UPF Research News (updated)

Dr. Kevin Hall is one of the leading researchers in ultra-processed foods (UPF). He seeks to understand whether these foods are responsible for the rise in obesity. Historically, he has studied the impact of foods based on their nutritional profiles. However, with the emergence of the NOVA classification, which categorizes foods according to their degree of processing, he began to examine whether the level of food processing influences calorie intake. He is a senior researcher at the National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH). Dr. Hall notes that thousands of studies associate UPFs with adverse health outcomes, chronic diseases, and mortality, which makes UPFs frowned upon. In the United States and the United Kingdom, more than 50% of the diet is made up of UPFs, while in Brazil, this percentage is around 20% despite rising obesity rates. Dr. Hall's team carried out one of the few controlled studies on UPFs since most of the data comes from observational studies with low levels of evidence. The results of their study, "Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake," showed that a diet rich in UPFs led to weight gain compared to a diet rich in unprocessed foods, https://www.cell.com/cell-metabolism/pdf/S1550-4131(19)30248-7.pdf . However, many scientists criticized the results, and an abstract published in the same journal by other scientists highlighted the temptation to attribute modern dietary problems predominantly to food processing. This shift implicitly blames the obesity epidemic on the food sector, which can lead to misguided public health strategies and food sector practices, https://www.cell.com/cell-metabolism/fulltext/S1550-4131(19)30307-9#section-e587233e-22aa-4221-8ae1-22df489d46f7 . Now, Dr. Hall is conducting new studies better to understand the role of UPFs in the human diet.

He was in Brazil last June to attend the International Congress of Obesity in S?o Paulo https://www.icocongress2024.com/convidados/dados_agenda.php?id_convidado=679937&dt_sel=2024-06-26&p=1. In his talk, he discussed his latest research on UPFs, revealing that these foods do not affect the brain's reward system as previously thought. Contrary to the belief that a combination of sugar and fat would increase dopamine levels in the brain's reward mechanism, Dr. Hall's studies using positron emission tomography showed that UPFs do not cause the same increase in dopamine seen in drugs such as cocaine or heroin. This challenges the narrative that UPFs are as addictive as drugs. According to Dr. Hall, not all UPFs are the same; some can lead to overconsumption, others are neutral, and some, like whole grain breads, are healthier options. He emphasizes the need to study the mechanisms of UPFs in depth to identify and potentially recreate problematic foods without the negative attributes https://www.medrxiv.org/content/10.1101/2024.06.24.24309440v1.full .

At the same congress, Dr. Carlos Monteiro, creator of the NOVA classification, gave several lectures, consistently demonizing UPFs. His opinion, outlined in an article published after the congress on the World Obesity website entitled "Ultra-processed foods are 'pushing aside' all other food groups to dominate global diets, "attributes the global obesity epidemic to UPFs, labeling them a threat to health due to their high salt, sugar, and fat content. Unlike Dr. Hall, Dr. Monteiro claims UPFs are universally harmful to health, while home-prepared foods are inherently healthy. He lists several diseases supposedly caused by UPFs but fails to mention that these studies are observational with low-quality evidence https://www.worldobesity.org/news/ultra-processed-foods-are-pushing-aside-all-other-food-groups-to-dominate-global-diets .

The big difference between these two scientists lies in their positions. While Dr. Hall acknowledges that some UPFs can be nutritious, convenient, and part of a healthy diet, Dr. Monteiro equates UPFs with tobacco, suggesting they should be treated similarly. He says: "Both tobacco and UPFs cause numerous serious diseases and premature mortality; both are produced by transnational corporations that invest the huge profits they make from their attractive/addictive products in aggressive marketing strategies and lobbying against regulation; and both are pathogenic (dangerous) by design, so reformulation is not a solution."

Unfortunately, Dr. Monteiro has this opinion. Comparing any food to tobacco is an exaggeration. Unlike food, tobacco is harmful, offers no nutritional benefits, and is addictive even in small quantities. Food and drink, essential for survival, vary significantly regarding nutritional content. Monteiro's critique leans towards business, claiming that processed foods are bad because multinational companies produce them, reinvesting their profits in their portfolios. He argues that these companies make their products attractive and addictive. Claiming that ultra-processed foods (UPF) are "pathogenic by design", and therefore reformulation is not a solution, is an affront and an attack on the entire food sector, the entire supply chain and all the professionals directly or indirectly involved. To say that food is pathogenic by design implies that it is intended to cause illness and danger and that reformulation is not an option because the sector does not want to produce safe food.

Dr. Kevin Hall, however, sees a significant role in processed foods and emphasizes the importance of choosing foods low in sugar, saturated fat, and salt.

Many opinion articles by scientists and government bodies are being published criticizing the NOVA classification, demonstrating that science evolves and what was once considered proper can change.

At the end of June, the annual congress of the American Society for Nutrition (ASN) in Chicago, USA, presented a new USDA-ARS study on UPFs. The study indicated that it is possible to put together a diet of low nutritional quality even when you choose mainly minimally processed foods. It also showed that more processed and less processed diets can be equally nutritious (or non-nutritious), with the more processed diet having a longer shelf life and being cheaper. This new research builds on a study published last year by the same USDA team, which demonstrated that creating a high-quality menu in line with dietary guidelines is possible while getting the most calories from UPFs. The new study asked the opposite question: is it possible to create a menu of low nutritional quality with most of the calories coming from "simple" foods? The study highlights the disconnect between food processing and nutritional value, suggesting that building a nutritious diet involves more than just considering the level of food processing as defined by NOVA. The nutrition research community needs to better characterize the concepts of "ultra-processed" and "less processed" foods https://www.news-medical.net/news/20240702/Presented-results-suggest-eating-primarily-minimally-processed-foods-does-not-make-for-a-healthy-diet.aspx.

As you can see, there is light at the end of the tunnel. Scientists still think about the common good, putting vanity and personal beliefs aside.

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