The Health Risks of Ultra-Processed Foods

By Dr. John Neustadt

What you eat is one of the top predictors of your future health. With every bite of food, you either promote your health or feed the disease process. Chemical engineering has created novel ingredients and food our bodies have never encountered and don’t know how to process. They’re called ultra-processed foods (UPF) and account for about 60% of all calories in the American diet.¹ Their dangerous health effects are now apparent. 

What are UPFs

If it comes in a package, it’s likely a UPF. While this isn’t always the case, 71% of packaged foods in the U.S. are UPF.² While it’s unrealistic in our modern world to expect everyone to avoid packaged foods altogether, minimizing how much you eat them is an important goal. At the very least, becoming an educated consumer to identify them and make healthier choices can go a long way toward reducing your exposure.

UPFs are ready-to-consume industrial formulations marketed as food. To create them, manufacturers deconstruct whole food into its components, such as starch, protein, and fat. They then separate the elements, chemically alter them into novel molecules, and combine them with synthetic ingredients. 

Manufacturers make UPFS using cheap ingredients to create highly profitable products that they then market heavily to consumers using appealing language and packaging. They also tend to have long shelf lives and contain little or no whole foods.³ 

Unlike whole foods, which have natural amounts and ratios of fiber, carbohydrates, fat, protein, vitamins, and minerals, UPFs are energy-dense and nutritionally unbalanced. They tend to be low in fiber but high in saturated fat, salt, and sugar.⁴ 

Chemical Additives

Industrial raw materials used to create these products fall into different categories. There are artificial colors, sweeteners, flavors, preservatives, thickeners, emulsifiers, and additives to improve the look, feel, and taste and increase shelf life.

While the high sugar, salt, and fat content in UPFs damages people’s health, food additives also play a role. Food manufacturing in the U.S. uses more than 10,000 food additives.⁵ 

A complete list of food additives is beyond the scope of this article; however, here’s a partial list: flavors, flavor enhancers, colors, emulsifiers (e.g., Polysorbate 80 and carboxymethylcellulose), artificial sweeteners (e.g., non-caloric sweeteners), thickeners, humectants, stabilizers, acidity regulators, preservatives, antioxidants, foaming agents, anti-foaming agents, bulking agents, bleaching agents, leavening agents, and clarifying agents.⁵

Health Risks

Dozens of epidemiological studies concluded a dose-response relationship between eating UPFs and people’s risk for many diseases. A systematic review and meta-analysis of 43 studies showed that the more UPF someone consumed, the greater their risks for obesity, all-cause mortality, metabolic syndrome, frailty, irritable bowel syndrome (IBS), acid reflux, cardiovascular disease, breast cancer and overall cancer risk, depression, and anxiety.³ Additional research has linked eating UPF to ADHD, cognitive decline, bone loss, inflammatory bowel disease (IBD), pregnancy complications, and male infertility.^6-13

Here are some startling conclusions from these studies. 

Acid reflux
People who consume more than 20% by weight of food as UPF, compared to people consuming less than 10%, have a 25% higher risk of acid reflux.³ 

ADHD
When looked at as a percent of total food consumed, each 5% increase in UPF consumption increases the risk for ADHD by 10%.⁸ One of the culprits appears to be artificial food coloring, including red no. 3, red no. 40, yellow no. 5, and yellow no. 6, although adverse effects from other artificial ingredients cannot be ruled out. A review of 27 clinical trials showed “a relationship between food dye exposure and adverse behavioral outcomes in children, both with and without pre-existing behavioral disorders.”

Furthermore, the researchers calculated that in the U.S., on average, children consume 55.8 mg/day of these chemicals; however, consumption was as high as 250 mg/day.¹⁴

All-cause mortality
Eating UPF products more than five times a day is associated with a 28% increased risk of all-cause mortality compared to people eating fewer UPF.³ 

Cancer
Consuming more than 10% of calories from UPFs is associated with increased risk for cancer. Each 10% increase in UPF consumption is associated with a 12% increase in getting any cancer, a 30% increased risk of dying from ovarian cancer, and a 16% increased risk of dying from breast cancer. Additionally, eating UPFs more than five days per week is associated with a 235% increased risk of breast cancer compared to women who eat it less frequently.^3,15 

Cardiovascular disease
The risk of coronary heart disease increases by 12% for each 10% increase in UPF consumption, and the risk of cerebrovascular disease increases by 11%.³

Cognitive decline
Consuming 20% or more calories from UPF is associated with a 28% faster rate of memory loss and decreased ability to recognize words compared to people eating less UPF. Additionally, it’s associated with a 25% faster rate of loss of verbal fluency.⁹ 

Depression and anxiety
Higher UPF consumption is associated with worse mental health, including depression and anxiety.¹⁶ Consuming 20% or more of calories from UPF is associated with a 22% increased risk of depression compared to people who eat less UPF.³ Every 10% increase in UPF consumption per daily calorie intake is associated with an 11% higher depression risk.¹⁷ Additionally, consuming higher amounts of UPF is also associated with higher feelings of boredom, crying, fear, loneliness, unhappiness, poor sleep, and sadness.¹⁸

Frailty
When men consume more than 24% and women more than 27% of calories from UPF, they are 367% more likely to develop frailty than people who consume less than 10%. Frailty is a major risk factor for falls and fractures in older adults.³ 

IBD
Consuming just one to four servings daily of UPF is associated with a 67% increase in Crohn’s and ulcerative colitis risk compared to people eating less. The risk also increases the more someone eats. Consuming five or more servings daily of UPF is associated with an 82% increased IBD risk.¹³

IBS
People who consume more than 20% by weight of food as UPF compared to people consuming less than 10% have a 25% higher risk of IBS.³

Low sperm count
Globally, about 8-12% of couples have difficulty conceiving, and about half of the time, this is due to male health problems.¹⁹ Eating UPF is associated with decreased sperm count, motility, and form. Their analysis found that replacing 10% UPF with unprocessed, whole foods would improve all sperm health parameters.¹¹  

Metabolic syndrome
Each 10% increase in UPF consumption increased the risk of metabolic syndrome by 4%.³

Obesity
People who get as little as 30% of their calories from UPFs have a 51% increased risk of obesity compared to people eating less UPF.³ 

Pregnancy complications
Consuming ultra-processed foods is associated with up to a 206% increased risk of gestational diabetes and up to 251% increased risk of preeclampsia in women who consumed UPFs as part of a Western dietary pattern, also called the Standard American Diet.¹²

How UPFs Create Disease

UPFs cause havoc with people’s biochemistry and health by creating nutritional imbalances, altering hormones, and causing dysbiosis and inflammation. 

Nutritional imbalances
Studies in Brazil, Canada, Taiwan, and the U.S. show that the more people consume UPFs, the lower their intake of healthy nutrients. Calories from nutrient-poor UPF displace healthy calories from whole foods. 

People who consume UPFs get lower amounts of protein, fiber, vitamin A, B-complex vitamins (B1, B2, B3, B6), vitamin C, vitamin D, and vitamin E. They also get less calcium, iron, magnesium, phosphorous, selenium, and zinc and fewer phytoestrogens.^4,20 

Eating More
When eating UPFs, people tend to eat faster and consume more calories. UPFs are often softer and easier to chew, so people eat them faster. Eating too quickly prevents the brain from receiving signals from the gastrointestinal tract that indicate fullness. A brilliantly designed clinical trial demonstrated this. Researchers invited ten men and ten women to live at the National Institutes of Health (NIH) research center for 28 days.  During that time, they fed them controlled diets containing either unprocessed foods or 81% of calories from UPFs. 

At the end of the study, people following the UPF diet ate more than two times faster than people eating unprocessed foods and consumed 459 more calories per day. Furthermore, people eating unprocessed meals and snacks lost about two pounds, while those eating UPFs gained about two pounds. 

Blood tests showed UPFs also caused biochemical changes. Glucagon-like peptide-1 (GLP-1) is a hormone that decreases hunger by suppressing appetite and slowing digestion. To help people lose weight, drug companies created weight-loss drugs like semaglutide that increase GLP-1. When GLP-1 decreases, it has the opposite effect—people eat more and gain weight. In the clinical trial, GLP-1 decreased in volunteers eating UPFs.²¹

Dysbiosis
The additives used in UPF products are seldom discussed; however, research shows they are a significant cause of the problems. One category of additives is emulsifiers. These chemicals contribute to the creamy mouthfeel experienced in ice cream, act as an anti-foaming agent in baking so confections don’t clump, and disperse water in baking to create a lump-free batter. Examples include polysorbate 80 (P80), carboxymethylcellulose (CMC), maltodextrin, carrageenan, gum arabic, xanthan gum, guar gum, and locust gum.²²

According to the FDA, they are allowed in ice cream, frozen custard, ice milk, fruit sherbet, and “nonstandardized frozen desserts,” yeast-defoamer formulations, pickles, and pickle products as a solubilizing and dispersing agent, fat-soluble vitamins in vitamin and vitamin-mineral preparations, and other products.²³ If you look at the list of ingredients on packaged foods, you’ll undoubtedly find these emulsifiers. Some of them, like P80, maltodextrin, and others, can also be found in dietary supplements but not NBI products.

A study of seventeen emulsifiers evaluated their effects on the microbiome in mice. The emulsifiers created dysbiosis in these animals by decreasing the diversity of the bacteria.²² Another mouse study found a microbiome disruption when the animals consumed P80 and CMC. In this study, not only did the emulsifiers harm the microbiome, but they also caused behavioral changes. Male mice exhibited more anxiety-like behaviors, and female mice’s social behavior changed.²⁴

Animal studies don’t always translate into human effects; however, in this instance, they do. When researchers tested seventeen emulsifiers on women and men, those who consumed more than five servings daily of UPFs containing emulsifiers developed dysbiosis.²⁵

Inflammation
Numerous emulsifiers, including P80, CMC, and carrageenan, create intestinal inflammation. Mice fed P80 and CMC developed “low-grade inflammation, obesity, and metabolic syndrome.^26,27 In another study, CMC and P80 promoted and aggravated colitis in a mouse model of IBD.²⁴

Carrageenan, another emulsifier, was also studied for its effects on inflammation. It is used as a thickener, stabilizer, and emulsifier and improves the mouthfeel of UPF products. Carrageenan is found in dairy products like chocolate milk, ice cream, cottage cheese, yogurt, and sour cream. It is also found in processed meats, infant formulas, milk alternatives (e.g., almond milk), mayonnaise, and soy products. 

Colon and embryonic cells exposed to carrageenan stimulated inflammation by increasing the pro-inflammatory chemical tumor necrosis factor-alpha (TNF-alpha). Another study of human colonic cells determined that carrageenan triggers a distinct inflammatory pathway. The researchers speculate this inflammatory cascade is a possible link between genetic predisposition and environmental triggers of IBD.^28,29

Marketing to Children

How UPFs are packaged and marketed affects our food choices and how much we eat. A review of 120 experimental studies in children aged 2 to 11 has demonstrated how packaging affects food preference, taste, liking, intake, and choice.³⁰

Preference: Food in McDonald’s packaging was preferred over identical food in plain packaging. 

Taste: The taste of foods in cartoon character packaging was preferred over identical foods in plain packaging. 

Liking: Children liked the food better when popular media characters appeared on the cereal box than those without a character. They also wanted the cereal more when it was named “Healthy Bits” versus “Sugar Bits.” Companies use this strategy to create exciting packaging and names that might indicate a healthier alternative when, in fact, it is not. 

Intake: Children who received meals with fast food logos ate 100 calories more per meal than unbranded meals.

Choice: When children were offered the option of apples with a sticker of a known character on them or a cookie without a sticker, they ate nearly double the number of apples compared to the pre-test control.  

How to identify UPFs

Generally, if an ingredient on a package isn’t something you’d commonly find in your kitchen, it’s probably a UPF. Beyond that, here are some general rules that will go a long way to helping you identify and reduce UPFs in your diet. 

Ingredient List
Check if the product contains ingredients not typically used in home kitchens, such as high-fructose corn syrup, hydrogenated oils, or hydrolyzed proteins. Additionally, additives like flavors, flavor enhancers, colors, emulsifiers, and sweeteners are strong indicators.

Packaging and Marketing
UPFs are often marketed as convenient, ready-to-eat, or ready-to-heat products with long shelf lives. Their packaging usually emphasizes marketing claims and uses bright colors. Companies frequently market to children using cartoon characters or prizes. 

Nutrient Profile
These foods usually have high levels of added sugars, fats, and salt and are energy-dense but nutrient-poor. The presence of these critical nutrients in excess can also help identify UPFs.

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