s how UPFs can increase the risk of depression and anxiety.
The problem is that it’s not easy to make changes, firstly because these foods are so addictive and secondly because it’s sometimes difficult to tell exactly what ultra-processed foods are.
A rough rule of thumb is: if you had all the time in the world, could you grow the ingredients yourself, or use an animal to prepare the food in front of you? If not, it’s a UPF.
This includes cereals and snacks that I thought were healthy: protein bars, frozen and ready-made meals (even low-fat, low-sugar versions), mass-produced breads, pastries, and margarine.
Just because something is marketed as healthy doesn’t mean it is: the coconuts I had were labeled as ‘rice with added goodness, no artificial colors or flavors and 30 percent less sugar’, and the health -‘traffic lights’ were mainly green.
But the cereal also contains 16 different ingredients, including glucose syrup, malt extract and cocoa mass.
The UPFs approach is partly about individual responsibility, but also about legislation and policy. As with smoking, the government must take responsibility for encouraging us to eat foods that do not harm us.
For example, with taxes on ultra-processed food, with subsidies to make non-ultra-processed food affordable; and, crucially, ensuring that public venues such as leisure centres, hospitals and schools serve and sell healthy food.
The question for me is: Will my late night snack choices ultimately kill me? The answer, based on this new study, is most likely yes. And that should set alarm bells ringing, not just for me, but for all of us.