“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
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I’m not much of a junk food eater, although I do like an occasional Steak ‘n Shake double cheeseburger, or a Big Mac with French fries — maybe a half dozen times a year — and, more often, a grilled all-beef hot dog, smothered in mustard and drowning in sauerkraut. My mouth waters as I write this! Mostly, though, I try to eat a reasonably healthy diet, with emphasis on reasonably. However, the food experts are telling us with increasing clamor about the horrors of consuming ultra-processed food.
I wrote about this last year, making the point that ultra-processed foods are packed with artificial flavors, additives, or emulsifiers; typically contain more calories, sugar, fats, and salt than non-processed foods; and are linked to several kinds of cancer.
What, exactly, are ultra-processed foods? They usually consist of junk foods such as chips, cookies, and fast foods like prepackaged dinners. Such foods are industrial formulations with little intact food, generally containing low nutritional value, lots of calories, and multiple ingredients to enhance flavor and prolong shelf life. Consumption of these foods has almost tripled between 1990 and 2010, from 11 percent to 32 percent of daily energy intake.
In addition to studies I mentioned previously, several new reports underscore the potential harm of this bad diet. In a study from Spain of almost 20,000 people followed for 15 years, people in the group consuming the most ultra-processed food (>4 servings daily) had a 62 percent greater risk of death than those consuming the least amount. The more ultra-processed food one consumed, the greater the risk, so for each additional serving, mortality increased by 18 percent. A study of over 100,000 French participants showed that greater consumption of ultra-processed foods was associated with increased risk of heart attacks and strokes.
A similar study from the U.S. found that individuals in the highest quartile of eating ultra-processed food — stuff like sugar-sweetened or artificially sweetened beverages, sweetened milk, sausage, sweetened cereals, and desserts — had a risk of all-cause mortality that increased by 31 percent. A much larger study of 44,500 participants from France also found higher mortality among those consuming ultra-processed foods, but interestingly also noted that these participants were more likely to be younger, live alone, to be physically inactive, have a lower income, a lower educational level, and a higher body mass index. It is important to remember that some of these lifestyle influences can also contribute to mortality.
So, which is cart, and which is horse? Do the lifestyle patterns contribute to eating junk food or does eating junk food impact lifestyle? Very likely both are operative and affect the development of cardiovascular and cerebrovascular diseases in this population.
These epidemiological reports are observational, and direct causality cannot be firmly established. But if the mortality outcomes are not sufficiently convincing to eat a proper diet, how about gaining or losing weight? For this there exists “hard science.”
A trial of twenty inpatient adults randomized to consume ultra-processed versus unprocessed food, each for fourteen days, found that those eating ultra-processed food consumed more calories and gained about two pounds during that time period while those eating unprocessed food consumed fewer calories and lost about two pounds.
Like many of us, I’m a bit overweight and I don’t need much more convincing to limit my ultra-processed food intake than that outcome!
So, readers, eat well, exercise, stop smoking, keep your blood pressure and cholesterol under control, and enjoy good health.
But I still can taste that delicious hot dog!
Featured image: Shutterstock
“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
Order Dr. Zipes’ new book, Damn the Naysayers: A Doctor’s Memoir.
As I ate my cereal for breakfast this morning, I read the ingredients listed on the box. In addition to the usual alphabet of vitamins, the cereal contained phosphorus, zinc, iron, magnesium, syrup, sugar, fats, and a variety of oils, salt, glycerin, molasses, soy, lecithin, corn starch…and the list went on. Can all these be good for me, I wondered?
According to a recent article in the British Medical Journal, ultra-processed foods packed with artificial flavors, additives, or emulsifiers typically contain more calories, sugar, fats, and salt than non-processed foods. People relying on such a diet tend to be more overweight and more likely to have cardiovascular problems or diabetes. A study in 2016 found that 50-60% of the calories in the average American, Canadian, and United Kingdom diets come from this kind of food, and more of the developing world is beginning to eat this way.
Several studies have also found a link between processed foods and cancer. Eating lots of processed meat like hot dogs is associated with an increased risk of bowel cancer. French researchers, analyzing 24-hour dietary records of nearly 105,000 adults in the NutriNet-Santé study, an ongoing web-based cohort launched in 2009, found that a 10% increase in the proportion of ultra-processed fats and sauces, sugary products, and drinks was associated with an increased risk for overall cancer, and ultra-processed sugary products were associated with an increased risk of breast cancer.
What might be the cause of a cancer relationship? Ultra-processed foods can contain contaminants with cancer-causing properties such as those found in heat treated processed foods. In addition, food packaging may contain carcinogenic materials that come in contact with the foods. Some food additives such as sodium nitrite in processed meat may be carcinogenic.
Importantly, food experts caution against strict interpretation of these results because of many confounding factors such as the lifestyle of those who eat these products: they may be more likely to smoke, not get enough exercise, and not eat healthy foods that might reduce risks of cancer.
What is the best advice? Eat a balanced and diversified diet containing real foods such as fresh, dried, ground, chilled, frozen, pasteurized, or fermented foods like fruits, vegetables, rice, pasta, eggs, meat, fish, or milk. Resist—as much as possible—mass produced packaged breads and buns; sweet packaged snacks, confectionery and desserts; and sodas and sweetened drinks. Avoid reconstituted meat products with added preservatives found in some meats, poultry, and fish nuggets. Instant noodles and soups, frozen or shelf stable ready meals, and other food products made mostly or entirely from sugar, oils and fats, modified starches, and protein isolates are probably not good, either. They often contain flavoring agents, colors, emulsifiers, humectants, non-sugar sweeteners, and other additives to disguise undesirable qualities of the final product.
If your conscience tweaks you after sneaking that jelly donut or a side of bacon with those eggs, remember what I’ve said before: moderation in all things, including moderation.