The Controversy Around Ultra-Processed Foods

The United States Dietary Guidelines Advisory Committee (DGAC) recently stated that there is “limited evidence” that ultra-processed food consumption is associated with “greater adiposity (fat mass, waist circumference, BMI) and risk of overweight/obesity.” They called for more research before the government would make specific recommendations to limit ultra-processed food intake. The headline from Daily Mail indicates that they aren’t too concerned yet, stating, “Ultra-processed foods do NOT cause obesity, says US government’s top diet advisors in bombshell review of current evidence: ‘Studies have been biased.’” 

I have been deeply entrenched in the healthcare industry for the past decade, treating patients from all walks of life, learning as much as possible about the human body, nutrition, and disease management, and becoming an expert in all things functional medicine. I also closely studied the Dietary Guidelines when getting my Masters in Public Health Nutrition. I can tell you from experience that the conclusion from DGAC is simply not true. Read on for my key takeaways…

What Are Ultra-Processed Foods?

Let’s start with the basics. What are “ultra-processed” foods? 

To keep things simple, food exists on a spectrum of unprocessed to ultra-processed, based on the NOVA food classification system. Even processed foods and ultra-processed foods are two different categories of foods. Processed foods have gone through some sort of processing but are still nutritious and have a resemblance to their natural forms, like sauerkraut, frozen berries, canned salmon, olive oil, and foods that undergo processes like fermenting, freezing, canning, and drying.

Ultra-processed foods, on the other hand, are food-like substances designed in a lab and use synthetic chemically derived ingredients like artificial dyes, colors, and flavorings. They often include refined oils, added sugar, refined starches, and/or salt, are depleted of fiber and other important nutrients, and are formulated to be hyper-palatable. Big food companies have flavor chemists whose sole job is to create an addictive flavor profile to get you to crave more. Examples of ultra-processed foods include soda, many conventional breakfast cereals like Fruit Loops and Lucky Charms, chips like Doritos, crackers like Ritz Crackers, condiments like Heinz Ketchup, snack bars like Nature Valley bars, and sweets found in boxes, like Twinkies and Pop-tarts.  

What’s So Bad About Ultra-Processed Foods? 

Despite what the government feels comfortable saying, ultra-processed foods are hands down one of the most significant contributors to our epidemics of chronic disease, mental health, autoimmune disease, infertility, excess weight, and more. Ultra-processed foods comprise 60% of caloric intake in adults in the US and nearly 70% in children. As my friend and Stanford-trained physician, Dr. Casey Means, highlights in her book Good Energy, “Ultra-processed foods are created in industrial factories by combining various extracted and adulterated parts from different foods with synthetic ingredients, like preservatives and food colorings. These are “Frankenfoods” you should never eat and never give to your children.” 

This isn’t just a little problem–this is one of the largest problems of our time. There’s nothing killing more Americans than the foods they eat every day. Diet-related diseases are the leading causes of death in the United States, according to data from the Journal of the American Medical Association. U.S. consumers paid an estimated $1.1 trillion for food in 2019 but that doesn’t include the additional $604 billion in health care costs directly attributable to diet-related diseases, according to The Rockefeller Foundation’s True Cost of Food report

There is considerable evidence that shows ultra-processed foods increase the risk of weight gain. One 2019 study by Hall, et al. was particularly strong because the subjects were living in a lab with their food measured out exactly. Participants were fed ultra-processed foods or unprocessed foods for two weeks (all meals were matched for calories, energy density, macronutrients, sugar, sodium, and fiber). This study found that those who ate ultra-processed foods over two weeks gained more weight than the unprocessed whole foods group.  

But the true damage is much more profound than weight.  There is accumulating evidence that shows an increased risk of cancer, heart disease, mental health issues, early death, and so much more. 

A 2024 high-level evidence summary in the British Medical Journal (BMJ) showed that “higher exposure to ultra-processed foods was consistently associated with an increased risk of 32 adverse health outcomes. Convincing evidence showed that higher ultra-processed food intake was associated with around a 50% increased risk of cardiovascular disease related death, a 48-53% higher risk of anxiety and common mental disorders, and a 12% greater risk of type 2 diabetes.” 

Adding to that, a 2019 study involving 45,000 middle-aged people in France showed that every 10% increase in ultra-processed foods consumed was associated with a 14% higher risk of all-cause mortality; another large 2019 study found that eating more ultra-processed foods was associated with an increased risk of cardiovascular events; a 2023 research review showed that the highest consumption of ultra-processed foods was significantly and positively associated with an increased risk of cardiovascular events; and a 2023 meta-analysis looked at 11 studies and stated that the current evidence “shows a consistent significant association between intake of ultra-processed foods and the risk of overall and several cancers, including colorectal-, breast- and pancreatic cancer.”

Three Considerations When It Comes to Ultra-Processed Foods

There is research to demonstrate the connection between ultra-processed foods and poor health outcomes, but the government will likely wait until they have more randomized control trials before making recommendations (we will wait to see what they officially recommend in the 2025-2030 Dietary Guidelines report). So where do we go from here? I have three recommendations for you: 

Consideration 1-Don’t Blindly Trust Government or Healthcare Recommendations.

This is the perfect example of a vital life philosophy that I live by and recommend to clients: just because the government says there “isn’t enough research” doesn’t mean you shouldn’t make a significant effort to avoid ultra-processed foods in your diet. Don’t wait until the government determines that the evidence is crystal clear. If you wait for the government to take a strong stance you may have type 2 diabetes, mental health issues, and cancer. You don’t need a PhD in nutrition or 1,000 randomized control trials to understand this. In the last 10 years of practicing as a functional medicine dietitian, I can unequivocally say that the most significant way to reverse disease and improve health is by ditching ultra-processed foods. 

For reference, the Dietary Guidelines are released every five years by the Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA). The government appoints a group of nutrition experts, the Dietary Guidelines Advisory Committee (DGAC), to review the most recent research and provide recommendations for the upcoming nutrition guidelines. 

The Dietary Guidelines influence nutrition recommendations for the general public and the entire food supply chain, and they shape the largest food assistance programs like the Supplemental Nutrition Assistance Program (SNAP), Women, Infants and Children (WIC), the School Lunch Program, and more. This translates to enormous opportunities for food companies to receive federal dollars through these programs. 

If the 2025-2030 Dietary Guidelines does not recommend limiting ultra-processed foods, companies will continue profiting while everyday people continue developing more chronic disease and experiencing early death. This is exactly what happened with added sugar recommendations in the United States. A good example of this is the lack of recommendations for added sugars in the food supply. In 2000, the Center for Science in the Public Interest (CSPI), one of the only nutrition agencies in Washington DC that doesn’t accept money from the food industry, loudly sounded the alarms on the harms of added sugar. But, despite strong verified evidence of the harms of a diet high in added sugars, it took nearly two decades before the Dietary Guidelines finally suggested limiting added sugars. The first time that the government provided specific recommendations for limiting added sugar wasn’t until the 2015-2020 Dietary Guidelines. 

Consideration 2-Follow the Money! 

In 2014, while getting my Master’s in Public Health Nutrition, I interned for CSPI because I respected that they had no financial ties to the food industry. During my internship, I had the opportunity to attend the Dietary Advisory Guidelines Committee Meeting at the National Institutes of Health (NIH) in Washington, DC, before the release of the 2015 dietary guidelines. 

During this meeting, approximately 75 individuals representing the National Dairy Council, the American Dairy Association, the American Beverage Association, the National Confectioners Association (aka the American Candy Association), and other organizations that represent the $6 trillion food industry were given about 2 to 3 minutes each to stand in front of the advisory committee and explain why their product should be included in the new recommendations.  

Of all the representatives, only one independent doctor and one dietitian presented to the DGAC, for a total of two health experts. I was outraged. It was at that meeting that I questioned: are the national nutrition guidelines based on evidence at all? Or were they a result of misled policies, financial gains, and industry-funded recommendations?

It turns out there is an enormous amount of bias in the formation of the Dietary Guidelines, notably: 

1) The connection of dietary advisory board members to food and medical companies (for example, 19 out of 20 nutrition professionals for the 2020-2025 dietary guidelines had ties to big food and/or big pharma)

2) The prevalence of lobbyists, which sway the direction and development of the guidelines

3) The biases created when the food industry funds nutrition research

4) The biases created when the food industry pays organizations like the Academy of Nutrition and Dietetics (AND), the largest organization of nutrition professionals with 112,000 members. (A 2022 study found that from 2011–2017, the AND received hundreds of thousands of dollars each from Conagra, Abbott, PepsiCo, Coca-Cola, Hershey, General Mills, Aramark, Unilever, and Kellogg. Appalling!)

3- Take Your Health into Your Own Hands. 

There are zero benefits to consuming ultra-processed foods. They are filled with artificial dyes, artificial sweeteners, refined grains, refined sugars, industrially refined oils, pesticides, and more. They are also completely void of any nutrients that help improve your cells function. If government agencies can’t be trusted to make unbiased recommendations that your and your family’s health depends on, it’s up to you to take matters into your own hands.

Do your own research. Find and follow like-minded individuals who base their recommendations on data and science. Don’t underestimate the impact of voting with your dollars at the grocery store and farmers markets and avoiding the purchase of companies who profit from your consumption of chemically-derived foods. Eat foods that make you feel good. Avoid foods that don’t. Cook your own food as much as possible. Ask a lot of questions. Use your best judgment. Listen to your body. Be empowered to take your health into your own hands.

In Health,