The Netmums Podcast - S13 Ep2: Dr Chris Tulleken: Unwrapping the Impact of Ultra-Processed Foods on Children's Health

Episode Date: April 23, 2024

Wendy and Alison are joined by Dr. Chris Van Tulleken, infectious diseases doctor and familiar face from CBBC's Operation Ouch. Chris discusses his latest book, "Ultra Processed People," which dives into the world of ultra-processed foods and their profound impact on our health, especially that of our children. Chris unpacks the definition of ultra-processed foods, their addictive qualities, and the perils of a diet dominated by these products. He addresses the elephant in the room: the role of big food companies in perpetuating the consumption of these foods and the urgent need for government regulation. This conversation doesn't shy away from the tough questions. From the link between ultra-processed foods and ADHD to the childhood obesity crisis, Chris provides a nuanced perspective on health beyond the scales. He calls for action, not just from the top down but also from each one of us, as parents navigating the daily challenges of feeding our families. Follow Dr Chris on Instagram @doctorchrisvt and buy his book "Ultra Processed People" here Stay connected with Netmums for more parenting tips, community support, engaging content: Website: netmums.com / Instagram: @netmums 

You're listening to The Netmums Podcast with me, Wendy Gollich. And me, Alison Perry. Coming up on this week's show... I mean, Wendy, I'll be coming to you in six years and going, what do I do with my 12 years? Don't ask me. No one has cracked this code, right? No. Welcome back, everyone. Wendy, how are you doing?

What has your week been like? It's a funny old podcast for me today, folks. I'm coming to you from Park Eagles, which is a detox retreat in Austria, which means not only am I likely to need a comfort break mid-podcast, because I'm drinking three litres of water a day and taking Epsom salts but I'm hungry I'm really hungry and we're chatting to a guest about food so I can't lie this is going to be a little bit tricky um I might just sit here eating just you know no just to really torture you I had two crackers and 30 grams of goat's cheese for dinner that's not dinner and

two crackers for breakfast that's right i'm sorry that's i'm not okay with this i think someone needs to stage an intervention and get you out of there wendy um but let me my gut is loving me my gut is loving me everything else hates me let me introduce our guest because i think he will have something to say about what you're doing our guest guest today is Chris Van Tulleken. As well as being a dad of three, Chris is an infectious diseases doctor at the Hospital for Tropical Diseases in London. But your kids probably know him best as the presenter of CBBC's brilliant Operation Out with his twin brother, Dr. Zand. Today, we want to talk to him about his latest book, Ultra Processed People,

which is all about ultra processed foods and the impact that they have on us and our children. Chris, welcome to the Netmums podcast. It's such a pleasure to be here. What an amazing start. I kind of want to spend the hour talking about Austrian detox regimes. Let's do it.

It's a special extended episode. He's certainly not eating any ultra processed food, so that's got to be good. I very much am not eating. I am having broth. There's a lot of broth. Broth is good, I guess. Broth and Epsom salts.

Epsom salts and magnesium sulfate. I worry about some of this. Don't go into it. I'm trying to remember my magnesium toxicity. I think, yeah, just don't overcook it on the Epsom salts. Well, this is by a chap called FX Mayor who started the Mayor Cure about 200 years ago. So I think he might have – it might be okay.

I don't think I'm going to do it. It was solid data 200 years ago so I think he might have it might be okay I don't think I'm gonna die it was solid data 200 years ago so yeah exactly nothing will change since then it's wonderful it's all going to be wonderful all right we'll stay near a defibrillator says the doctor before we start asking you proper questions I hadn't realized until today that you worked at the London Hospital for Tropical Diseases. I spent a large amount of time there when I caught something that nobody ever identified in Madagascar once.

They were very nice to me. This is the Wendy Bowell podcast, isn't it, really? No, this wasn't Bowell's. It wasn't Bowell. This is a personal consultation. Wendy just booked you, Chris, for a personal consultation and everyone else is listening. Ultra processed foods, Chris. What are they in a nutshell, please? Well, it's a very long, formal definition, but it boils down to this.

If you're eating something in a package with an ingredient that you don't recognise, you don't find in a normal kitchen, then it's probably an ultra-processed food. The definition was invented to just test a pretty straightforward hypothesis that the thing that was driving, it was invented in Brazil, and they'd seen in Brazil the sudden explosion of diet-related disease, especially obesity. In the space of about a decade, obesity went from being basically unheard of to being the dominant public health problem. And a group of scientists there theorized that perhaps it was this influx of American products wrapped in plastic, full of funky ingredients, very high in sugar and salt and saturated fat that were displacing traditional foods that were driving this epidemic. And so the definition is really just a way of describing what we might call the Western diet or American food.

It's packaged stuff made by food companies that are owned by pension funds. So you can ask yourself, is there a funky ingredient? You could also ask yourself, is this food made by a very, very big company that's owned by an even bigger institutional investor? And if the answer to that question is yes, what we know is those big investors really mainly care about the money that's returned to them. They don't care that much about their health. And my research is now all with economists, and we can show this using their own data. Now, playing devil's advocate, some ultra-processed foods taste really good. And I'm a busy mum who's just trying to keep my shiz together, juggling work and kids.

What's the harm in serving up fish fingers, baked beans and potato waffles to my kids for dinner? Tell us, what is the real negative impact of these ultra-processed foods? Well, I wouldn't frame it really in terms of negative impact of eating some baked beans or fish fingers, partly because my kids eat baked beans and fish fingers both at their nursery, their school, and probably I serve it to them once a week. Even if you don't believe the evidence on ultra-processing, if we look at the UK, just to be, I'm going to be nerdy here. Let's look at the UK dietary guidance on sugar, saturated fat, and salt. Because the traditional way of thinking about food is there are three things in food that harm you, sugar, salt, and saturated fat, and energy density, calories, if food's a very calorific program. And there's a thing that's

good for you called fiber, and then there's fruit and veg. And so if we just look at our UK dietary guidance, and we apply it to a tin of baked beans or some fish fingers, what we find is that both of them are very high in sugar or salt or fat. So in the case of the baked beans, they're high in sugar and high in salt, much higher than we'd recommend. And so we don't even need to worry about whether the beans are ultra processed in order to go. They're not healthy foods. Now, it's striking to me that the healthiest part, the goto healthy meal for all of us and i say this myself um of a sort of standard uk diet our source of fiber and fish the the question of like is is it harmful well yeah if you if these these are the healthiest things in our diet so the british nutrition

foundation for example which is funded majority by companies that make ultra processed food will say you know some ultra processed foods are healthy, baked beans have fiber, whole grain bread has fiber, fish fingers have fish. And they're not entirely wrong, those foods do have some beneficial attributes. But the problem is they are the healthiest things in our diet, and we know they do us harm. So that's the risk. And each of those ingredients, salt, saturated fat and sugar, do us particular harms. When we add on the ultra processing aspect, though, the thing to remember about when companies make a tin of beans, for example, or a fish finger or a breakfast cereal, they are engineering that product so that you eat as much of it as possible. So I interviewed dozens of

people in the food industry. I interviewed CEOs, food lab scientists, the people who sell the products into the supermarkets. I mean, you know, many, many, many people, every single one of them said the same thing, that all of the food companies, every single person in every food company is incentivized by selling as much food as often as they possibly can. And so your dinner, if you make baked beans at home, which you can do, you can go and buy tomatoes and haricot beans and you can do it. It's very easy. What you'll find is you eat a sensible portion of them. When a big food company make them, they have iterated that tin of beans through decades of product development and they

have perfected the flavorings, the salt sugar ratios, the cooking time, the type of tomatoes they use, all of it to make it so that those beans are irresistible. And that's why we love feeding this stuff to our kids, because the kids just they eat it willingly. And so part of the issue is the foods have harmful nutrients. But on top of that, the foods have been engineered so you eat them to excess, so you get an even bigger dose of salt and sugar. So if you make salty, sugary beans at home, your kids will eat them. But none of us are good enough chefs.

It's not that we're not good enough chefs. Even if you're a brilliant cook, you're not making baked beans at home or homemade pizza or homemade bread you're not making it to drive your child to eat the entire loaf and buy another one quickly you're making it with love so that the purpose of ultra processed food is part of the definition it's an incredible incredibly sophisticated definition that has this sort of bit of social theory in it that says it's the purpose of the food that's important and the purpose of this food is to make money for transnational food corporations. So hit us with the reality then. According to data, what impact does eating this kind of food have on us as human beings?

So the evidence, let's remember, is around the whole category of food. So you can point at a fish finger and go, well, it's high in salt, or you can point at beans and go they're high in sugar. But when it comes to saying, how does ultra-precious food harm us? We're not talking so much about an individual product. There's definitely a spectrum. So we could say, you know, the most, the very harmful end are the fizzy drinks, which have no nutrients that are good for you, and they're just full of sugar. We could look at the ready meals that are high in fat, salt, and sugar. The evidence around a diet high in ultra-processed foods, so the UK diet on average is 60%. Many of the community listening to this, many of you will be eating 80% of your

calories from UPF. And that is not because you're ignorant. It's not because you want to do that. It's because this is the only affordable, available food for many, many, many people. So first, I want to surround what I'm about to say by going, I speak without wanting to shame or stigmatize everyone. We'll get to this, I'm sure. But my ambition is to change the food environment. Because especially with kids, none of us control what our kids eat, whether we're wandering around the shop with them, whether we're walking down the street with them, or whether they're at school, we just don't have control. So a diet high in ultra processed food, like the UK diet that we all eat, has been linked to lots and lots of what we sort of euphemistically call negative health outcomes. So some of these include things like early death, so a very negative health outcome,

but they've been linked to cancers, anxiety, depression, cardiovascular disease, so heart attacks, cerebrovascular disease, strokes, dementia, inflammatory bowel disease like Crohn's disease, metabolic disease like type 2 diabetes, weight gain and obesity, irritable bowel syndrome, cancers, particularly gastrointestinal cancers, and early death from all causes. So it's the same. Chewy stuff. Well, it's the same kind of list that we find cigarettes are linked to. And that's not very surprising. If we start to disentangle what the foods are made of, the fact that they're high in salt damages the linings of our blood vessels,

puts our blood pressure up. The sugar causes metabolic disease and weight gain. The saturated fat also damages our metabolism and our hearts and our brains. And then the foods full of additives that generally inflame us and then they make us gain weight. Well, it's not surprising they damage every single body system. And particularly with kids, we're building our children's bodies out of molecules that have, in some cases, never occurred in nature and certainly never been mixed together in ways until a few decades ago. They're mixed together in formulations that don't

occur in nature. So it's not surprising they are incredibly damaging. We are what we eat, literally. And people forget food isn't just fuel. It's the things we build our bodies from. And with children, adults, to some extent, the damage is done. You know, we can unpick a lot of this, but we're not building our bodies at the same rate. Children eat far more calories per gram of their own body weight because they're constructing themselves. And so if we put in unusual fats, strange sugars, if we disrupt their microbiome, if we have all the migratory plastic molecules from the packaging it's not surprising that children end up very sick so you've said that it's less about willpower and it's more about the big companies making a profit but you've also said that we shouldn't really be painting all of the

food industry as the bad guys because it's there's challenges in moving away from UPFs as well. So I guess I want to ask, this is all quite depressing and terrifying as a mum who does feed her children these things. Where do we go? What do we do from here? Where do we start, I guess? So I'm trying, you're absolutely right. I try and hold two ideas quite lightly in my hands. So the depressing thing is, we are living in a terrible, terrible crisis. Okay, we cannot shy away from this. 25% of children in this country leave primary school living with diet related disease, obesity, okay? Not overweight, obesity. It was 5% in 1990. So, it is an appalling crisis that successive governments have sort of supervised. Not

only are our children some of the heaviest in the world, they're also some of the shortest in the world. So, compared to their counterparts in Northern and Eastern Europe, they're about that much shorter at the age of five. That much shorter. So you put a class of year two British kids against a class of year two Bulgarian kids or Norwegian kids, you will be able to spot that the British kids will look two years younger, or the Bulgarian kids will look two years older. So there is a crisis that needs action. A note on willpower. It's not just that it doesn't have much to do with willpower, it has zero to do with willpower. So willpower, the arguments about

willpower are scientifically, morally, socially, politically, and economically redundant. They are dead, they are buried. None of this has anything to do with willpower. We eat the food that is in front of us and our choice is severely constrained by the structure of our economy, by the cost of living crisis, by the food that's simply in our shops, and by the fact the food is addictive and it's aggressively marketed to us and our children and institutions feed our kids foods that we don't choose. So willpower, when it comes to kids, when it comes to grownups, has zero, zero, zero to do with it. The food companies are, just a note on that, are they evil? They're neither evil nor good. They have very sophisticated press teams that paint them as our friends and allies, and they're not. They're faceless, giant corporations. They have no interest in our health, And they are constrained.

So the reason you have to understand the constraints, the food industry cannot change, is because it's an argument for government regulation. If it's not individual willpower, and the companies themselves have to keep selling rubbish because of their obligations, then we know that the government needs to intervene. And so that's kind of the focus of my efforts. You talk about pessimism. We've got loads of cause for optimism. We know that when people have resources and education, that they really, really want to feed their children, right? We have evidence from Chile that when we label food properly with big black warning labels on the worst products, children ask their parents

not to buy it. Probably as people have, I mean, you're both a bit younger than me, but roughly our generation will remember, I bet you are, but do you remember telling your parents to stop smoking? I can remember saying to my dad, you know, dad, this isn't good for you. It did work. My dad actually, actually, it did work. And we have some evidence that kids do stop their parents smoking. So kids are not, you know, my six year old wants to be smart and tall, and healthy and, and do well in life that most kids do. And so children also given autonomy will make make good decisions. And the main thing is, we did it with tobacco, right? The three of us are not on this call smoking cigarettes. Yeah,

if I look out my window, none of the people walking past are smoking a cigarette. I can't go to my pub and smoke a cigarette. I can't buy cigarettes. Children can't buy cigarettes. There are no cigarette ads on. There won't be a cigarette ad break in the middle of this podcast. If we'd been doing this 20 years ago, there would have been. Maybe 30 years ago. So we did it with cigarettes. And I think part of the reason the book seems to be resonating with people is because people feel gaslit by their food. They find their children are not feeling well. Their children are incredibly picky eaters. We see massive rates of eating disorders, including binge eating. And we see lots of diet-related disease in kids. And people are going, well, I'm doing my best here. I'm

trying to cook healthy food, but the kids won't eat it because they're fed all this stuff in other places. So we know there is will from from the population we know a majority of people support food industry regulation and we know it won't tank the economy you know we know it's fine you can regulate these companies so the world's biggest cigarette companies they're doing fine we brought in all this regulation they're okay the share prices haven't tanked mainly because they're flogging us all vapes but you know that's that's another episode. Let's not go there.

With the whole food industry regulation thing, I find it really interesting because, you know, you mentioned the changes made to the tobacco industry regulation. How do we regulate the food industry in a helpful way? Because we've already seen calories being listed on menus, which a lot of people have said they find that really unhelpful and triggering. Yeah, because it loads the responsibility onto you. Yes.

It's back to willpower, right? But more than that, when we write on a package, a loaf of bread per 100 grams, it's got 520 calories. For a start, you've got to get out your calculator, you've got to know the weight of a slice of bread, you've got to know the calories that you spread onto that bread, you've got to then regulate how much you eat, you've got to do a whole bunch of maths. And then you have to know the maths for the calories that you consume for the rest of the day in order to know how your slices of bread fit into that overall picture. And you have to know your calorific demand for the day. So it's stigmatizing,

it's complicated, and it is impossible to use, especially if you think of trying to work out, you know, I've got these three kids, I've got a baby and a three-year-old and a six-year-old. I don't know the calorific requirements for a three-year-old. And I actually have looked them up, let alone go on, the three-year-old gets this size and have looked them up, let alone go on the three-year-old gets this size and then they're fed all this stuff at school. So it doesn't work. We do know what does work. The place to start, and we're very, very clear on this, is warning labels. Now, it sounds like a bit of an odd place to start, but we have very good evidence that when you put warning labels on food for fat, salt, sugar, and calories, and you put it on packaged food, so you apply it to ultra-processed

food, but also processed food, because we have a set of foods in this country that aren't technically ultra-processed. So things like ready meal lasagnas are not technically, many of them are not ultra-processed. They've got no ingredients that are funky technically, many of them are not ultra processed. They've got no ingredients that are funky. You would have them all in a normal kitchen. And yet they're incredibly high in salt, incredibly high in sugar, incredibly high in calories, and they are engineered carefully so that you eat loads of them. So I would call that what we say clean label ultra processed food. It needs a warning label. So if you start with black octagonal warning labels, we know that the worst products then get four octagons, but the okay products might just get

one octagon. But we know that people then start shifting away from octagon food, the octagon stop sign. They start going, you know, I just don't want to eat food with an octagon. But most importantly, all your other regulations come under the octagons. So if a food has an octagon on it, obviously it can't also have a cartoon character on it. Obviously, you can't also market it to children. Obviously, you can't also make a health claim. So at the moment, if we look at our favorite breakfast cereal, at the moment it has two green traffic lights and two orange traffic lights. So it's basically a healthy food in terms of salt, fat, sugar.

Now, the traffic lights don't use our national nutritional dietary guidance for fat, salt and sugar. It's so bizarre. The recommended serving size. Oh, it's tiny, isn't it? It's 30 grams. I have weighed out a bowl of it. It's one giant spoonful for me. It's basically nothing. I can eat five or six servings. My six year old can eat multiple servings. So as a result, I don't think it's an HFSS product defined by our TV regulator. So it's got a cartoon character on it. You can have ads. It may be HFSS. That's a sidebar. The point is there are, the last time I counted, there are 12 health claims

on a box. It's vitamin D enriched. It contains iron. It supports your family's health. On and on and on. There are 12 different health claims and a monkey selling it to your kids. Now, if we use UK dietary guidance, we don't have to write any new legislation here. We just use the thresholds we agreed 20 years ago for salt, fat, and sugar. And you know what? People actually stop wanting to buy a lot of when we buy ultra processed food. I think early on, Alison, you said it was, no, Wendy, you said it was delicious. We know that isn't true. In fact, people don't find the food delicious. They do find it desirable and irresistible and somewhat addictive. But when you actually sit down and try and savor it and taste it, rates of obesity have been nearly undetectable. There has been some historic obesity if we look at Henry VIII. But broadly, especially in childhood, rates of obesity were all but nil.

And that wasn't because food is short. It's not because wild animals don't lack obesity because their food is in short supply. They lack obesity because we all have internal regulatory systems that if we eat normal food, tell us to stop eating. Now, if you go to the shop and you eat nothing but salami and cheese and bread and butter, you can gain weight on non-ultra processed food, especially if you're like me in your mid-40s, it's possible to do. But if you feed children a diet of normal food, of rice and meat and fish and vegetables and fruit and butter and traditional bread, what we know from the data is very clear about this is they gain weight, they live at a very healthy healthy weight with very very low rates of obesity and other diseases so yes it's not surprising and we understand a lot about how ultra processed food subverts these internal mechanisms that go time to stop eating yeah you know we've got great data on

loads of different aspects whether it's the flavorings the ratio precise ratios of salt and sugar the way they use acids to be able to add more salt and sugar. The softness of the food is crucial and the energy density. So this food you're eating in Austria, it will be – Very dense. It's chewy, it's robust, but it will have a water content that displaces calories. You can eat a calorific meal but in general real food does have water ultra-precious food is often very dry

so does banning those would banning food work or is it just i guess if there was one upf that you could see banned instantly would that improve? Or is that too simplistic an argument? I wouldn't ban anything. I wouldn't ban cigarettes. And that's not just because I'm a libertarian by nature. It's because we know that banning things doesn't work. It restricts people's freedoms. My view, what I say in the book is, and this is always a problem on podcasts like this, is I refuse to give anyone any advice. OK, I do not know. I don't know your budget. Well, we're done then. People are always like, what would you ban?

So what I say to the adults reading my book is eat the food while you read the book. If you want to understand ultra processed food, you've got you read the book. If you want to understand ultra-processed food, you've got to read the book. If you can't afford my book, go and listen to the podcast, but open the packet, smell it, read the ingredients list and ask yourself, is this food while you eat? And what does it really taste of? What's it doing to me? Most people find by the end of the book, or many people find by the end of the book, they no longer want the food, which is kind of what you're hinting at, Wendy. Once you start to engage with what food is and what it does to you, it's actually quite quick to flick from addiction to disgust. And lots of people see this with cigarettes.

We see it with infatuation with other human beings. So we know people that love and disgust and addiction. They all sit quite close to each other in the brain, and you can make the journey quite quickly. So my advice to people is don't try and ban it. If you want it, eat it. Eat it without shame. Eat it without stigma. Understand what it does to you. And in terms of banning, you don't need to ban it. If you put it on high shelves and stop advertising it and promote really healthy food, you know what, people do that. There's a natural experiment, right? Which is you go to the house of someone

with enough money that their food bill is an irrelevant. So we call these people food price insensitive. They just don't care. And you don't need much money before your food bill is just not big. So these will be people in the top 5% of earners say they can shop at the fancy supermarkets, they can buy wine and cheese. They might not be flying business class on holiday, but they just don't care about the price of food. They'll buy organic milk. Those people who don't care about the price of food nearly universally eat real food that's organic and whole and they cook for themselves. Essentially, if you give people money, they make really smart decisions and they buy good food. And it's people with low incomes that are essentially forced to buy terrible food. Many of my patients and my patient demographic, because I treat patients with

infections, they are vulnerable people. They're often migrants, asylum seekers, people without addresses, drug users. They just don't have resources. Many of them are extremely smart and they all know they're eating terrible food and they would love to eat better food. So there's a kind of natural experiment that people with money just don't buy bad food. And the poorest people are children. Children have no money. They're very low education, even children in wealthy families. So they are very, very vulnerable. They're the most vulnerable people and they are the people we should be protecting most. So it does sound like what you're saying that this is definitely a privilege thing with

this that it's all well and good us you know talking about how unhealthy these foods are and how we should make changes to the way that the choices that we're making but also talk about the regulation but it is it is a privilege is a big factor here, right? Well, 100%, except that I don't think anywhere in my book nor in any podcast ever have I said what people should eat. I've never, ever used that word. And that is because I don't know your children. I don't know your tastes. I don't know your culture. And I do not know your budget.

I don't know if you own a freezer. I mean, of course, it's cheap for me. I have to own my privilege. Look at who I am. I'm a doctor. I am a food pricing sensitive person. It's cheap for me because I own a freezer and I own a stovetop cooker and a load of pans. I can batch cook a big meal and it's really cheap. But I haven't had to buy any equipment for that. I'm not counting that. And I have time. So I quite like cooking. So I don't count the cost of my time. But if I'm on a zero hours contract and I only have a microwave, it becomes, and I don't have a freezer storage and I haven't bought a load of Tupperware 10 years ago, it becomes incredibly expensive to make a real meal. And buying microwave food is much, much cheaper. Energy, time, preparation costs, equipment needed, all of it is cheaper.

So yes, it is entirely a discussion about privilege. And that is why we... And this is weaponized, by the way. So the food industry are brilliant at going and the scientists they pay, they say, oh, well, Chris is being snobby when he says that emulsified foam bread isn't bread. I'm not being snobby. I'm the very opposite. The engine of inequality in our society is that people with low incomes are forced into poor health through terrible diet. And the food industry saying that in order to avoid stigmatizing people, we should continue to not regulate terrible food is completely upside down. What we should have is really good food and really high quality sourdough bread and organic fruit and veg. That should all be affordable for absolutely

everyone, regardless of the household they're born into. And everyone should be able to eat sourdough bread and organic fruit and veg, that should all be affordable for absolutely everyone regardless of the household they're born into. And everyone should be able to eat the same. And the other thing that I have not done is proposed taxation. So I do think that we could look at salt and sugar taxes, and we can have a gradual tax on things. But all of the policies I'm recommending are about improving the affordability and accessibility of real food, and about warning people and educating people and increasing choice. So the snobbery argument is one of the cruelest. And if you look at the poverty campaigners, and I've spoken to a great many of them and I work with food charities that do a lot of poverty campaigning, what harms people and drives stigma is that having diet-related disease because of poor food. So it's deeply cynical of the food industry and, frankly, of charities like the British Nutrition Foundation, who are funded by companies like McDonald's and Coca-Cola.

It's one of their cruelest and most cynical ploys. That makes sense, yeah. Now, being a dad of three, since doing all of this research, you've mentioned that you do serve up fish fingers. I'm sorry, I don't mean to keep obsessing over fish fingers. I feel like I mentioned them so many times. I could quite go a fish finger now, actually. What I wanted to ask you, though, was,

does your diet and your kids' diet look very different now compared to a couple of years ago, before you did all of this research and wrote the book? And were there some serious mealtime protests when you cut out ultra-processed food? So I won't give anyone advice, but i will tell you what i do and this is a lot of what i do comes out of working as an academic advisor to the world health organization and their infant nutrition teams i don't advise them on nutrition i advise them on

what we call the commercial determinants of health and how big companies and their economic incentives work and i work with unicef a lot and I work with First Steps Nutrition. So I'm good pals with a whole bunch of child nutrition experts, none of whom are paid by the food industry. My diet and my children's diet has changed dramatically. So my first child was fed a lot on those kind of organic pouches, which seemed great to me and they're non-UPF and they seem to be developing tastes and also those organic snacks and also had

follow-on formula when they moved on to the follow-on milk yeah um the uh second and third child follow-on milk has no evidence it's completely unnecessary um so they haven't had they they haven't and they won't get any of that the one thing i i did didn't do with any of them is my kids really only drink milk and water if you only do one thing for your child's health this is the one bit of advice i will give because this is so well-advised. Yes. I'm going to quote the World Health Organization in UNICEF's advice. How about that?

Okay, that will do. Kids should drink milk and water. Free sugar in drinks, artificially sweetened drinks, flavored drinks, they are all entirely unnecessary. They're expensive, and they really change kids palates so i i that is the one thing i've done and i'm really pleased my kids don't drink any juice and they don't particularly like juice so i may be a bit lucky with them um but we just don't have it in the house there's no squash is nothing um that's the only thing we really don't have in

the house now until recently i've talked a lot about our big blue bowl that we've got this, you know how grandparents, party bags, Easter, Christmas, that even if you try and run a junk-free household, it's like a black hole. So we have this big blue bowl in the kitchen, sits up on a high shelf, and it's full of eggs and chocolate and Percy this and caterpillar that and so that's been my sort of naughty thing and the kids have a little treat and the more I've been doing the more I've just been sort of looking at the science around the book and talking about food policy and I've just testified to the House of Lords and I'm an author on a big Lancet

series and I'm like you know what twice day, my kids get a big snack from this big blue bowl. They get a huge chunk of chocolate or a bar of something or a lollipop. And it's a massive part of their calorie intake. And it's really hard for them having it sitting up on a shelf in eyesight. So we've emptied the blue bowl and I'm really trying to make puddings in the household. I'll buy them a cake from a good bakery. We'll bake a cake. They'll get yogurt and honey. They'll get bread and peanut butter and jam.

They can almost have anything they want. So I am tightening up on that because I'm just increasingly persuaded, I think, by the evidence, whether it's around salt, fat, sugar, or it's around the emulsifiers, the cosmetic additives, the harmful fats, the plastics, all of it is pretty harmful. And my kids are eating masses of it. So I'm tightening it up. But my kids are not banned from eating anything. When they go they go to a party i never say don't have juice if they i mean the three-year-old i'd probably take a can of cola out of her hand but you know if the six-year-old wants to drink drink a can of coke then then she can so joe wicks has been

in the press recently about the link between upfs and adhd and we wanted to ask what your take was on that. I love Joe Wicks. And he sends, maybe I shouldn't disclose this. He sent me a WhatsApp recently. And I think I've never been, when you're a public figure, you do end up with a few famous people in your phone for various reasons. I've never been so excited to get a WhatsApp from anyone. And it was a very funny WhatsApp and he signed it Wix. Anyway, I was made up. Maybe I'm breaking

your confidence there. I suspect he's absolutely right. We don't have really strong evidence at the moment. The evidence would be hard to get because defining ADHD is quite complicated. It's a spectrum defining any of these behavioral disorder difficulty entities is complex. It's all up for discussion. Look, the food contains neurotransmitters, some of it. They put neurotransmitters into food. We know that the food contains molecules that muck around with your microbiome and the neurotransmitters produced in your gut. We know that many of the cosmetic additives, the colors, act directly on the brain. We know that the fat molecules, the odd fat molecules,

become then part of the fat membranes of your brain cells. We know that the addiction reward behavior bits of the brain that drive so much of human activity are very directly affected by having hyperpalatable addictive food. So the idea that these foods would disrupt attention and an ability to concentrate and change activity levels in ways that were abnormal is completely plausible. And I think we are going to see more evidence emerge on that. We know the food drives anxiety, depression with much more certainty. We know it drives dementia with quite a lot of certainty. We know it's acting on the brain. And the addiction stuff is very important. The food is addictive. And for the people who are addicted to the product.

So just can I talk about addiction for a moment? I'm sorry, I've leaped into this. Let me round up ADHD. So I would say I suspect Joe is right. And the other circumstantial thing is we know when we feed kids and prisoners healthy diets, their behavior changes very, very dramatically. And every parent knows. I mean, there's a certain cluster of stuff you do with your kids, whether it's watching bad television or playing computer games or eating junk food. They end up being weird and difficult at the end of those things. It doesn't necessarily mean it's permanently damaging their brains but if i want my kids to do something if they've just spent an hour rummaging around the internet looking at videos you know they're really hard for the hour

afterwards versus an hour in the park they come back you know yeah they're tired it's great so so look i think joe i think joe's spot on with that and with that. And Joe can talk around the evidence in a way that I have to be a bit more measured, I suppose. But I think people like Joe leading on suspicion and probability is a vital part of the discussion. Why should the burden of proof be on Joe Wicksicks for example to go this food seems to be there look we've got an epidemic of this behavior we're all eating this terrible food my observation as a parent is this stuff happens there's some science like it's all very plausible why is the burden of proof on joe wicks to to prove to do some scientific study is ridiculous the burden of proof should be on the food companies to prove that the food is totally safe and doesn't cause this. With addiction, so addiction has been very controversial

because the problem with addiction, there are two problems. First of all, the food doesn't seem to contain addictive molecules. Fat is not addictive. You don't eat butter by the spoonful. Sugar isn't addictive either. If you have a bowl of sugar, you're not eating it by the spoonful. We don't eat raw honey. I quite like a little spoonful of honey, but you'd never eat a jar of honey. My jar of honey sits undisturbed and it's more or less pure sugar. And then there's the unease that built into the idea of addiction is the only treatment for addiction is abstinence. If you're a smoking addict, you can't go, I'll smoke one a day. That's the point about addictions. Drinkers can't be moderate drinkers if you live with alcohol addiction. So the lovely thing about

the definition ultra processed food is the only food that people seem to be addicted to or develop binge eating disorder with is our ultra processed products. Now, the crucial thing to remember is when we say the products are as addictive as cigarettes, most people, around 90% of people can try cocaine, alcohol and cigarettes without developing a problem. Okay, the 10% of people that do develop the problem, it's rather like the 10 to 12% of people that develop problems with UPF. It won't be all UPF products. It'll be for some of us, it'll be aF products. For some of us, it'll be a particular biscuit. For some of us, it'll be a particular takeaway. Others of us, it'll be a fried chicken thing. Once you are addicted to that thing, the addiction seems to be as strong as the smokers are addicted to their cigarettes. Maybe I shouldn't say this. I've tried cigarettes. Most

people have. I've drunk drunk alcohol i have never ever been addicted to anything in the same way that i i have been addicted to certain very particular types of ultra processed food so and the addiction science is is real and so i i think that is really important to remember that's kind of terrifying when you lay it out like that yeah can i say these questions i these questions are so sophisticated like you know i mean obviously you two are pros and you know exactly what you're doing but you know i've you know i've anyway i've done a lot of like news current affairs the today program on radio 4 these are anyway these are great questions i'm really enjoying

this sorry we're journalists ch Yeah, no, exactly. Hungry journalists, Chris. Literally hungry. But you're people with lived experience. So you're asking the, you're in the nitty gritty because you're living this and you're like, but what, yeah, but hold on. You know, you talk about the science and yet here I am faced with this pack of X, Y, or Z

and a screaming child. Well, I'm faced with a 12-year-old who the only way she'll eat chicken is if it's a bird's eye crispy chicken fillet and and with that then you're like well i have to try and make her eat it a different way but the battle is real if you're trying to do that in your own home i mean wendy i'll be coming to you in six years and going, what do I do with my 12-year-old? Don't ask me.

No one has cracked this code, right? Kids are very susceptible to addictions, much more than adults, because they don't have much of a frontal lobe, the bit that can override all the addiction stuff. They lack, not entirely lack, but they have diminished capacity for long-term thinking consequences. They haven't lived much of life. And the food is engineered to mess around with your 12-year-old's brain.

They have tried, I know, so the food company scientists describe these testing trials. Well, they'll just get a load of kids, and loads of them spoke to me about this. They get a load of kids in the lab, and they feed them five or six different variations. Some are a bit saltier, some are a bit sweeter, some are a bit crispier. And the product that the kids eat the most of, okay, that is the one that goes on the shelf. Now, the kids might not rate that as the one they like the best, but if they eat the most of it, it goes on the shelf. Next year, they get another hundred kids in the lab and they try it all over again and they every characteristic of that breaded chicken you know reformulated you know mechanically recovered meat product every every single of

the thousand properties that it has from the labeling to the ad to the the way it looks on the plate has been optimized to mess around with your 12 year old so it's nothing to do with her and i my only experience of this is with my brother it was when i let go of his of his problem that he was able to solve it and there is it's very hard with children to allow them to make mistakes and and you know find that that navigate that way through going look you can eat what you like it's there but um i just think you should know it does this to you and as a parent it's all you know they might listen to me saying it but i will never say you will never hear an episode of operation ouch where i say a single word of any of this because i am not going to impose on a community

of people who cannot afford different food a load of advice that they they should eat stuff they can't afford that feels deeply also on that topic um this is this this is our final question we will let you go after this after this uh this grilling this news night level grilling that we have given you um you know you've mentioned the you know childhood obesity situation. And it's something that I really struggle with because I feel like, well, there's a couple of things. I look around and I don't see a bunch of fat kids. And I've got twins. I've got five-year-old twins.

And from maybe age one, one of them, when I pick her up, is so much heavier than the other. So look at, they look the same and they're the same height. And I know that they, that, you know, the kids get weighed in reception at school and one will be heavier than the other. Now I struggle with weight being the main way that we determine health in kids. And it's talked about in the news all the time, obesity crisis, it's terrible. And I struggle with, on one hand, listening to what you're saying in terms of, oh yeah, kids are eating a load of crap, like this is bad, but also thinking,

but it's not just about fat kids. Surely, we should be assessing health in a better way. What's your take on that? Firstly, I 100% agree with everything you're saying. Let's break it down bit by bit. So obesity is a huge problem, but it's one of many, many problems. So I try and talk about diet-related disease, including obesity. It's very easy to get laser-focused on obesity and forget that if children aren't gaining weight, or adults, if they aren't gaining weight, but adults, if they aren't gaining weight, but they're still eating a terrible diet, they will still be at risk of heart disease, brain

disease, anxiety, depression, inflammatory bowel disease, cancers, and so on. So you're right, the diet does affect those who don't gain weight. Now, when it comes to the Mark I eyeball at the school gate versus the national statistics. There are two observations I have about that. First of all, there is an enormous gradient in who is affected and where they are affected. And if different schools with different demographics will have massively different levels of obesity. The second thing is that the way our eyes work,

and this was explained to me by the president of the Royal College of Pediatrics and Child Health, is they said, look, people have, including doctors and pediatricians, we've lost the idea of what a healthy weight looks like. So a healthy, what we know is a healthy weight for a child will look pretty scrawny actually now. You should be able to see, medically, you should be able to see a lot of ribs and that's quite unusual. So I'm not sure we have as a nation figured out a perfect way. I mean, I know we have not figured out a way of having a discussion about health and weight that doesn't horribly stigmatize those that live with excess weight. We can start by changing our language. So

I try and talk about living with obesity rather than being obese. It's not an identity. Weighing children is fraught and telling parents that their kids live with obesity or excess weight is fraught because it assumes that you can do anything about it and you basically can't obesity in children and adults is fundamentally an incurable condition without changing the food environment so um how we manage the information is hard we also use a very particular cutoff. So this is, I'm going to finish on a really nerdy thing here, because there was a very poisonous piece published by someone who's funded by the food industry, saying that the child obesity pandemic in the UK is a myth. It simply doesn't exist because the data is so poor.

And this commentator pointed out that the way we define obesity when you get your letter from school is we say, more or less, not quite arbitrarily, but we say that in 1990, rate of childhood obesity was 5%. So now, how many children are over the 5% rate of obesity. So we picked a BMI for each age group in 1990. And we want to know now what proportion of children would be at that rate. And so now it's 25% at the age of 10. Now, when it comes to defining, when you then, so you get this information and you're told your child lives with obesity, when you go and see a pediatrician, they use a different threshold. They're saying to define obesity in the clinic, you have to be as heavy as the top 2% of children, not the top 5% of children in 1990. Now, there's a really good reason for this. It isn't a conspiracy to inflate our national numbers. We pick that 5% cut off. In other words, to be a beast now, to live with obesity now,

you have to be in the top 5% of children in 1990 in order to match our data with other people internationally, because that's what we decided to do. And because you have to know about the rate of change. So in a way, it doesn't matter where you draw the line, you just want to know how much it's gone up by. Now, the 2% threshold is important for sort of treating kids in clinic. And so we have a tighter definition in a clinical setting. So there's no conspiracy. And the tighter we make the definition. So if we did what this food industry commentator wanted, and we said, okay, let's use as our national definition, 2% in 1990, what we'd find now is that around 16% of children would be as heavy as the top 2% in 1990. Now, that is still appalling, right? It's still 16% of kids. But you'll notice

the difference between 5% and 25% is a five-fold increase. The difference between 2% and 16% is an eight-fold increase. And the tighter we make the definition, the bigger the increase we see. So if we're concerned about the heaviest children, we now see our heaviest children simply didn't exist in 1990. There were no kids as big as the biggest kids we see now. And that's the tragedy is we're seeing an entirely new pediatric specialty of endocrinology and metabolic disease has had to be developed because these kids didn't exist 30 years ago. And it's all because of the food industry. So I think the way we measure weight is good. I think it is a bit simplistic and we aren't

brilliant at communicating about it. And I think we need a much improved national understanding that there is no parental responsibility at all. It is entirely due to the food environment and it all bolsters my argument that what we need is very, very tight regulation around the shops that kids pass on their way to and from school, around the food that they're served in schools and around the food that parents are sold to them to feed them at home.

Are you persuaded? I kind of am. and around the food that parents are sold to them to feed them at home. Right. Are you persuaded? I kind of am. I'm kind of surprised that you have persuaded me a little bit. Yeah. I'm open to persuasion. Oh, good. And I'm going to mull, you know, what you've said.

I'm going to have it go around my head for the rest of the day, and I'll get back to you. I'll let you know. I'll send you a voice note like Joe Wicks did. He won't be half as excited, I can tell you right now. No, I would be. That's what that mum says. It's all of the misinformation that people believe around their food, around health, around weight,

almost all of it you can trace back to the actions of the industry, promoting things. And it's never the head of a big food company saying something bad. It's they fund an institute that funds a lab that has a scientist in it. They fund a charity. They fund an influencer. All of it comes from the food industry. And that is maybe the thing I really want to end on is the one thing we have to end. So I want warning labels on food. And there's

lots of nuance around that. The thing we have to end is the conflicts of interest with the food industry, our biggest nutrition charity there. So the British Nutrition Foundation, their healthy eating week in 2023 was sponsored by Coca-Cola. The Government Scientific Advisory Committee on Nutrition has 14 people on it. Around half of them have past or present relationships with big food companies. Our biggest food university labs are funded by companies. So from the government committee to the charities, to the universities, to the communication centers, everything is funded by 10 to 15 major transnational food corporations. So this is bluntly a conspiracy and food industry money has to become dirty.

Well, thank you for taking on the battle, Chris, because I feel like the battle needs fighting your listeners your listeners will they are the they are the allies you know if they want to protect their kids health they they have to start pushing back and there's there's a real groundswell I think I'm I'm optimistic yeah that's great thank you so much for coming on and talking to us about this today Chris it has been eye-opening it really has lovely to meet you thank you very good luck on your retreat wendy nice to speak to you bye