Could ultra-processed foods be the new ‘silent’ killer?

Hundreds of new ingredients that were never encountered in human physiology are now found in about 60 percent of the diets of adults and about 70 percent of children’s diets in the United States.

While obesity and lack of physical activity are well-recognized contributors to avoidable morbidity and mortality in the United States, another emerging threat is the unprecedented consumption of these ultra-processed foods in the standard American diet. It may be the new “silent” killer, as was unrecognized high blood pressure in previous decades.

Physicians at Florida Atlantic University’s Schmidt College of Medicine explored this hypothesis and gave healthcare providers important insight into the battle where the entertainment industry, the food industry and public policy are not aligned with their patients’ needs. are Their findings are published in a commentary. American Journal of Medicine.

“Those of us practicing medicine in America today find ourselves in a notorious and unique position — we are the first group of health care professionals to increase life expectancy in 100 years. has presided over the reduction,” said Don H. Sherling, MD. , corresponding author, associate program director for internal medicine residency and an associate professor of medicine, FAU Schmidt College of Medicine. “Our life expectancy is lower than that of other economically comparable countries. When we look at the rising rates of non-communicable diseases in less developed countries, we look at the increased consumption of ultra-processed foods in their diets. Can track this increase as well.”

Although professional organizations such as the American College of Cardiology warn patients in their 2021 dietary guidelines to “choose minimally processed foods over ultra-processed foods,” there is a caveat that “for ultra-processed foods There is no generally accepted definition, and some healthy foods may fall into the ultra-processed food category.”

“When food ingredients are contained within a natural, whole food matrix, they are digested more slowly and more inefficiently, resulting in fewer calories, a generally lower glycemic load, and triglyceride-rich lipoproteins then increase. This can lead to atherosclerotic plaque formation,” says Alison H. Ferris, MD, senior author, an associate professor and chair, Department of Medicine, and director of the Internal Medicine Residency Program. , said the FAU Schmidt College of Medicine. “Therefore, even if the offending additives were removed from ultra-processed food, high consumption of these products would still likely lead to obesity, diabetes and heart disease.”

The authors added that public health organizations are increasingly using the NOVA classification system, which divides foods into four categories – whole foods, food ingredients (such as butter, oil and salt), conventionally highly processed foods (such as bread and yogurt made with certain ingredients), and ultra-processed foods — or foods that are industrially made and use ingredients that are commonly found in the home kitchen. are not found.

According to the authors, one plausible mechanism to explain the risks is that ultra-processed foods contain emulsifiers and other additives that are largely indigestible by the mammalian gastrointestinal tract. They can serve as a food source for our microbiota, and thus create a dysbiotic microbiome that, in the right host, can promote disease.

“Additives, such as maltodextrin, can promote a mucus layer that is friendly to certain species of bacteria that are more prevalent in patients with inflammatory bowel disease,” Scherling said. “When the mucosal layer is not properly maintained, the epithelial cell layer can become vulnerable to injury, as in other studies in humans using carrageenan and in rodent models, polysorbate-80 and cellulose gum. using, has been shown in studies to stimulate an immunologic response. host.”

Colorectal cancer has increased significantly in the United States, especially among young adults, the authors added. They believe that increased consumption of ultra-processed foods may contribute to several other gastrointestinal diseases.

“Whether ultra-processed foods contribute to our currently rising rates of non-communicable disease requires direct testing, preferably in well-designed analytical studies,” Charles H. Heinekens, MD, FAC. PM, said co-author, First Sir Richard Dole. Professor of Medicine and Senior Academic Advisor, FAU Schmidt College of Medicine. “In the meantime, we believe that all health care professionals have a duty to discuss with their patients the benefits of increasing consumption of whole foods and reducing consumption of ultra-processed foods. “

The authors also believe that just as the dangers of tobacco began to emerge in the middle of the last century, it took decades for the preponderance of evidence and the efforts of forward-thinking health officials to discourage cigarette use. It led to a change in policy for Shakuni. A similar path is likely for ultra-processed foods, he says.

“Multinational companies that produce ultra-processed foods are just as powerful, if not more powerful, than tobacco companies were in the last century, and it is unlikely that governments will move quickly on policies that would protect whole foods. will promote and discourage their consumption of ultra-processed foods,” said Sherling. “Importantly, health care providers must also recognize the difficulties many of our patients face and seek healthier options, which requires a broader public health response. “