Book Review: Ultra-Processed People by Chris van Tulleken

Ultra-Processed People by Chris van Tulleken, (2023), Cornerstone Press

The issue of how our eating habits impact our physical weight has received a great deal of attention, especially over the last 50 years. The most prominent in a string of works that have come up with rather simplistic solutions to the weight-loss challenge is perhaps that from Dr. Herbert Atkins, with his Dr. Atkins’ Diet Revolution, 1972, where he claims that low intakes of carbohydrates, including sugar, seem to be key. The low-carbohydrate diets seem to be still the most prominent approach for achieving weight-loss today. Central elements of this are to minimize the intake of sugar, as well as to lower the intake of starch, often found, for example, in potatoes or bananas. Subsequent alternative approaches have featured the lowering of one’s intake of calories, above all, fats, or focusing more on exercising, as well as enhancing people’s disciplines and habits regarding eating practices. However, none of these approaches seems to have significant or lasting effects on managing one’s weight in their own right.

The author’s research seems to indicate that so-called ultra-processed food might be an important co-contributor to weight-gain. While Dr. van Tulleken does not disclaim positive effects from other types of diets, especially those relating to low carbohydrates, less intake of calories, and/or regular exercise, he claims that limiting the intake of ultra-processed food might often have an equal or even higher effect on one’s weight.

The author defines ultra-processed foods as “food that is wrapped in plastic and contains at least one food ingredient that never or seldom might be found in the kitchen”. Since the author seems to refer primarily to food offerings most predominant in the US and the UK, this reviewer should want to add other types of packaging, such as tin cans or glass containers. Such food was relatively rare until around 1950 but has since become the dominant type of what we eat, with as much as 60% of the food people eat in the US of UK. A large part of such food may be so-called junk food, quite easy to identify. The  more difficult food to identify, “ethical food”, is often marketed as “healthy” or not ultra-processed. Examples might be cold cuts, or canned soups. But, according to the author, this type of food is equally dysfunctional when it comes to impacting our health and/or losing weight.

The author also indicates three additional key factors that can be associated with the size of dysfunctional food (i.e., in addition to the effects on our weight): this food might cause environmental damages (such as impacting climate change, and/or causing overuse of antibiotics causing growing resistance when it comes to antibiotics, as well as increased plastic waste pollution, especially in our oceans. Let us discuss each in some more detail:

-       Climate. Today, to process various food types to the extent now called for usually requires a lot of energy to provide heat for food processing.The result: excessive emissions of heat, and thus also of undesirable climate gases.

More farmland is needed to meet the needs for farming of additional farm products needed for ultra-processing. The result is “encroaching” on what so far has been forested land, resulting in another loss of CO2 absorption, from no longer existing forests.

-       Antibiotics. We humans are not equipped to handle antibiotics on a steady level. But antibiotics are now typically fed into animals and fish used as raw materials for ultra-processed foods. These antibiotics remain in the food also after being ultra-processed, and thus eventually enter our human body digestive systems. Too much of this, and over a relatively long time, can lead to resistance against such antibiotics.

-       Plastic waste. With the exponential increase of the use of plastic stemming from the increased availability of processed foods, we see a dramatic increase in plastic waste. This takes a long time to decompose, if at all! Perhaps the most dramatic examples of excessive plastic waste can be found in oceans and on beaches. Even at such remote places such as the far north Spitsbergen Islands, plastic waste on the beaches represents a major challenge.

So why is the increase in these so-called processed foods becoming so prominent? The author points to these factors, all interrelated.

-       In an increasing number of food outlets (read: supermarkets) so-called “food sumps” seem to be on the rise. These are stores where there is relatively less fresh, natural food available. In some such stores, fresh food may actually be all gone! For storeowners, it is easier (and thus more economical) to follow this trend, also with less food waste! But there may be no other option for the consumer other than ultra-processed foods!

-       Food manufacturers may also see the benefits of going this way. It may make particular sense for such firms to produce what seems to be in demand. And these firms may actually contribute to increases in demand for ultra-processed food! Repeated steps of cooking and processing may lead to the removal of less than desired tastes, colors, and smells. But additives may now be introduced to enhance taste, color, and smell.

-       The consumers. Ultra-processed food usually tastes good. It can be relatively soft and easy to eat (additives!). And it stays edible in the fridge for longer periods (more additives!). Importantly, many such foods also break down the ability of humans to say stop – “I am full!”. Important molecules for instilling such fullness have been removed,

So, all in all, there seems to be ample evidence that ultra-processed food is becoming more and more predominant. While classical weight loss approaches, to limit one’s intake of carbohydrates, in particular, are still to be followed, the weight loss effects may become lessened due to all the non-processed food we may also consume. Thus, to achieve effective weight loss today shall increasingly imply that one’s intake of non-processed food should also be controlled, And the direct effects from this on our health and wellbeing are significant.