FAU doctors believe ultra-processed food a ‘silent killer’ plaguing U.S. diet
We’ve been told innumerable times by health and nutrition experts that, whenever possible, we should avoid eating or drinking “processed” foods.
But of course, that’s proven virtually impossible for the vast majority of Americans over the last several decades.
As a research report from Florida Atlantic University published in February in The American Journal of Medicine noted, there are now “hundreds of novel ingredients never encountered by human physiology found in nearly 60% of the average adult’s diet and nearly 70% of children’s diets in the United States.”
Physicians from Florida Atlantic University’s Schmidt College of Medicine are so concerned about the myriad dietary chemicals so many of us consume, they believe that the ultra-processed foods in the standard American diet have become a quasi “silent killer” in much the same way that unrecognized high blood pressure was in the late 20th century.
So they decided to explore their hypothesis and gather meaningful data. Their goal was to provide important insights to health-care providers in an environment in which the entertainment industry, the food industry and public policy do not align with their patients’ needs. Their findings were recently published in a commentary in The American Journal of Medicine.
“Those of us practicing medicine in the U.S. today find ourselves in an ignominious and unique position — we are the first cohort of health-care professionals to have presided over a decline in life expectancy in 100 years,” said Dr. Dawn H. Sherling, FAU Schmidt College of Medicine associate program director for the internal medicine residency, associate professor of medicine and one of the article’s authors. “Our life expectancy is lower than other economically comparable countries.”
What qualifies as ‘ultra-processed’ food?
Although the nation's health field is flush with advice for the public to choose "minimally processed foods" over "ultra-processed foods," the message can still be confusing. As the American College of Cardiology noted with its 2021 guidelines, there's no universally accepted definition of what constitutes "ultra-processed," and depending on the definition in play, some healthy foods might land in that category.
For a variety of scientific and biological reasons, the additives in ultra-processed foods cause the digestive system to work more slowly and inefficiently than it does with whole foods, explains Dr. Allison H. Ferris, FAU Schmidt College of Medicine associate professor, chair of its Department of Medicine, director of the internal medicine residency program, and another of the article’s authors.
The digestive "delay" caused by these additives can result in overeating and other problematic health complications.
"Even if the troublesome additives were removed from the ultra-processed food, there would still be concern for an over-consumption of these products, possibly leading to obesity, diabetes and heart disease,” Ferris said.
The article noted that today public health organizations are increasingly using the NOVA classification system, which essentially divides foods into four categories:
- Whole foods
- Culinary ingredients (items like butter, oil and salt)
- Traditionally processed foods (such as bread and yogurt made with few ingredients)
- Ultra-processed foods (those foods that are industrially made and use ingredients not normally found in a domestic kitchen)
Perhaps not coincidentally, last month the U.S. Department of Agriculture announced major steps to promote the health of America’s children through school meals, with federal nutrition standards gradually being updated between 2025 and 2027. The updates include reducing sugar and sodium while also allowing for more locally sourced agriculture when possible. In addition, school-lunch providers will have flexibility with menu planning.
Why might emulsifiers and other additives cause health problems?
The FAU researchers' commentary surmises that one plausible explanation for the deleterious effects is that ultra-processed foods contain emulsifiers and other additives that “the mammalian gastrointestinal tract mostly does not digest. They may act as a food source for our microbiota, and as such may be creating a microbiome that can, in the right host, promote disease.”
“Additives, such as maltodextrin, may promote a mucous layer that is friendly to certain species of bacteria that are found in greater abundance in patients with inflammatory bowel disease,” Sherling said.
This response, they believe, could explain why there have been marked increases in colorectal cancer in the U.S., especially among younger adults. They also believe that increased ultra-processed food consumption may also be contributing to several other gastrointestinal diseases.
“Whether ultra-processed foods contribute to our currently rising rates of non-communicable disease requires direct testing in analytic studies designed to do so,” said Dr. Charles H. Hennekens, FAU Schmidt College of Medicine senior academic advisor. “In the meantime, we believe it is incumbent upon all health-care professionals to discuss the benefits of increasing consumption of whole foods and reducing consumption of ultra-processed foods with their patients.”
The article also points out that, just as the dangers of tobacco began to emerge during the middle of the 20th century, decades passed before the preponderance of the evidence and the efforts of forward-thinking health officials prompted policy change to discourage the smoking of cigarettes.
They believe a similar path is likely for ultra-processed foods.
“The multinational companies that produce ultra-processed foods are just as, if not more, powerful than tobacco companies were in the last century,” said Sherling. “And it is unlikely that governments will be able to move quickly on policies that will promote whole foods and discourage the consumption of ultra-processed foods.”
In today’s inflationary economic environment, when so many folks are experiencing sticker shock at the grocery store, Sherling also urges “all health-care providers to remain cognizant of the difficulties that many of our patients have in being able to afford and find healthier options.”