Full Transcript Ultra-Processed Foods and Mortality 0:00 Doesn't it seem like when it comes to nutrition, there are more opinions than 0:04 facts to go around? Every day we hear new [music] theories 0:08 about diets and supplements and best foods to eat. Well, my role is to take 0:13 the mystery out of good nutrition and look at the science. Welcome to the 0:18 Nutrition Facts Podcast. I'm your host, Dr. [music] Michael Greger. Today we 0:23 continue our exploration of ultra-processed foods and we start with 0:27 the two categories of these foods that have been associated with premature 0:31 death. Even a small increase in the consumption 0:34 of ultra-processed foods is associated with an increased risk of developing 0:38 several diseases. And for each additional daily serving, the risk of 0:43 dying prematurely may increase by 2%. Are there any 0:48 babies we'd be throwing out with the bathwater if we avoided ultra-processed 0:52 foods? Are there any that haven't been associated with disease? 0:56 It's such a big category. All we need are studies that break it down. And here 1:00 we go. The Framingham Offspring Study. Higher consumption of ultra-processed 1:05 foods is associated with increased risk of cardiovascular disease, but was it 1:09 because of the burgers or the bagels? The link between ultra-processed foods 1:14 and disease was largely driven by the ultra-processed meat. The sausage, 1:20 bologna, salami, hot dogs, and burgers. Breakfast cereals, nearly all of which 1:25 are ultra-processed, was associated with lower risk, presumably because cereal 1:30 eating less bacon and eggs. In another US study, this one 30 times larger, 1:35 researchers came to the same conclusion. The more ultra-processed, the more 1:39 cardiovascular disease, but which ultra-processed foods? Soft drinks, both 1:44 regular and diet, and meat, specifically burgers, fried chicken, fried fish, and 1:49 meat pizza, salty snacks like corn chips and potato chips, and candy. 1:55 Ultra-processed food consumption and high blood pressure driven mostly by 1:58 soda and meat. If we excluded soda and meat, would there still be an 2:03 association between ultra-processed foods and cardiovascular disease? We can 2:07 turn to the three big Harvard cohorts, 200,000 people followed for decades, and 2:13 yet total intake of ultra-processed foods is associated with cardiovascular 2:17 risk, but that was driven by soda and meat. 2:21 Sugar-sweetened beverages and processed red meat, poultry, and 2:25 fish, like fish sticks. What if we exclude soda and meat? The 2:30 relationship between ultra-processed foods and cardiovascular disease 2:35 disappears. So, nutritional advice for 2:38 cardiovascular health should consider the differential consequences of 2:41 group-specific ultra-processed foods, and specifically, that means soft drinks 2:46 and processed [clears throat] meats should be discouraged. 2:50 You know what else is an ultra-processed food? Vodka. So, when you look at food
Which Ultra-Processed Foods Drive Disease Risk 2:55 processing and cancer risk, if you exclude alcoholic drinks, all of a 2:59 sudden, the link between processed foods and a number of cancers becomes 3:02 insignificant, suggesting that it was probably the alcohol driving those 3:06 associations. Though for colorectal cancer risk, 3:09 soda and ready-to-eat foods like pizza and ready-to-eat meat, poultry, and fish 3:14 may also be playing a role. For pancreatic cancer, the association 3:18 between ultra-processed foods and pancreatic cancer was really more just 3:21 an association with foods like donuts, cakes, cookies, and meat and meat 3:25 products. Diabetes. You can see the straight-line increase in diabetes risk 3:30 with increasing ultra-processed food intake, but not all ultra-processed 3:34 foods, mostly animal-based products and the pizza category again. 3:39 What about mortality? Those with the most ultra-processed food 3:42 consumption had a higher risk of dying from all causes put together, but it 3:46 mattered what kinds of foods. Ready-to-eat red meat, poultry, and 3:51 seafood products had particularly strong associations with mortality. 3:56 The worst ultra-processed food when it came to dying prematurely in general, 4:01 meat, poultry, seafood. The worst when it comes to dying from 4:04 cancer, meat, poultry, seafood. The worst when it comes to dying from 4:07 cardiovascular disease, meat, poultry, seafood. The worst when it comes to 4:11 dying from lung diseases like emphysema, meat, poultry, seafood. The worst when 4:15 it comes to dying from neurodegenerative diseases, ice cream. And the worst when 4:20 it comes to dying from other causes, meat, poultry, seafood. 4:23 The bottom line is that the major factors contributing to the harmful 4:27 influence of ultra-processed foods on mortality are soda and processed meat, 4:31 including poultry and fish. That's what a systematic review and meta-analysis of 4:36 all such studies showed. Higher mortality associated with drinking more 4:40 sugar-sweetened beverages like soda, diet soda, and eating more processed 4:44 meat, or eating any processed meat at all. 4:48 So, the ultra-processed foods problem may really just be a soda and meat 4:53 problem. There was one ray of sunshine in the 4:58 study, though. The researchers found one ultra-processed dessert that was 5:02 associated with lower mortality, dark chocolate. 5:06 In the next story, we look at a natural solution to the ultra-processed food 5:11 problem, something that I talk about in my book 5:15 that came out, I think, just earlier this year on ultra-processed foods. 5:20 [music] Check it out. In two Harvard cohorts, researchers 5:24 followed about 100,000 men and women for decades, and found that high consumption 5:28 of ultra-processed foods is associated with dying earlier, which provides 5:32 support for limiting consumption of certain types of ultra-processed foods 5:36 for long-term health. In particular, processed meat, poultry, seafood, which 5:41 generally showed the strongest and most consistent associations with mortality. 5:45 So, here the negative life-shortening effects of ultra-processed foods was 5:50 really mostly talking about the negative life-shortening effects of processed 5:54 meats like burgers, chicken nuggets, and fish sticks. 5:58 But the association between more ultra-processed foods and higher 6:01 mortality appears to be present even among vegetarians. 6:06 Yes, plant-based diets, which reduce or avoid eggs, dairy, fish, and other 6:10 meats, have been linked to a reduced risk of various chronic diseases, 6:13 including our leading killer, cardiovascular disease. 6:17 But that doesn't mean you can live off vegan donuts. Non-ultra-processed plant 6:22 foods like fruits and vegetables are associated with lower risk of disease, 6:25 but ultra-processed foods like Oreos and Mountain Dew are associated with higher
Plant-Based Alternatives as a Possible Solution 6:30 risks. So, dietary guidelines shouldn't just 6:33 tell people to cut down on meat and other animal-source foods, but also to 6:36 cut down on junk. No big surprise. But this is how the paper was reported 6:43 on. The hidden health hazards of vegan sausages. Vegan fake meats are linked to 6:48 increase in heart deaths. What? 6:51 If you look at the study, meat alternatives only made up 0.2% 6:57 of their diet. 39.4% of their diet was composed of 7:01 ultra-processed plant foods, but only about 1/500 of their intake was meat 7:05 alternatives. The study participants were eating 30 times more pastries. 7:10 Aren't those more likely to be the culprit in the relationship between 7:13 ultra-processed foods and disease? 14 times more french fries and candy, 7:18 even four times more vodka and other hard liquor. But apparently, there's not 7:21 a lot clickbait to be had telling people not to eat vodka and cream puffs. You 7:26 really want to see if meat alternatives were an issue, you'd have to run more 7:31 granular studies that separate out meat alternatives for analysis. 7:36 This study on obesity had an eclectic category of ultra-processed fruits and 7:42 vegetables that included meat alternatives along with powdered soup 7:46 and fruit compote. And there was no tie to obesity. The culprits were mostly 7:52 soda, ice cream, mayonnaise, bologna, fish sticks, and the like. 7:55 But ideally, we'd have a study big enough to completely separate out 7:59 plant-based meats. If only there were some epic study. And indeed, here it is, 8:05 the EPIC study. More than a quarter million people were followed for more 8:08 than a decade. Yes, higher consumption of ultra-processed foods increases the 8:12 risk of cancer and cardiometabolic multimorbidity like cardiovascular 8:17 disease and diabetes. Yes, but which ultra-processed foods? It's the 8:22 animal-based ultra-processed foods like processed meat and soda. No associated 8:28 risk with ultra-processed breads and cereals or plant-based meat. And when it 8:34 comes to diabetes, plant-based meats and milks appear to cut the risk of 8:38 developing diabetes in half. Animal-based products were associated 8:42 with more than twice the risk. Plant-based alternatives were associated 8:46 with less than half. The [clears throat] authors concluded that higher 8:49 consumption of ultra-processed foods may increase the risk of cancer and other 8:52 diseases, but their data really only show that the consumption of foods of 8:56 animal origin and soft drinks is associated with such a risk, which is 9:00 like, duh. Indeed, if you go back and exclude the 9:03 animal-based foods and sodas, the relationship between ultra-processed 9:07 foods and these multiple diseases disappears. 9:11 So, the only ultra-processed food that appears to be killing people is meat. 9:17 In that case, instead of being a contributor, plant-based meats may be 9:22 the solution to the ultra-processed foods problem. The only other 9:27 ultra-processed study that separated out plant-based meats looked at telomere 9:32 length, which is used to measure cellular aging. Their study found that a 9:36 higher consumption of total ultra-processed foods was associated 9:39 with shorter telomere length, which is a sign of accelerated aging. 9:44 However, some subclasses may be associated with longer telomere length, 9:48 suggesting slower aging. And the class of foods associated with 9:52 the longest telomeres, vegetarian alternatives, to 9:56 meat. There have been other population studies 10:00 on plant-based meats. This one found that those who ate plant-based meat 10:03 daily appeared to cut the risk of hip fracture in half compared to those 10:06 eating it less than once a week. School children who eat plant-based meats 10:10 appeared to have half the odds of being overweight compared to those eating 10:13 regular meat. And girls who eat more meat start their periods at an earlier 10:18 age, which may help explain why childhood meat consumption is linked to 10:21 breast cancer later in life since the earlier you start your period, the 10:25 higher your lifetime risk. In contrast, those eating plant-based meats appear 10:29 able to delay the onset of menstruation by 9 months. 10:33 But observational studies like these can't ever prove cause and effect. For 10:37 that, you need interventional trials. There have been 10 published up to 2023
Research on Plant-Based Meats and Health 10:42 and a few more since then. I did a video on the Stanford Swapped Meat Study that 10:47 showed swapping out a few servings a day of meat for plant-based meat 10:51 alternatives for 2 months significantly decreased circulating levels of the 10:55 microbiome toxin TMAO, as well as lowered LDL cholesterol and body weight. 11:00 But there have been a about a dozen other studies, including this 11:04 4-year-long randomized clinical trial in which 11:07 people with diabetes and ailing kidneys were randomized to replace half their 11:10 animal protein intake with an ultra-processed plant meat replacement 11:14 called TVP. The researchers saw significant 11:18 improvements in blood sugar control, cholesterol, triglycerides, 11:22 inflammation, and significant improvements in their kidney function. 11:25 I'll cover all these studies. Stay tuned. 11:29 And if you don't want to wait, I've got a new book out that covers them all, a 11:33 short peer-reviewed paper that's free to download at c.nf/ultra, 11:38 and a continuing medical education approved webinar you can watch as well. 11:45 Visit nutritionfacts.org/audio to see all the podcast episodes with 11:49 descriptions that include links to the associated videos. 11:53 Sources cited and other details are available on each video's page. 11:57 Information about my books, How Not to Die, How Not to Diet, and How Not to 12:00 Age, is at nutritionfacts.org/books. All proceeds, which I get, are donated 12:07 directly to charity. And I've got a new book in the publication pipeline, the 12:11 manuscript for How Not to Hurt on diet and lifestyle approaches to pain 12:16 management, has been handed in and will be published December 15th. 12:21 >> [music] >> I'm going to be doing a series of 12:22 webinars to feature some of the new research I've discovered. Sign up for a 12:26 free newsletter at nutritionfacts.org/subscribe 12:30 to stay updated on when those will be. Nutritionfacts.org is a science-based 12:37 nonprofit, and everything on the website is free. There are no ads, no corporate 12:40 sponsorships, no kickbacks. We're strictly noncommercial, not selling 12:44 anything, just put up as a public service, as a labor of love, as a 12:47 tribute to my grandmother, whose own life was saved with 12:51 evidence-based nutrition. We just have like [music] a 12:54 a Wikipedia-type nonprofit model where everything's free, and we just hope 12:58 maybe, you know, one in a thousand people will find it so valuable that 13:01 they'll kick in a few bucks so we can continue to churn out new content to 13:05 help you and your family be healthier. Thanks for listening.
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