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Why Ultra-Processed Foods Are So Addictive & How We Can Eat Less Of Them
Ultra-processed foods are as addictive as certain drugs—and it's time to call out the dangers they pose to public health. That's the strong stance that scientists and physicians took in an in-depth analysis recently published in the British Medical Journal (BMJ)1.
In light of this report, we were curious to dig into what, exactly, makes it so hard to stop eating the processed foods that inundate the inner aisles of grocery stores worldwide. So, we recruited an internal medicine physician and nutritionist to help us unpack this new analysis, its significance, and what it could mean for the future of food.
Meet the experts:
- Anant Vinjamoori, M.D.: Harvard-trained, board-certified internal medicine physician and chief medical officer at Modern Age. Vinjamoori's clinical focus is longevity and healthy aging. He prioritizes a multi-system, preventive approach to well-being.
- Jessica Shapiro, M.S., R.D., CDN, CDCES: certified diabetes educator, registered dietitian, and associate wellness and nutrition manager at Montefiore Medical Center in New York City. Shapiro believes in both holistic and realistic improvements when it comes to nutrition to support a sustainable healthy lifestyle.
What are ultra-processed foods?
Plenty of foods are processed before consumption—they can be frozen, roasted, spiced, and more. So, what exactly does "ultra-processed food" mean?
"Ultra-processed foods (UPFs) can be loaded with ingredients, many of which are sugar, salt, fat, and other substances derived or extracted from real food (think 'made in the lab') and/or additives such as artificial colors, flavors, and preservatives," Shapiro explains.
"Ultra-processed foods are also nutrient-poor, meaning they lack essential vitamins, minerals, and other beneficial compounds, and consistently consuming these foods can lead to nutritional deficiencies and inflammation, which can shorten one's life span and lead to obesity and a variety of diseases," Vinjamoori states.
This level of processing is often used to boost sales of the product and preserve its shelf life, as well as bring down the cost of production. According to the BMJ analysis, addiction to these foods has become just as prevalent as addiction to other legal substances like alcohol and tobacco.
"A recent analysis of two systematic reviews including 281 studies from 36 different countries found the overall pooled prevalence of food addiction using [the Yale Food Addiction Scale] was 14% in adults and 12% in children," the authors state. This prevalence is quite similar to the levels of addiction seen for other legal substances in adults (noting 14% for alcohol and 18% for tobacco), but the level of implied addiction in children is unprecedented, they say.
In the full analysis1, the authors dive deep into the health and longevity implications of this addiction, including higher rates of chronic diseases, mental health and cognition concerns, and worse treatment outcomes.
What makes them so addictive?
Ultra-processed foods aren't addictive just because they taste good: Their structure actually impacts the brain's reward centers.
The high carbohydrate and fat content in many UPFs has a direct impact on the brain's dopamine pathways2, which play a role in reward and motivation.
The BMJ analysis even noted that the spike in dopamine is so high that it's comparable to the rise seen with addictive substances such as nicotine and alcohol.
This isn't a mere analogy; it's an acknowledgment of the real, tangible impact these foods can have on our neurobiology.
In addition, UPFs can deliver carbs and fat to the brain very quickly, further contributing to their addictive potential. The faster a substance can reach the brain, the more addictive it can be. "This is the rationale behind substitution therapies and why a cigarette, which rapidly delivers nicotine to the brain, is more addictive than a slow-release nicotine transdermal patch," the analysis authors explain.
"This isn't a mere analogy; it's an acknowledgment of the real, tangible impact these foods can have on our neurobiology," Vinjamoori says.
He notes that we have more than enough compelling evidence on the health risks of ultra-processed foods to warrant major change.
What scientists propose
As for what we can do to reduce the risk of addiction to ultra-processed foods, the analysis includes four tangible recommendations:
- Taxes on ultra-processed food (UPF) and beverage: For this suggestion, researchers lean on the evidence from previous food-related taxes including the sugar-sweetened beverage tax (SSB) that 103 countries3 have adopted thus far. Preliminary evidence has also linked such taxes with reductions in body mass index among adolescent girls in Mexico4 and declines in dental caries among people with low incomes in a large U.S. city5, the BMJ report states, implying that a tax on UPFs could help to reduce consumption and thus reduce the health-related concerns UPFs have on the body.
- Labels on ultra-processed foods: Food producers in over 20 countries, including Argentina, are now required to add labels to some ultra-processed foods high in sodium, sugar, fat, and calories. Researchers note that labeling schemes like these could make it easier for consumers to make healthy choices in the store.
- Mandatory or voluntary reformulation of the food supply: A few programs have encouraged food companies to make their offerings less salty or fatty—and they have led to promising early results. The UK's voluntary salt reduction plan, for example, led to a 15% reduction in sodium intake6 and 42% and 40% reduction in stroke and ischaemic heart disease mortality over eight years. New York City's trans-fat ban in restaurants has been associated with 4.5% drop in cardiovascular disease mortality7 since 2008. "In addition, the implementation of healthier nutrition standards in U.S. schools was associated with reductions in body mass index among youth8," the authors note. This is strong evidence that changes in the food supply can have a positive trickle-down effect on public health.
- A suite of policies targeting UPFs: Finally, the authors point out the need for a multipronged approach to ultra-processed food policy. "No one food policy will transform unhealthy food environments. Countries such as Chile and Mexico have implemented a bundle of healthy food policies, including taxes, nutrition labels, and marketing regulations on UPFs," they note. This bundle approach has led to a significant decrease9 in highly processed food and beverage sales in some countries.
What experts think about the new proposition
As the popular saying goes, actions speak louder than words—and this analysis can only be considered a success if it inspires action. That said, many positive changes could come from this recommendation if put into motion.
"If 'food addiction' becomes an official diagnosis, then there would likely be more opportunities for research around the topic," Shapiro says, adding, "This could also improve insurance coverage and more access to professional support for those looking for help." On the flip side, she says that there is a stigma attached to being 'addicted' to a substance, even if it is food, so the way we discuss addiction as a society would also have to change.
"As we continue to uncover the mechanisms linking ultra-processed foods to potential addictive behaviors, there's a clear societal responsibility at hand," Vinjamoori adds. "Not only do we need to transparently communicate these findings to the general public, but we also must advocate for protective policies. Moreover, it's imperative that we develop clinical resources and tools specifically designed to address food addiction."
Finally, there is another significant hurdle to cross before less processed diets can go mainstream: economic and geographical inequities in the food system.
Framing UPFs as addictive may be a step in the right direction to encourage systemic change in the food industry and apply pressure for health care and health insurance to take nutrition more seriously—which is great. However, until natural and minimally processed foods become more affordable and accessible than ultra-processed foods, there will always be a layer of inequality rooted in food access and nutrition choices.
The takeaway
Nutrition scientists recently published a data analysis in the British Medical Journal with a suggestion to call out the addictive nature of ultra-processed foods (UPFs) and advocate for change in the food industry, encouraging government regulation and public education.
The data shows that UPFs affect the brain's dopamine receptors in a similar way (and to a similar degree) as addictive substances like nicotine and alcohol, in part due to their carbohydrate-to-fat ratio. These foods also lack the nutrients the human body needs to function properly, which is another reason experts are concerned about the mass consumption of UPFs in America.
The path to limiting the negative public health impacts of UPFs is long, complex, and multifaceted, but hopefully, this BMJ analysis will serve as a jumping-off point for increased awareness and action. Throughout this process, it will be essential for those advocating for change to acknowledge the economic disparities of food.
The recommendations provided in the analysis give us a glimpse into a world where access to whole, nutrient-dense food is a human right—and that's definitely something worth working toward.
9 Sources
- https://www.bmj.com/content/383/bmj-2023-075354
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124340/
- https://pubmed.ncbi.nlm.nih.gov/36988952/
- https://pubmed.ncbi.nlm.nih.gov/34902003/
- https://pubmed.ncbi.nlm.nih.gov/36863896/
- https://pubmed.ncbi.nlm.nih.gov/24732242/
- https://pubmed.ncbi.nlm.nih.gov/26620830/
- https://pubmed.ncbi.nlm.nih.gov/36780186/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012389/
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