The Case for Ultra-Processed Food

Why we need Twinkies that last 20 years

There is a good chance that, as you read this, representatives of big food companies are in conference rooms in Washington, DC, making the case to government officials for ultra-processed food.

By themselves, their arguments won’t carry the day. That’s what agribusinesses’ $200 million in political donations are for. But the arguments do matter. The more persuasive the food companies are, the easier it is for legislators to sign on, for Fox News commentators and other paid influencers to parrot the talking points, and for voters to be swayed.

What are they saying, and in the national conversation about ultra-processed food (UPF), how should we respond?

The case

The food industry’s talking points appear on two of their websites (here and here), and in this statement that their trade association gave to food journalist Helena Bottemiller Evich.

“America has one of the safest and most highly regulated food systems in the world…We welcome fact-based conversations about nutrition, but safety is not up for debate. As consumers continue to seek a diverse selection of foods and beverages, the makers of America’s trusted household brands provide a wide variety of affordable products to choose from, along with access to the information consumers need to make informed choices. Companies adhere to the rigorous evidence-based safety standards and nutrition policy established by the FDA to deliver safe, affordable and convenient products that consumers depend on every day.”

(Highlighting mine.) Taking these talking points one at a time:

• Safety

The industry must think that their strongest argument is that ultra-processed food is “safe” because they mentioned it four times.

And it’s true that ultra-processed food (UPF) is safe from contamination with bacteria. That’s a good thing. Before the Pure Food and Drug Act of 1906, contaminated food was a major source of disease and death. In part because of this law, deaths from foodborne diseases are now rare (here and here), and are mostly due to mistakes in kitchens, not contaminated grocery items.

But 120 years later, we’re overdue to update what we mean by food safety. People eating UPF take in an astonishing 500 more calories per day than people eating food that is not ultra-processed, gain weight fast, and are much more likely to become obese and develop type 2 diabetes. Obesity is causing an estimated 483,000 excess deaths a year, which arguably makes it the biggest killer in America.

So calling ultra-processed foods “safe” is dead wrong.

• Nutrition

Amazingly, the food companies are claiming that UPFs are good for our nutrition.

Mainly, that’s because many UPFs (including Twinkies and Froot Loops) are “fortified” with vitamins and minerals. No question, vitamin fortification is good for us. Adding folic acid to flour prevents more than > 1,000 babies each year from being born with devastating neural tube defects.

But most vitamin deficiencies are relics of the past that afflicted only people with extremely narrow diets. In my entire medical career, I’ve never seen or heard of anyone with pellagra, beriberi, rickets, or scurvy.

Regardless, adding vitamins and minerals to foods does not lead them to be classified as ultra-processed. No health expert is recommending that we stop fortification, and no proposals to limit ultra-processing would interfere with fortification.

The food companies also argue that ultra-processing enables them to produce food for people on specialized diets, like gluten-free or vegan. But none of the proposed policies on UPF would ban gluten-free cookies or soy milk.

• Affordability

Ultra-processed food is cheap…excuse me, affordable. In the debates about UPF, we’ll hear a lot about that. And we’ll hear that UPF therefore helps fight food insecurity, and that regulating it would exacerbate health disparities. Playing the poverty and race cards is a tried-and-true technique of the food industry.

UPF is cheap because it can be produced in huge quantities in cost-efficient factories. It contains preservatives that give it an incredibly long shelf life, which lowers costs by cutting spoilage and reducing resupply runs.

But, as I’ve written before, healthy food is actually no less affordable than processed junk food.

And it does not help people to offer them cheap food that makes them sick. Instead, it imposes costs on them - costs like the suffering from illness, lost work time, and out-of-pocket medical costs of obesity and its complications (which run about $4,000 a year for a person with type 2 diabetes).

Effectively, “affordable” UPFs just push industry’s costs onto us. And the consumers who pay the most are minorities and people with low-incomes.

• Convenience

Yes, UPFs are extraordinarily convenient. With UPFs, you don’t have to refrigerate, chop, cook, mix, stir, or clean up afterwards. And the decades-long shelf life enables food companies to place ready-to-eat UPF within arm’s reach everywhere, from gas stations to school vending machines to hardware stores. If convenience is all we care about, the food industry wins hands down.

But the long shelf life that makes UPFs so convenient is unnerving. On YouTube you can watch a guy slicing into – and then eating – a 20-year-old Twinkie. It had the consistency of a teething biscuit, but it was mold-free and otherwise completely Twinkie-like. That sure doesn’t make me feel good about what it would do inside my body.

Source: YouTube

I think we should value health – which, after all, often means the difference between life and death - above convenience.

• Consumer choice

American consumers have a right to eat whatever they want. For the government to restrict their choices is un-American. We will hear plenty of this argument, which taps into our deeply-held values.

I heard this argument in New York City in the early 2000s, when the Board of Health was considering a ban on trans fats in restaurant foods. The “grease police” were taking away your choice to eat tasty fries.

Source: New York Post

Since then, trans fat has been banned nationwide, and I have yet to hear anyone demand that we put trans fat back in their food.

But to the general point, I have three responses. First, a typical supermarket has some 30,000 items on its shelves, and the food industry introduces 10,000-20,000 new products each year. We don’t need more “food products” for people to choose from. We just need food.

Second, when companies spend billions each year in advertising to persuade us to eat ultra-processed junk, are we really making independent choices?

And third, health experts are not proposing a ban on UPFs. If you’ve come to depend on Twinkies to give your life meaning, you can rest easy.

• Access to information

Consumers already have access to information that they can use to make their own choices, the food companies argue. If people choose UPF, it’s because they’ve decided that they’re ok with how healthy it is or is not.

Sure enough, food packages are loaded with nutrition information. But that information has become available only over the fierce resistance of the food industry. For example, the food companies fought hard to prevent listing “added sugars” on the nutrition facts panel.

And the information on labels is utterly confusing. Can anyone without a degree in nutrition and a calculator make sense of this?

Under pressure to provide information that is easier to find and more interpretable, the food industry is pushing its Facts Up Front labeling scheme, which looks like this.

But is that any better?

What policies are proposed?

Any argument about UPF must consider what people propose we do about them. Given the enormity of the epidemic of diet-related diseases, health experts’ proposals are modest. They suggest that we:

• Restrict some techniques of marketing and promotion, for example, prohibiting placement of UPFs in supermarket checkout lines and limiting advertising to kids

• Require labels on UPFs that are either just informational (“ultra-processed”) or warnings (stop signs)

Source: Change.org

• Run counter-advertising campaigns, along the lines of Tips from Former Smokers

• Prohibit UPFs in schools and in other government-operated programs

• Restrict the use of SNAP benefits to buy UPFs

• Tax the most dangerous UPFs, like sugar-sweetened beverages

Bottom line

Agribusinesses have invented “food products” that are cheap, convenient, addictive, and - over time, for many people - fatal. Today we finally have some momentum in our fight against them. That fight will mostly involve political muscle, but one of the fields of battle will be the debate on the internet. It’s time for people who care about health to engage.