Ultra-Processed Food: Individual vs. Population Health Perspectives

Dr. David Wiss

July 4, 2021

Nutrition

There are no nutrition recommendations that are universally true. People appear to be more interested in learning what not to eat rather than what to eat. Demonizing a particular food or food group can lead people to rationalize eliminating it when it may not be harmful to them.

The philosophy of Wise Mind Nutrition is informed by non-diet culture. This means that we are careful not to highlight negative aspects of food and generally take a “food-positive” approach to treatment and care. We focus on adding nutritious food rather than on subtraction or exclusion. We believe nutrition should not be punitive! The reason is simple: too many people engage in overly restrictive diets that may be harmful in the long run (e.g., rebound bingeing). Meanwhile, we do recognize that ultra-processed foods may be contributing to food addiction symptoms among certain individuals. 

So how do we separate general nutrition advice from personalized recommendations? Generic nutrition advice such as “eat sweet potatoes rather than white potatoes” might have merit for some but will not necessarily apply to all. Other examples of generic nutrition advice include recommendations to not eat grains, without recognizing there are big differences between common refined grains and whole intact grains (e.g., quinoa, faro). Many people are told to avoid dairy, without acknowledging the difference between conventional milk/cheese and a product such as unsweetened organic kefir. Clearly, the nutrition space needs more nuance.

Meanwhile, except perhaps in developing countries with calorie deficiencies, one public health recommendation that would be hard to argue against is the global reduction of ultra-processed foods. These can be defined as formulations of several ingredients which, besides salt, sugar, and fats, include food substances not used in culinary preparations: flavors, colors, sweeteners, emulsifiers, and other additives used to imitate sensorial qualities of unprocessed or minimally processed foods or to disguise undesirable qualities of the final product [1].

It is well-established that non-communicable diseases (e.g., cancer, stroke, heart attack) have been linked to ultra-processed food and drinks [2–5]. Transnational corporations drive unhealthy commodity industries such as tobacco, alcohol, and ultra-processed foods with a long history of evading public health efforts toward regulation. We have made the argument that targeting food policy is more effective than targeting individuals, which can perpetuate weight stigma. We have also made the argument that “intuitive eating” is more accessible when the food environment contains less ultra-processed foods (e.g., sugary foods). 

In the United States, ultra-processed foods comprise more than half of energy intake and contributed nearly 90% of energy intake from added sugars [1]. It has been argued that ultra-processed food is the primary cause of non-communicable disease in the US and that sugar reduction is required to save the health care system [6]. In other words, the quality of the food does matter and informs both health and disease. Many individuals are reporting sugar addiction symptoms and looking for help for food addiction. We are here to help. 

There are few redeeming qualities to ultra-processed food outside of convenience and pleasure, but are there actually some cases when ultra-processed food would be recommended to an individual? Many would say yes. For example, what if someone has a history of bulimia nervosa and has long avoided ultra-processed foods at the expense of their mental and social well-being? Would it be wise for that person to include more ultra-processed food? The answer is likely yes (though not necessarily in all cases). The key is discernment and we specialize in that process. We believe in body image healing and making peace with food. 

While many see the consumption of ultra-processed food (rather than dieting) as a causal factor in the development of eating disorders [7], the eating disorder community might be outraged at recommendations to reduce consumption of ultra-processed food. It may even view such recommendations themselves as a causal factor in the development of eating disorders (based on the theory that dieting precipitates all eating disorders).

So how do we reconcile these opposing truths? How can we hold them both simultaneously true? The answer is the essence of Wise Mind Nutrition. We can see that both perspectives can be valid, and it varies from person to person. Thus, it is essential to distinguish the individual from population health perspectives on matters of nutrition. We must discern what is true for the individual and accept that “truth” can evolve. We may not have all the answers, but we ask the right questions and can guide you toward developing food-positive principles that are individual and personal. Are you ready to discover what is true for you?

If you have experienced symptoms of processed food addiction, it may be due to underlying trauma. Therefore, treatment approaches must be trauma-informed. Our program is designed to help you navigate the tricky food environment while also dropping out of “diet culture.” 

References

1. Steele EM, Baraldi LG, Louzada ML da C, Moubarac J-C, Mozaffarian D, Monteiro CA. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. Bmj Open. 2016;6(3):e009892.

2. Moodie R, Stuckler D, Monteiro C, Sheron N, Neal B, Thamarangsi T, et al. Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. The Lancet. 2013;381(9867):670–9.

3. Zhang Z, Jackson SL, Martinez E, Gillespie C, Yang Q. Association between ultraprocessed food intake and cardiovascular health in US adults: a cross-sectional analysis of the NHANES 2011–2016. Am J Clin Nutrition.

2020;113(2):nqaa276-. 4. Chen X, Zhang Z, Yang H, Qiu P, Wang H, Wang F, et al. Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies. Nutr J. 2020;19(1):86.

5. Lane MM, Davis JA, Beattie S, Gómez‐Donoso C, Loughman A, O’Neil A, et al. Ultraprocessed food and chronic noncommunicable diseases: A systematic review and meta‐analysis of 43 observational studies. Obes Rev. 2020;

6. Lustig RH. Ultraprocessed Food: Addictive, Toxic, and Ready for Regulation. Nutrients. 2020;12(11):3401.

7. Wiss DA, Avena NM. Food Addiction, Binge Eating, and the Role of Dietary Restraint: Converging Evidence from Animal and Human Studies. In: Frank KW, Berner LA, editors. Switzerland: Springer Nature; 2020. p. 193–209.