The Dr. Hyman Show - Why the Last Thing You Should Ever Eat is Ultra Processed Foods: It Kills 11 Million People a Year

Episode Date: April 12, 2024

View the Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal In the health space, we hear the term ultra-processed foods thrown around often for its clear link to chronic diseases such as depression, Alzheimer’s, and diabesity. But what exactly does “ultra-processed” mean? How can you tell if a food is ultra-processed? In today’s Health Bites episode, we will learn exactly what ultra-processed foods are, how to identify them, their impact on human health, and the global economy. We’ll also discuss tips and tricks for how to read food labels to better navigate the grocery store, and the innovations happening in Washington to develop label laws that helps protect the consumer. In this episode, I discuss: Definition, examples, and deceptive health claims of ultra-processed food (2:06)  Health risks and impacts of ultra-processed food (7:30)  Case study: impact of an ultra-processed diet on twin girls (10:00)  History and rise of processed food (12:09)  Difference between ultra-processed and minimally processed foods (17:45)  Impact of food packaging and additives on health (24:01)  Economic and societal consequences of chronic diseases caused by poor diet (28:04)  Identifying ultra-processed foods and understanding food labeling (35:00)  Avoiding ultra-processed foods and using food scoring systems (40:50)  This episode is brought to you by Rupa Health, Essentia, and Cymbiotika. Streamline your lab orders with Rupa Health. Access more than 3,000 specialty lab tests and register for a FREE live demo at RupaHealth.com. Receive an extra $100 off your mattress purchase! Go to myessentia.com/drmarkhyman and use code HYMAN at checkout to get this great deal. Upgrade your supplement routing with Cymbiotika. Get 20% off with free shipping on all orders. Head to Cymbiotika.com and use code HYMAN.

Coming up on this episode of The Doctor's Pharmacy. Ultra-processed food is the number one cause of death in the world today, period. This is not my opinion. This is from the Global Burden of Disease Study of 195 countries. The data is very clear. Too much of that crap and not enough real food.

This is, my friends, the new smoking. Ultra-processed food are the new cigarettes, and we're gonna talk about why. Hey everyone, it's Dr. Mark. As functional medicine practitioners, we need to get to the heart of root causes behind our patients' health concerns. And let's face it, ordering labs to get the data can be an administrative nightmare. Luckily, Rupa Health is here with the solution. Rupa's simple lab ordering platform helps you access and order

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Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman, and that's pharmacy with an F, a place for conversations that matter. And this conversation on today's special episode of Health Bytes is going to matter to all of you because it's about one of the most pressing and powerful destructive forces on humanity today. And what I'm talking about is ultra processed food. And we're going to get into what that is, why it matters, why you should be concerned, destructive forces on humanity today. And what I'm talking about is ultra-processed food. And we're going to get into what that is, why it matters, why you should be concerned, the conditions that it causes, and how to avoid them. Because this is, my friends,

the new smoking. Ultra-processed food are the new cigarettes. And we're going to talk about why. The question is, what's ultra-processed food? What's not? So let's talk about what exactly are ultra-processed foods? What are the characteristics? How do we define them? Well, there's something called nova classification. I'll get into a minute, but essentially it's deconstructed food. Basically take raw materials from things like corn, wheat, and soy. You deconstruct them chemically in a lab. You all structurally alter them. So they're not actually the same chemical structure. And our body, remember, gets messages from the outside environment and regulates this biology through chemical signals that depend on the structure and shape of the molecule to create a signal in the body that does good or bad, right?

This is really important. So these are funky, weird, Franken molecules. And then they're turned into food-like substances that come in every color, size, and shape of chemically-construed yuck, basically. Now, they're super energy-dense, usually. They're high in calories. They have pretty much no nutritional value, usually. They're high in sugar. I mean, they may have added vitamins. You know, you get your cereal or Froot Loops with added vitamins. Well, that's not exactly a health food. They are high in sugar. They come from all different

sources. High fructose corn syrup, dextrose, maltodextrin, cane sugar, fructose. There's a million different names of sugar. You can Google it and see. I'll put a link to all the different kinds of names of sugar, but they hide the names of sugar on the label. So you get confused. It doesn't just say sugar. It's also high in refined grains. So these are highly pulverized grains that mostly wheat that are chemically altered and are not resembling their original form. And they're maybe from corn, from wheat, from beans like soy. Also high in unhealthy fats, usually trans fats still in the market, refined oils and so forth. They contain often excess salt.

They're hyper palatable. They're easy to overeat. They're low in fiber, typically low in protein. They're low in vitamins and low in minerals. So all the things you need to thrive, they don't have. They also tend to spike your blood sugar a lot. They also don't make you feel full. So people who eat ultra processed food eat 500 calories more a day.

This was a controlled study at the NIH with Kevin Hall. Really impressive data. So basically people who were allowed to eat whole food versus ultra processed food as much as they wanted, the ones who ate the ultra processed food ate 500 calories more a day, 3,500 calories a week. That's a pound a week. If you keep doing that all year, that's 52 pounds of weight gain in a year. So what are the examples of ultra processed food? Well, it's potato chips, crackers, pretzels, candy, microwave popcorn. Don't ever eat that. Muffins, donuts, sandwich breads, cookies, flavored yogurts, puddings, jello, breakfast cereal, granola bars, things with added sugar, food dyes, natural artificial flavors, colors, preservatives, gums, emulsifiers. Oh my. Right? It's a lot of stuff. So don't eat that. It's not food.

Ready to eat meals, instant noodles and soups, frozen TV dinners, canned ravioli, pastas, packaged meal kits, nasty. Unless they're made from whole food. Processed meat and dairy. Again, we eat a lot of this stuff. Hot dogs, deli meats, fish sticks, which I don't even know what they are. Often they're not fish. Chicken nuggets.

Most chicken nuggets have like 35 ingredients, only one of which is chicken. Processed cheese slices. They're not even allowed to be called cheese because it's not actually cheese. It's not 51% cheese. Various spreads, flavored milks, non-dairy beverages, coffee creamers, various protein shakes you have to be careful of, like isolated soy proteins, deconstructed soy. Potentially very cancerous, so be careful of that. Flavors. So it says soy, a soy shake, and that's like maybe really bad for you.

Flavors, sweetened nut milks often can be problematic. You have to watch what's in them. And of course, sugar, sweetened beverages, soft drinks, lemonade, iced tea, soda, fruit drinks, punches, energy drinks, flavored coffees, all this stuff is just nasty. So you want to stay away from that. When it comes to a healthy diet, we hear a lot of these terms. Ultra processed food, processed foods. Most people have no clue what they are. And I think it takes a little bit of education to understand

how to navigate this landscape of processed and ultra processed food. Now, what does it mean? We're going to talk about the difference between ultra-processed food and other types of processed food. For example, Doritos versus a can of sardines, they're both processed, but highly different in their effect on your biology. You know, is one worse than the other? How do we tell the difference? We're going to get into all of that. Part of the problem today is that most people need a PhD to understand nutrition labels. And many of us fall into the trap of convenience and just sort of get whatever seems good or whatever package looks like it's going to be healthy. And basically,

there's a health claim on the label. You think it's good for us, but that's basically one of my rules of eating. If it has a health claim, it's not good for you. In other words, gluten-free potato chips or a sugar-free this. When it says that, it's always something bad that's added. So these are made by big food in order to lure you in and get you sucked in and trapped. As a result of that, we have a nation and a world increasingly where more than half the calories come from this hyperpalatable, easy to overeat, ultra processed food-like substance. And you have to look at the definition of food. Food is something that supports growth and life. The truth is these don't. So by definition, they are not food. Just look it up in the dictionary. If you can convince me that these things are food, well, good luck because they're

not. And they don't meet any definition of what food should be like. And it essentially is a substance that helps support life and growth and ultra processed foods do neither. In fact, they do the opposite. Now I'm not just making this stuff up. There's an amazing study. Now it's a, it's an observational study, but it's a very well done study, recently published, news just out in the British Medical Journal. They looked at 45 different pooled meta-analysis involving 10 million people. The hook here is that these were studies that were not funded by ultra-processed food companies. You know, we might have heard me talking the other day about artificial sweeteners and how there's a large study that showed artificial sweeteners are not harmful at all.

But when you look at the funders of the study, it was the American Beverage Association, formerly known, my friends, as the American Soda Pop Association. Clearly, we need to look at data that is not corrupt. And when you look at studies that are funded by the food industry, it's 8 to 50 times more likely to show a positive impact for their food product, whether it's dairy or artificial sweeteners or whatever. And when they looked at the data from this large pool of meta-analyses, I looked at people who ate higher amounts of ultra-processed food. There was a 50% increase in the risk of cardiovascular death. It was a 48 to 53% increased risk of anxiety and other mental health disorders like depression. Now think about that. The risk of having heart disease and a heart attack and mental illness are the same from eating ultra processed foods. We get that these foods can cause obesity and diabetes and heart disease, but mental health crisis is also driven by these ultra processed

foods. We did a whole episode on this. I think it's really important to go back and listen to it. We'll link to it in the show notes. There's also a higher risk of type two diabetes and many, many other conditions. They go through many conditions, autoimmune disease, inflammatory disorders. The evidence also showed that there was a link between ultra-processed food and a greater risk of death from any cause and a 40% to 66% higher risk of heart disease-related deaths, obesity, type 2 diabetes, sleep problems, and a 22% increase in depression. We're seeing this mental health crisis, obesity crisis, diabetes crisis, heart disease crisis, autoimmune crisis.

I mean, the list goes on. Chronic disease is the number one driver of our healthcare expenditures. It's the number one driver of death globally. Why is this happening? We never had these problems. You know, I saw something on Instagram the other day. There was a video from 1930s film and there was not one person who was overweight in the entire video of people walking down New York. Big change from then to now. And this has led to the epidemic of chronic disease that's driven by this ultra-processed food. We're going to get into it. We're going to go deep in this topic and we're going to learn about how we begin to determine what is ultra-processed food, what

we should avoid. And hopefully maybe we'll live in a day when food labels are clear. I'm working on that in Washington with my Food Fix campaign on clear labeling and child-friendly labeling. Let's get started with a case example of what an ultra-processed diet can do to our bodies in as little as two weeks. You think, oh, this takes years and years to develop problems. Well, not really, my friends. You see the results very quickly. Now, Tim Spector and a scientist from King's College in London performed a short-term study on a 24-year-old set of healthy twin girls. This is a different twin study than the vegan twin study. Now, one twin was assigned to eat an ultra-processed diet when you included a typical breakfast, a pancake syrup, or a cereal

with a blueberry muffin. Pretty much our average diet. Lunch was a peanut butter and jelly sandwich on white bread with chocolate milk and chips. And dinner was either a cheeseburger and fries or a meatball sub with cheese, crackers, and a diet Coke. The other twin ate a minimally processed whole foods diet. Now, each diet, and this is really important, each diet was controlled for calories. So they ate exactly the same amount of calories. I'm going to say that again. They ate exactly the same amount of calories. They also had the same amount of fat, same amount of sugar, and fiber. But the difference was the processing of the food. Now we're going to get into what this means in a minute. What was striking about the study,

after just two weeks, that the twins eating the ultra-processed diet had higher blood cholesterol and lipids, higher blood sugar. They gained more weight. Now remember, they had the same amount of calories, friends. So it's not all about the calories. It's what the calories do to your biochemistry, to your hormones, to your immune system, to your inflammation, your gut microbiome. It's not just calories in, calories out. It's more complex than that. Also, the study showed, they looked at the microbiome, had a really negative effect on the gut microbiome. Now, we know that if you swap out in animals a healthy microbiome for a microbiome, for example, an obese mouse, that the other mouse eating the same amount of food will gain weight. So we know that it's not all about calories, how they're processed, how they're metabolized, and so forth.

Now, none of these changes, these adverse changes that were in the twin eating the ultra-processed diet were seen in the twin eating the whole food diet. She actually lost weight. So one twin, again, eating the same amount of calories gained weight on ultra-processed food. The other twin lost weight. Just register that for a minute. Now, the results aren't published yet. Hopefully, they will be. Again and again, I see my practice over and over again, how ultra-processed foods wreak havoc on our health and they do it very fast. The good news is you can reverse it very quickly too, right? So eating real health foods can reverse these effects. That's what I did with my 10 day detox diet. And we saw amazing results in thousands of patients. I often talk about this one patient I had in three days was off insulin.

Simply after 10 years of diabetes on insulin, three days of eating this way completely eliminated her need for insulin. Now, how did this happen? How did this become 60% of our diet, 67% of kids' diet? Globally, it's increasing everywhere. Well, the Industrial Revolution spawned a whole bunch of advancements in food processing technologies and the mass production of canned goods and refined grains. And it was seen to be a boon to humanity. And it did help a lot. We got to preserve food. We got to store it longer. We got to be able to feed people who couldn't be fed. We have hunger. So it wasn't all bad. In World War I and II, there was a huge catalyst for ultra-processed food production because there was a huge demand for non-perishable foods shipped to soldiers overseas. And so it needed to be something that was stable,

that could be sent to the battlefield, it wouldn't rot. One of the basic rules of healthy eating is only eat food that rots. I don't know if you saw, it was something I saw once, I don't know if it was a movie or something, but some guy had a forgotten like a Big Mac in his pocket for years and it was fine. It hadn't degraded, it hadn't decomposed, it hadn't gone moldy, it was just fine. Now, you want to eat food that rots. That's a good, that's a good concept. So after World War II, you know, the economic growth and lifestyle changes that happened, women entering the workforce, there was an increased demand for convenience foods, fast food, TV dinners. There was a gathering of all the fast food and processed

food makers in the late 50s, as I recall. This was written about in Salt, Sugar, and Fat by Michael Moss. He was my first podcast guest, actually. And in that meeting, all these companies were like, we have to fight this trend towards eating real food, which there was another sort of group of people promoting that. They decided to make convenience king. And so they created a culture of convenience. They disintermediated people from the kitchen. They invited Betty Crocker to get recipes of junk food in the house. So you apply your Ritz crackers on top of your broccoli casserole or the Velveeta cheese or your can of cream of mushroom soup from Campbell's all in your recipe. So it was a lot of processed food in the recipes. And there was no Brady Cracker. She was a made up person. I thought she was real because my mom had the cookbook. But anyway,

in the 80s and 90s, the food companies began engineering foods even more. And they were engineering foods at an accelerated pace using all sorts of technologies that allowed them to use additives, preservatives, emulsifiers, which were terribly damaging for your gut and microbiome. There's like 600,000 of these products now on the market and starch, sugar, refined grains, and processed oils became ubiquitous in supermarkets, vending machines, fast food outlets, and are basically what we call the SAD or the sad diet, the standard American diet. Now, as I said, it's 60% of diet here, 67% of kids diets. It's more than half the energy in high-income countries, even like Canada,

the UK, Australia. It's nasty. The studies are clear on this. And we're linking to all the studies. Everything I'm saying is evidence-based, is backed by references. You can just go to the show notes, you'll see them all. So studies show that the more ultra-processed foods that make up your diet, the less nutritious their diet quality tends to be overall, and the greater risk they are of developing chronic inflammatory diseases. Heart disease, obesity, diabetes, cancer, high blood pressure, stroke, dementia, autoimmune diseases, depression. I mean, the list goes on and on and according to cdc more than 70 percent of deaths or 1.7 million deaths a year in the u.s are caused by chronic diseases mostly caused by our processed food diet this is a kicker i've mentioned this before but for every 10 of your diet that comes from ultra processed food the risk of death goes up by 14 this is from the global burden disease

study we'll talk about that in a minute you know's enormous. So if you think of 60%, right? So it's six times 14. It's a big number. It increases your risk of death, not just getting a disease. Now, what's really scary is that the government is funding this. They're funding the subsidies that go into the agriculture that produces the commodity crops that are turned into ultra-processed food, benefiting from the incredible food stamp program, which is great, except that 75% of the SNAP benefits are used for ultra-processed food and 10% are used for soda. It's about $10 billion a year. We're working on trying to change this in Washington, and we have a bill now in to prevent ultra-processed food from being purchased with SNAP dollars if you're a kid, because we know these are deadly for kids.

The data is so clear. Hey everyone, it's Dr. Mark. Now, modern foods aren't nearly as nutrient-dense as they used to be, so we all need a little help from supplements if we want to function and feel our best. But supplements can also be tricky. Some use low-quality ingredients that are difficult for the body to absorb, and others add cheap fillers and additives. And that's why I love Symbiotica. Cutting-edge formulas they have, like liposomal glutathione and liposomal vitamin C use liposomal

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I also love they come in convenient packets, so I never have to worry about missing doses or packing big bottles when I'm traveling. Right now, you can try them for 20% off with free shipping on all orders. Just go to Symbiotica.com and use the code Hyman. That's Symbiotica, C-Y-M-B-I-O-T-I-K-A.com and use the code Hyman for 20% off plus free shipping. And now, let's get back to this week's episode of The Doctor's Pharmacy. Now, what's the difference between ultra processed food and just regular processed food? I read an article in a nutrition journal years ago about defending processed food as being something as old as humans. We've been, you know, drying food and preserving food and fermenting food and curing food for a long time. So what's the big deal about processed food? If you look at the funders of it,

if you look at the journal, it's just funded by the food industry. It's so corrupt, my friends. It's so corrupt. I wrote about that, I think, in my book, Food Fix or, you know, one of my other books, but it's a pretty frightening thing. Unless you just pick an apple from a tree and eat it, or just eat a raw egg, most food is processed to some degree. Cooking is a form of processing, right? It's not really that processing is bad. It's what is the processing? So minimally processed foods are fine. We've been doing it for thousands of years. Olive oil is processed food. Yogurt, but hopefully from A2 cows or goat or sheep, right, that are generally raised. Cheese is a processed food.

Canning food, so sardines, canned tomatoes. Fermented foods, sauerkraut, miso. Frozen foods, beef, jerky, dried foods. Basically, those are all processed foods, but they're fine if you can recognize the ingredients, if you know where they are, if you can see the number of steps it took to get from farm to your fork. It's okay if it doesn't have a list of weird franken ingredients, that's okay. It depends on how they're processed. Certain foods may seem like they're minimally processed. There may be some protein powders that are okay or protein bars from whole ingredients, canned beans, frozen vegetables. Those are all fine, but be very wary about what you're eating. Even if it comes from

Whole Foods or Erewhon or some great natural food store that you're shopping at, it can still be fraught with all sorts of problems. And what does the science say about what is an ultra processed food versus what is not? And there are many classification systems. The most reliable and the most common and most well accepted is something called the NOVA classification. It's kind of the most comprehensive version and it has some flaws, but it's still pretty good. So it just gives us a rough idea. There's basically four classification of food with NOVA. The first is minimally processed and unprocessed food. So it's basically peanuts, right? Taking the shell off of a peanut is processed food. Any kind of husking, shelling, drying, crushing, grinding, roasting, boiling, pasteurization, refrigeration, freezing,

these are fine. They often can be placed in containers or packages without having to add sugar, salt, oil, or fat. Things like whole grains, beans, fruit, veggies, nuts, seeds, milk, meat. These are all fine. And I want to say milk. I'm being, you know, you know my stand on dairy. I'm being very specific. It should be A2 casein dairy. It should be regeneratively raised. It should be either goat or sheep, ideally. So you want to make sure you're eating the right dairy. The second classification is NOVA Group raised. It should be either goat or sheep, ideally. So you want to make sure you're eating the right dairy. The second classification is NOVA Group 2. It consists of processed culinary ingredients derived from nature. Oils, fat, sugar, salt.

So it could be pressing olive oil. It could be grinding of flour or milling. It could be seasoning and cooking of foods that are in Group 1. So if you want to put a chicken in the oven and bake it for 20 minutes, that's processing, right? So that's group two. And things like olive oil, butter, flour, salt, vinegar, these are all NOVA class two. And NOVA class three is more processed foods. You're adding things to it.

You're adding salt and oil and sugar to group one and two foods, and they make them more durable, more palatable, more enjoyable, last longer. So it could be canning, smoking, fermenting that extends shelf life. And it may include adding other things like salt, sugar, fat. So you can add salt and, for example, sugar to beef jerky. Well, you may not want to do that. I like the South African biltong. It's just pure dried beef with some spices on it. We've been processing food for as long as we've been human. Cooking is a form of processing. Fermentation is a form of processing, like sauerkraut, yogurt, cheese, canning, jarring vegetables. I used to do that when I was in college. We'd jar vegetables in the winter, fruit, vegetables, pickles, olive, cans of tuna, cans of chicken, salmon, cured meats, cheeses. These are all processed, but often without bad stuff, but sometimes with bad stuff,

right? Added salt. Class one is the best, and two, three, you have to be smart, but you can get away with it. Now, class four is what really is the boogeyman here. This is the ultra-processed food category. And it's a series of industrial formulations of five or more ingredients. It could be less, but it's generally more than five. This is something that's not actually considered food. I don't think they should call it food. They shouldn't call it ultra-processed food. They should call it ultra-processed science projects or food-like substances or non-food edible things or something. I don't know. But all your processed foods are really made from whole foods originally, right?

But then they're broken down, they're mechanically altered, they're chemically separated, and they're changed to, you know, the isolated sugars, fats, oils, proteins, starches, fiber extracts to make food look and taste good and make it resemble food, but it's not food. And they're really derived from commodity crops that are funded by our industrial agricultural system. Corn, wheat, soy, sugarcane, beetroot, they're the derived from commodity crops that are funded by our industrial agricultural system. Corn, wheat, soy, sugar cane, beetroot, they're the basis of these foods. You know, I mean, corn is hundreds of different things that are made from it.

They're all highly processed. And I think 5% of the corn that is grown in America for, quote, human consumption is actually corn of the cob or corn things that we eat. It's mostly turned into junk food. And now they'll add a whole variety of bad stuff. They'll add, if you're a manufacturer, they'll make really bad stuff and they'll reassemble them into food-like substances.

They'll add high fructose corn syrup, different kinds of sugar, maltodextrin, lactose, dextrose, various oils that are often hydrogenated, soy protein isolates. They'll add extra gluten, casein, mechanically separated meats, flavors, emulsifiers, gums, various thickening agents. And it basically makes your product look good, have a good mouthfeel, be hyperpalatable, create a highly profitable

product. There's a cheap product to make with long shelf life, and they mark up something hugely to an enormous price. So the profit margins are huge. I mean, think about it. This is the most significant industry in the country. When you combine food and healthcare, I think it's $10 trillion. That's a lot of money. And a lot of this is just driving a sick and diseased society. Now, there's some limitations to the NOVA, right? It's qualitative in nature. It basically assigns food products to groups. And sometimes it's a little subjective and maybe a little ambiguous and maybe inconsistent, but it's still helpful. For example, minimally processed foods may be high in natural sugars or fats, while some ultra processed or processed foods may be okay, but probably not. Minimally processed foods for sure.

It doesn't really address portion size or eating pattern. When you have mixed meals, the classification isn't really straightforward. So these nuances can lead to real challenges in implementing food policies or regulations due to misinterpretation among consumers, but all processed foods are unhealthy when some may be okay, like whole food protein powders or protein parts from whole ingredients or grass-fed meats or pasture-raised turkey sticks. I like venison sticks. Tofu is a processed food. Dairy alternatives, canned fish, they're obviously processed, but they're whole foods. They're made from real ingredients. Now, machine learning technology may be the future of predicting food processing. And this is interesting, actually. If we use AI to help figure this out. In a 2023 paper, which we'll link to in the show notes, researchers created a machine learning

algorithm that takes nutritional measures into account to predict the degree of food processing and what nova group the food falls into. It's done in a reproducible, scalable fashion. And based on this data, it predicted that 73% of the US food supply is ultra processed. So even more than the 60%. So almost three quarters of what we eat is crap and not food. No wonder we're also sick and overweight. Now, what does this stuff do to us? I mentioned early on some of the things, but in addition to being loaded with sugar, starch, processed carbs, oils, additives, the reason they're often bad is they need to have a long shelf life. What they do is they put it in packages, plastics and different kinds of packaging that often contains BPA, phthalates, PDAS, microplastics, nanoplastics that end up in our food. So stuff not even that

in the food when you originally produced it, even if it's a highly processed food or ultra-processed food, it's actually what it's delivered in, what it's stored in, what it's sold in is plastics and packaging that can leach into the food. Now, this is a big deal. As a result of this food processing, there's other things that happen, right? Toxic compounds can be produced in the very act of this processing. For example, like heterocyclic amines, which are highly carcinogenic, polycyclic aromatic hydrocarbons or PACs, ages or advanced glycation end products, which are changing the chemical structure,

causing glycation, which is where sugars and proteins bind up to various proteins in your body and create a lot of inflammation. It includes trans fats that can be formed, acrylamide, which are really bad, cause many, many health issues. Many, many animal studies and human studies

have shown these compounds to cause disease in humans. Animal studies have shown that food additives have a really bad effect on mental and physical health due to their bad impact on the gut microbiomes. That can lead to inflammation. It can lead to DNA damage. This is just kind of a mess. And often when the research is done on various ingredients, they only look at one. For example, look at one element of the processed food diet, but they won't look at this whole cocktail of additives in these foods and their combinational effect on our health. And that's a problem because these are not just one ingredient that we get. Like we get all sorts of these things and our body doesn't know what to do with them. We eat about three to five pounds of additives a year

per person. And that's not including all the ultra processing of the food, of the raw materials. So it's just the additives. We eat three to five pounds of these compounds from emulsifiers, colors, additives, archivals, sweeteners. Many of these things that are in our food supply in America are banned in Europe. Things like titanium dioxide classified as a 2B carcinogen, according to the committee in Europe that determines what's carcinogenic. Azodicarbonamide, it's a bleaching and defoaming agent and it's a potential carcinogen common in yoga mat ingredients and was in Subway sandwich brand, for example. What is the impact on ultra-processed foods on a risk of chronic disease? Studies really clearly link the NOVA

class four foods to an increased risk of bad cholesterol profiles in kids, to an increased risk of poor cardiometabolic health, leading obesity, type 2 diabetes, cardiovascular disease, and what we call all-cause mentality in adults, which means death from any cause. Just to recap that new British Medical Journal study, which I think is an important study, it's sort of a landmark study. Again, it's observational data, but it's mass amounts of people looking at significant trends, and I don't think we can ignore this. And when they looked at ultra-processed food, they found a 50% increased risk of heart disease

related death, 50 plus percent increased risk of anxiety and mental health diseases, depression, 12% higher risk of diabetes, 21% higher risk of death from any cause up to a 66% increased risk of death from heart attacks and obesity, type two diabetes, sleep issues, and a 22% increased risk of depression. Now that's a lot and it's a lot of suffering, a lot of cost, a lot of death, and it's totally preventable. I'm just going to say it really clearly, unambiguously. Ultra processed food is the number one cause of death in the world today, period. This is not my opinion. This is from the Global Burden of Disease Study of 195 countries. The data is very clear. Too much of that crap and not enough real food. Now, what's

really interesting is how these ultra-processed foods affect the brain. When we look at ultra- processed food intake, there's a 44% increased risk of dementia. One or more servings of fried food daily result in a 12% higher risk of anxiety, a 7% higher risk of depression. That's pretty high. Mechanism, how would that happen? Well, we don't know exactly, but chrylamide exposure, which is common in processed and fried foods, increases free radicals, damages our cell membranes, cause oxidative stress, cause inflammation, and any of these mental issues are related to inflammation in the brain. So what are the larger consequences of this for society, for our economy? What is this doing to us as humanity, basically? Well, there's 11 million people that

die of bad diet. Again, this is from the Global Virulent Disease Study. I really think this is an underestimate. It's really an underestimate. Probably 75% of deaths worldwide from chronic disease. So I think it's over like 70 million deaths, 40 million are from chronic disease. And so we're talking about probably somewhere between 11 and 40 million deaths a year, because if most of the chronic diseases are linked to diet and the dietary factor that's And so we're talking about probably somewhere between 11 and 40 million deaths a year because if most of the chronic diseases are linked to diet and the dietary factor that's driving it primarily is ultra processed food, then it's got to be a little bit north of 11 million. But still, even 11 million makes it the number one killer in the world.

And more than 2 billion people in the world are overweight globally and they're sick from eating our ultra processed industrialized diet. And the study I mentioned that was the Global Burden of Disease Study was published in the world are overweight globally and they're sick from eating our ultra-processed industrialized diet. And the study I mentioned that was a global burden of disease study was published in the Lancet. It looked at dietary risk factors in 195 countries. It was the most comprehensive study on diet ever done, over 27 years of data. And there were limitations, of course. So what they found was this, a diet without enough healthy foods, fruits, vegetables, nuts, seeds, whole grains, you know, healthy protein, et cetera, good fats. And with too many bad foods, ultra-processed foods, refined grains, sugar, sweetened beverages, trans fats, accounted for 11 million deaths and get this, 255 million years

of disability and life years lost, making it the number one cause of death globally, surpassing smoking. Now, so it's not just that it causes death. It causes massive amounts of disability, costs society, productivity. It's bad news. In 2018, the Milken Institute issued two major reports. One of them was called The Cost of Chronic Diseases in the United States. And the second, America's Obesity Crisis, the Health and Economic Costs of Excess Weight. And we're going to put links to those in the show notes. Now they map out the staggering impact that food driven obesity and disease caused by our current food system is having in the United States. And here's what they found in these reports. First, 60% of Americans have one chronic disease. 40% have two or more. In 10 years, 83 million Americans will have three or more chronic diseases. They're all connected, right?

High blood pressure, cholesterol issues, diabetes, heart disease, stroke, you name it. These are all chronic diseases. 70 plus percent of Americans or about 220 million Americans are either overweight or obese. The direct healthcare costs for chronic health conditions was $1.1 trillion in 2016 or 5.8% of our US GDP. The indirect costs, including just lost income, reduced productivity, and impact on caregivers, not actually all the costs, and this didn't include the impact of the food system on the environment, the climate, all the other secondary damage we're doing from our environment, was another $2.6 trillion. The combined direct and indirect costs are $3.7

trillion, or about $1 in $5 in our US economy. That's just from obesity. It's just staggering to me, right? One of the other important things to note is that these costs don't include, and this is important, don't include pre-diabetes, which now affects one in two Americans and also drives healthier costs. And it doesn't include the 93% of Americans who are metabolically unhealthy who are also driving costs and lower productivity and so forth. And most of the diseases that are driving these costs are related productivity and so forth. And most of the diseases that are driving these costs are related to our poor diet. And that drives obesity, inflammation, and all the downstream diseases, hypertension, cholesterol issues, arthritis, type 2 diabetes, high blood pressure, cancer, Alzheimer's, dementia, and kidney failure. So

this is a big deal. The other thing we're seeing, and this is kind of staggering, is the declining life expectancy. And more than 60 countries and economies now exceed the United States in life expectancy. 60 countries. So we're like bottom of the pile, 60 countries, and how long we live, despite spending double everybody else on healthcare and having a robust economy, and what the hell, right? We spend two to four times more on healthcare than other high-income countries. And why is this happening? Well, we can see this in America. It's so clear. When you look at the maps of obesity, diabetes, and the geographical distribution and the rates of life expectancy, it just maps over clearly 100%. So in the South, in America, mostly in the South, there's a declining life expectancy and it has the highest rates of obesity

and type 2 diabetes. So it's really clear. The pattern is really clear. And it's really caused by the increased rates of processed food consumption in some of these areas. The other big thing is we need to make sure we can defend our country. And one of the scary things is that we're seeing a decline in military readiness because recruits are being rejected for poor health. 70% are rejected. And we'll get into this. So the CDC reports that the Department of Defense spends about $1.5 billion annually. This is staggering. This is the Department of Defense. Spends $1.5 billion annually in obesity-related healthcare costs for both current and former service personnel and their families, as well as a cost to replace

unfit personnel. Now get this, lost work days due to being overweight and obese for active duty military personnel is 658,000 days per year, costing the Department of Defense $103 million a year. This is a really both human issue, a societal issue, an economic issue, a military issue. One in three adults is too heavy to serve in the military and 70% are rejected for service because they're unfit to fight. Almost 20% of active duty service vendors were obese, not just overweight, 20%. So one in five people in the military were obese in 2020, which increased by 3% from 2015. What else is problematic because of our ultra-processed diet? The COVID pandemic revealed our vulnerabilities. America had the worst outcomes, almost of any country. It's 4% of the world's population, but accounted for 16% of the COVID cases and deaths.

And again, all of this is referenced. You can look it up. I'm not making this stuff up. There were 7 million COVID deaths to date, and the US accounted for 1.2 million of those and 6.5 million hospitalizations for severe COVID. We literally crippled our country, accumulated mass amounts of debt, which we didn't have to do if we were a healthy nation. It's scary. When you look at the effect of chronic disease on our immune system, it's very clear. The strongest risk factor for having bad outcomes with COVID was having one or more chronic diseases. People who had one to two had a 70% increased risk of death. And if you had three or more disease, like high blood pressure,

high cholesterol, high blood sugar, you had 130% increased risk of death from COVID. All right, bad news. Let's get into the good news. First, how do you defend yourself? How do you tell if a food is ultra processed or not? Well, I always use this saying, it's pretty kind of goofy, but I use it in faith-based wellness programs that I teach. Ask yourself a simple question. Did God make this or did man make this? Did God make an avocado? Yes. Did God make a Twinkie? No. If God made it, eat it. If man made it, leave it, right? Not always so simple, right? Because man does make, for example, cheese and man makes yogurt and other things, but those are mentally processed. What's confusing everybody? Guidelines have changed over the last 30 years and we don't

really know what to eat anymore. We're so confused, but we do know this. We do know that ultra processed foods are bad. What makes a food ultra processed has made people confused because big food is trying to confuse us, right? They're trying to use their slick marketing tactics and food labeling and all these halos of health claims on labels to make things seem great. But don't be confused by that. Food companies are not required to state on the food label if it's ultra-processed or not. It's not clear if a food is ultra-processed when you pick up the package, right? It doesn't say ultra-processed. I mean, imagine a food label that was just clear, like they have in Europe.

Red is bad for you. Yellow, eat with caution. Green is good for you. Or maybe they have, like in South America, these big black box warning labels with a stop sign shape that says what you should and shouldn't eat or what's in it that you should be wary of. Labels in America have a lot to be desired. We're going to get there. We're going to fix those. But it's still important to understand what you're doing by educating yourself. Some versions of foods might be processed and some might be ultra-processed. So you have to read ingredient labels. For example, fresh baked sourdough bread from regeneratively raised wheat, which has no pesticides or glyphosate and is minimally processed in the grinding and is coarsely ground. They're very different than Wonder Bread. They're

both bread, right? Wonder Bread is full of vegetable oils and calcium propionate and monodiglycerides and high fructose corn syrup, whereas the sourdough bread might be made from ancient non-hybridized heirloom grains, which is non-GMO whole wheat, flour, water, sourdough starter might be 100 years old, and salt, right? Simple. How about oats, right? Quaker instant oatmeal versus regeneratively raised steel-cut oats or whole oat groats, right? Quaker oats is going to be filled with sugar, salt, various kinds of flavorings, highly processed, and the whole oats or the seal cut oats maybe have one ingredient, right? Oats. And then you have to cook them for a long time. It takes like an hour. So it's supposed

to instant oats, which basically just are full of junk and are very bad for you and you should not start your day that way. Now, how do you identify if a food is ultra processed? What's the most practical way? Well, does the food look whole, right? Did God make it? Did man make it, right? That whole thing. An apple, an egg, an almond, a sweet potato, a piece of chicken, fish. You recognize it. Does the food come in a box or a bag or a package?

Could be okay, but not necessarily, right? Check the ingredient list. How many ingredients are there on there? Are there five more ingredients? Is the list a paragraph or longer? Do you recognize what's on there? Could you pronounce them all? Would you easily find the ingredients sold separately in the grocery store to put on your food? Like do you have

butylated hydroxy toluene or maltodextrin in your spice cabinet, right? No, you don't. Don't eat that stuff, right? Are there long chemical names? Are there preservatives, flavor enhancers, artificial flavors, sweeteners, dyes. Don't eat it. Natural or artificial flavors sounds maybe good if it's a natural flavor, but not necessarily good, right? Monosodium glutamate, caramel color, red 40, corn syrup solids, soy lecithin, aspartame. Just stay away from all that stuff. It's not that hard, right? If you really don't know what it is, don't eat it. Can you tell what the food is by simply reading the ingredient list, right? If you cover over the front of the package and you look at the ingredient list and you can't tell if it's a pop tart or a corn dog, don't eat it. If you turn up label and you say it says tomatoes, water, and

salt, you know it's a can of tomatoes. Or you say sardines, olive oil, salt, you know it's a can of sardines, right? You know what that is. Now to add to the confusion, food labeling is not tightly regulated. So food packaging often features a variety of claims designed to attract consumers by highlighting specific qualities or the health benefits, right? It's natural. It doesn't guarantee that it's minimally processed or it doesn't contain artificial flavors, colors, preservatives. Made with real fruit, lightly sweetened, even quote healthy, all this stuff, stay stuff stay away from products are gluten-free organic healthy vegan paleo plant-based low fat low sodium keto doesn't mean it's healthy right

you got to be smart it can still have a whole laundry list of ingredients it can be still ultra processed and there's a lot of ultra processed vegan foods fake meats impossible burger beyond me these are science projects these are not whole foods right there they have the halo of being plant-based or vegan or good for you. They're made from pulverized soy, deconstructed chemical products from industrial food production. They're not whole foods. They're not health foods. So fake meats, fake eggs, plant-based cheeses can sound okay, but you have to be really careful. And these have been associated with the same risk for cardiometabolic diseases. So the basic rule, if it has a health claim on the label, it's probably bad for you. Michael Pollan, in his beautiful book, I encourage you to read it.

It's called In Defense of Food and Eater's Manifesto. He talks about this whole idea of nutritionism. It's a way people approach food and eating in the modern world. And basically, it reduces nutrition down to individual ingredients. Saturated fat is bad, salt is bad, sugar is bad, whatever. It it's just reducing it and what happens is this looks at the individual ingredients focus on scientific analysis it breaks it down to constituent parts so like vitamins fat protein and it doesn't look at the whole ingredient complex of the food it doesn't look at the food as a whole food and so what this does why this is bad is that allows food companies to dial up and down ingredients. So one day,

sugar is bad, so we increase fat. Or one day, fat is bad, like we had the low-fat air, we had snack bowl cookies. Well, they're not good for you, right? They're sort of low-fat cookies. Our low-fat yogurt, that's terrible for you, especially since it has a lot of sugar in it. It allows us, the food companies, to dial up and down ingredients, which kind of they can do all day long and process things in different ways, but it's still junk food. It's still ultra processed food. So that's why I love a classification system that focuses on ultra processed food as the boogeyman. It is the new cigarette. How do you avoid these? Well, I encourage you to shop at a place like Thrive Market where you can get whole, unprocessed foods. There may be packaged foods there, but they're

for minimally processed ingredients. Make whole foods the bulk of your diet. Just buy food. Go around the outside of the grocery aisle. No meat, fish, chicken, veggies, nuts, seeds, fruit, some whole grains, beans. All that's fine. Salt, olive oil, spices, all that's great. But avoid as much as you can, things that have ingredients you don't recognize, can't pronounce, or in Latin, or science projects. Avoid foods that come in a colorful packaging with long list of ingredients. Just stay away from that. There's a lot of different food scoring systems that may be coming around in the future. We have the UK, Australia, New Zealand using something called Nutri-Score, which looks at seven to nine ingredients, salt, sugar, some vitamins,

protein, puts them together, give a score on the front of package. So you got A, B, C, D, or E. That should be an F too, I think. Now it helps consumers make choices easier, look at the ingredient list, a number or a letter that grades the food. We're working on a grading system for child-friendly labeling in the United States called Make the Grade, which will force manufacturers to actually reformulate their foods, hopefully, and allow people to have an understanding of what they're eating and have some choice. And it'll hopefully get the industry moving in the right direction. In Latin American countries, avoiding ultra processed food is the golden rule of all the guidelines that they have, all the national dietary guidelines. So if the product gets too many calories, too much salt,

too much sugar, the wrong kinds of fat, it gets a black box warning label. It essentially looks like a stop sign. I was in Chile and Argentina. I saw it. I was like, and everything, every package of junk food had all this. They're like, oh, I don't eat that. Problem is it's not perfect because it scores poorly on high fat foods that are healthy, like nuts and seeds and extra virgin olive oil. It says too much fat, but fat isn't necessarily bad. So you have to have the right framework for developing these. And there's some tweaking that needs to be done, but it was a good first step. The problems also are that people don't have access to food. There are food deserts, food swamps, food insecurity is real. Nutrition security is also a big factor, which is lack of being able to get the right nutrition. And so

we have to make whole foods accessible, affordable, and we're working on a lot of that within our policy efforts in DC. There's also another labeling or classification system called the food compass. I did a podcast with Dr. Daria Mazzafarian from Tufts about this. A lot of controversy about this, got a lot of blowback, but it uses an algorithmic model that looks at 54 attributes of food, a little more sophisticated than the NOVA classification, looks at ratios of vitamins and minerals. It looks at carbohydrates, fiber, saturated fat, unsaturated fat, omega-3s, trans fats, additives, refined starch, level of processing, fat, fiber, protein, phytochemicals. And it basically ranks the food from one to 100,

one being the worst and 100 being the best. So foods that are less than 30 should be avoided. Foods that are 30 to 60, eat moderately. And over 70, get thumbs up. The goal of this classification system was to try to get classification system that didn't allow food industry to manipulate the foods to be healthier by turning up and down different ingredients. And that was a good effort, but there were a lot of drawbacks to it, right? Whole grains may be scoring too high, right? Whole grain Cheerios might sound good, but it's, again, highly processed. Animal foods might be scoring low, which may not account for the glycemic impact or load of the food. Now, one of the big flaws, the big flaws on this, which is hard because there isn't a large

classification database that can be used to analyze foods, was probably the most important criteria of a food. And it was not included in the system. And it's called the glycemic load or index of a food, which is how much a food raises your blood sugar. This is the single biggest driver of insulin resistance. It's the single biggest driver of chronic disease. And so missing this is not good. And it wasn't the fault of the scientists. It's just that there's no large database available of the glycemic load of foods. And so it's hard to do this. I think we need to kind of, in our minds, think about that as well. Like I kind of superimpose a glycemic framework. Is this thing going to raise my blood sugar? Now you can use, for example, glucose monitors. You can track your blood sugar. There's a lot of really cool ways to

do it. And that's probably a better way to do it. So we're going in the right direction. We need a clear classification system. We need clear food labeling. You need to watch out because this is the biggest killer out there. If you get rid of these foods from your life and your diet, you're going to be so much healthier. And I think the work we're doing at Congress with Food Fix and Food Fix Campaign, you can learn more at foodfix.org. It's trying to push policies in the right direction, allow child-friendly food labeling, deal with dietary guidelines, and hopefully the new dietary guidelines are going to call out ultra-processed food as an issue. There's a lot of work we're

doing. We're trying to create a campaign in Washington to help senators and congressmen and the white house understand the dangers of ultra-processed food, how it is the new smoking, how it is driving our federal deficit. It's the biggest driver of our economic burden in terms of the burden on driving federal debt, GDP ratio. So it's a big issue. We have a long way to go, but I think we're starting to get in the right direction. I think this whole concept of ultra processed food is in the zeitgeist now. People are beginning to talk about it, to understand that there's just tremendous amounts of research building up around this. And it's so, so critical. So I really encourage everybody to avoid these foods, to learn about it and to insulate yourself from them and to advocate for food companies to do the right thing and start to make healthier foods for all of us. So I hope you've enjoyed

this version of the doctor's pharmacy health bites. It's a lot of information, but I want to provide deep dives into really important topics that help you uplevel your health, understand what's out there in the marketplace so you can protect yourself, and also give you guidelines on how to live a long, healthy life. So thank you for joining, and I hope you love this Health Byte today, and we'll see you next time on The Doctor's Pharmacy. Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health, and subscribe wherever you get your podcasts. And follow me on all social media channels at DrMarkHyman. And we'll see you next time on The Doctor's Pharmacy. I'm always getting questions about my favorite books,

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