Should food be made cheaper? Specifically ultra-processed foods?
For context I answered this question on Quora
Not only should food not be cheaper but the Ultra processed food items (UPF) that makes up the majority of the American diet should be made more expensive via an excise or consumption tax to discourage its consumption. A large and expanding body of scientific evidence suggests that UPF items are slow-acting poisons that make chronic disease and death more likely when they become regular parts of our diets, which the food industry is getting us hooked on by introducing it at the earliest stages of life. A recent study of commercially available infant and toddler foods (n = 651) found that 74% dry or semi-dry snacks and finger foods for this age range (n = 122) contained added sugars or artificial sweeteners. UPF prevalence not genetics is why childhood obesity has nearly tripled for children five years of age or younger and quadrupled and quintupled for children older than 5 years over the past half century in which UPF has become more prevalent. Genetics doesn’t change that drastically in such a relatively short period of time; but our diets have.
An ecological cross sectional study found, across 19 European countries, that every 1% increase in household consumption of UPF is associated with a 0.25% increase in obesity rates. An ecological study investigating Euromonitor recorded sales of UPF sales across 80 countries and BMI trajectory found that every 1 standard deviation increase in per capita sugary drink consumption is associated with a 0.2 kg/m2 increase in BMI for men and every 1 standard deviation increase in per capita UPF consumption is associated with 0.3 kg/m2 increase in BMI. In the U.S., U.K. and Canada, individuals in the highest quintile or quartile of UPF consumption have the highest risk of obesity, waist circumference and excess weight compared to individuals in the lowest quintile. An NIH RCT conducted among 20 weight stable healthy adults in the U.S. found that participants that ate an 81% UPF diet ate more and gained weight on the UPF diet and ate less and lost weight on a strictly whole foods diet.
UPF based diets don’t just increase cases of cardiometabolic disorders i.e. obesity, diabetes, cardiovascular disease and hypertension because UPF based diets are also neurodegenerative diets that deprive both the body and brain of essential nutrients and accelerate atrophy. A cross sectional study (n = 9,317), using 2009–2010 National Health and Nutrition Examination Survey and the NOVA food classification system, found that 57.5% of calories in the average U.S. daily energy intake were from ultra processed foods while only 30% were from whole foods. The average dietary content of protein, fiber, vitamin A, vitamin C, Vitamin E, Vitamin D, zinc, potassium, magnesium, calcium and phosphorus decreased in higher quintiles of ultra processed food consumptions while the average dietary content of carbs, sodium, added sugars and saturated fats increased with higher quintiles of UPF consumption. Unfortunately, the average saturated fat and sodium content of all quintiles of UPF consumption exceeded the recommended limits of the 2015–2020 Dietary Guidelines for Americans.
As I elaborated 5 years ago in How Congress Created Our Obesity and Mental Disorder Epidemics, UPF diets characterized by high concentrations of saturated fats and refined sugars and a lack of nutrient dense foods are not only independently associated obesity, diabetes, cardiovaschular disease and hypertension, they are also associated with cognitive impairment and mental disorders.
A multicenter, prospective cohort study conducted between 2008 and 2019 among 3 different waves of active or retired public servants in six Brazilian cities between 35 and 74 years of age (n = 10,775) found, through a food frequency questionnaire and cognitive assessment performed 3x every four years, that participants who reported that UPF constituted 20% or more of their daily calories had a 28% faster rate of global cognitive decline and a 25% faster rate of executive function decline compared to participants who reported that UPF constituted less than 20% of their daily calories after a median follow up time of 8 years. This difference was only found for participants 60 years of age or younger. UPF was only 27% of average daily caloric intake in this longitudinal Brazilian study.
Drawing on data from the Personality and Total Health Through Life project, a longitudinal cohort study, that involved two structured interviews conducted 4 years apart, two MRI scans within the same time frame (n = 341) and a food frequency questionnaire for Australian adults born between 1937-41 (n = 255) found that dietary patterns were associated with the rate hippocampal atrophy in old age. A prudent dietary pattern of low UPF consumption was independently associated with larger left hippocampal volume while a western dietary pattern was independently associated with smaller left hippocampal volume. Participants who scored higher on the prudent dietary factor scale had a hippocampal atrophy rate difference that corresponds to 62% of the average decline in left hippocampal volume.
A prospective cohort study (n = 26,730) which utilized data from the French web based NutriNet-Santé cohort study to investigate the association between UPF consumption, captured in dietary records every 6 months, and depressive symptoms assessed every two years, found a strong and linear relationship between the percentage of UPF as energy intake and the incident of depressive symptoms. Specifically, a 10% increase in the percentage of UPF in a participant’s diet was associated with a 21% elevated relative risk of depressive symptoms. This association was slightly weaker after accounting for use of antidepressants during the follow-up but remained statistically significant at the 0.05 alpha level, but ‘was stronger in participants with low energy intakes compared to their needs than their counterparts.’ When the analysis was stratified by age, sex, BMI, comorbidities, and healthy pattern scores subgroups of women, participants 49 years of age or older, participants with chronic diseases, and participants with a BMI of 25 or greater had an even higher risk of depressive symptoms from an increase in the percentage of UPF in their diets. ‘In the main model, the estimated HR (Hazard ratio) for the analysis with a 10% increase in UPF consumption was 1.43.’ UPF was only 30% of the participants' caloric intake in this study; imagine how much worse the problem must be in the U.S. where it is twice that.
Another prospective study using data from the French web based NutriNet-Santé cohort study to investigate the association between UPF consumption and the incidence of cancer diagnosed up to January 1, 2017 for participants with at least two 24 hr dietary records over a two year follow up (n = 104,980) found that a 10% increase in proportion of UPF making up participants’ diets was associated with a 12% higher risk for cancer in general and an 11% higher risk of breast cancer. UPF were less than 19% of the average participant’s caloric intake.
A prospective analysis of participants at least 20 years of age in the third National Health and Nutrition Examination Survey conducted between 1988-94 with no pre-existing chronic diseases or cancer at baseline (n = 11,898) found that participants in the highest quartile of UPF consumption (>5x a day) higher intakes of saturated fat and added sugar and lower intakes of protein, fiber, and micronutrients compared to lower quartiles. Over a median follow up time of 19 years, participants in the highest quartile of UPF consumption had a 31% increase in all cause mortality compared to participants in the lowest quartile (<2.6x a day) of UPF consumption. Another prospective cohort study of participants recruited from the aforementioned NutriNet-Santé cohort study (n = 44, 551) found that a 10% increment of UPF consumption was associated with a 14% higher relative risk of all cause mortality.