Do Ultra-Processed Foods Make You Fat?

Written by Dr. Steve Chaney on . Posted in ultra-processed foods

What Is The Secret For Weight Loss?

Author: Dr. Stephen Chaney

 

Do ultra-processed foods make it harder to loose weight?

ultra-processed foods questionsIt is so confusing. It seems like everyone has a magical weight loss diet. You just follow their diet and the pounds will melt away. The problem is that everyone’s recommendations are different. What is the average consumer to think? Is the best diet low fat, low carb, low sugar, Paleo, Keto, or vegan? Or is intermittent fasting the secret to successful weight loss?

What if the secret to weight loss was none of the diets mentioned above, yet was something common to all of them?

The one common feature of every popular diet is they cut out sodas and processed foods and replace them with whole unprocessed foods. What if cutting out highly processed foods was the secret to successful weight loss, and none of the other restrictions of the various diets really mattered?

There are lots of studies suggesting that ultra-processed foods might be the problem. [Note: In the scientific community the term highly processed foods has been replaced with ultra-processed foods. There are subtle differences between the two terms, but for our purposes we will consider them identical]. Consumption of ultra-processed foods has been shown to be associated with overeating, obesity, poor health outcomes, and premature death.

For example, consumption of ultra-processed foods and obesity have increased in parallel. Today ultra-processed foods constitute the majority of calories consumed in America, and 40% of Americans are now obese.

However, associations don’t prove cause and effect. In the words of the authors of the latest study: “There has never been a randomized controlled trial demonstrating any beneficial effects of reducing ultra-processed foods or deleterious effects of increasing ultra-processed foods in the diet.”

The latest study (KD Hall et al, Cell Metabolism, 30: 1-11, 2019 ) was the first randomized controlled trial designed to test the hypothesis that consumption of ultra-processed foods leads to obesity.

 

How Was The Study Done?

ultra-processed foods studyTwenty overweight subjects (10 men and 10 women) volunteered for the study. Their average age was 31 and their average BMI was 27, which means they were overweight, but not obese. All were weight-stable in the months preceding the study.

They were admitted to the metabolic ward at the NIH where every aspect of what they ate and the exercise they got was controlled. The subjects were randomly assigned to consume an ultra-processed or an unprocessed diet for two weeks followed by the alternative diet for the final two weeks.

During the study the subjects were given three meals a day that provided twice the calories they were accustomed to eating plus unlimited snacks. They were instructed to eat as much or as little as they desired. The calories consumed were calculated based on how much food they left on their plates.

The ultra-processed diet and unprocessed diets were matched with respect to:

  • Total calories in the food portions given to the subjects.
  • Caloric density (calories per serving size).
  • Macronutrients (carbohydrate, fat, & protein).
  • Sugars, fiber, and sodium.

The ultra-processed and unprocessed diets were neither low fat, low carb, or high protein. The caloric composition was around 48% carbohydrate, 35% fat, and 17% protein.

However, because of the differences between ultra-processed and unprocessed foods, it was impossible to match all parameters. For example, the ultra-processed and unprocessed diets differed significantly in:

  • Added sugar: 54% of the sugar in the ultra-processed diet was added sugar versus only 1% added sugar in the unprocessed diet.
  • Insoluble fiber: 16% of the fiber in the ultra-processed diet was insoluble fiber versus 77% in the unprocessed diet.
  • Saturated fat: 34% of the fat in the ultra-processed diet was saturated versus 19% in the unprocessed diet.
  • Omega-6 to omega-3 ratio: The ratio was 11:1 in the ultra-processed diet versus 5:1 in the unprocessed diet.

To give you an example of what the two diets looked like, dinner one night for the unprocessed diet group consisted of beef tender roast with barley and spinach and a parfait made of fresh berries and nonfat, unflavored Greek yogurt while the ultra-processed diet group got processed turkey and cheese sandwiches (on white bread) with baked chips, canned peaches and nonfat vanilla Greek yogurt. For breakfast one morning the unprocessed diet group got omelets made from fresh eggs while the ultra-processed diet group got omelets made from Fresh Start liquid.

 

Do Ultra-Processed Foods Make You Fat?

ultra-processed foods make you fatThe results of the study were quite interesting:

  • Subjects ate an additional 508 calories per day when on the ultra-processed diet.
  • Those extra calories came from both carbohydrate and fat, not from protein.
  • Subjects gained 2 pounds in just two weeks on the ultra-processed diet and lost 2 pounds in two weeks on the unprocessed diet.
  • Subjects ate their food more quickly on the ultra-processed diet (50 calories/minute) than on the unprocessed diet (32 calories/minute).

The authors of the study asked the participants several subjective questions about the two diets to better understand why they consumed more calories on the ultra-processed diet. However, those questions did not provide any useful insights. For example, the subjects rated the two diets equally with respect to:

  • Palatability and familiarity of the foods in the diet.
  • Hunger prior to eating and both fullness and satisfaction when they were finished eating.

These findings surprised the authors. The authors had assumed their subjects would eat more ultra-processed foods because they liked them better.

With respect to the overall study results, the authors concluded: “Limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment.”

In short, their study confirms what many experts have long suspected, but does not provide a mechanistic explanation of why ultra-processed foods lead to overconsumption and obesity.

 

What Is The Secret For Weight Loss?

 

ultra-processed foods secretThe arguments over which diet is best for weight loss never end. Everyone claims they have the secret, and everyone quotes studies showing their diet works.

Yet the diets are as different as night and day. They shouldn’t all work, but they do. For example, weight loss is virtually identical on a very low-fat vegan diet and a very low carb keto diet. That tells us that the secret can’t be either low-fat or low carb.

The secret must be something all these diets have in common. When you ask what they have in common, the answer is simple. All the popular diets start by eliminating sodas and ultra-processed foods and replacing them with unprocessed foods.

Could it be that something as simple as eliminating sodas and ultra-processed foods and replacing them with unprocessed foods is the secret to successful weight loss? Many experts have hypothesized that ultra-processed foods were the cause of the obesity epidemic, but this is the first randomized controlled clinical trial to prove that hypothesis.

Like any individual study, this study needs to be confirmed by additional randomized controlled studies. One might hope for longer duration studies with more subjects, but it would be very difficult to duplicate the precision of this study. Asking volunteers to enter a metabolic ward where every aspect of their life is controlled for multiple weeks is both expensive and a huge commitment by the volunteers.

My recommendation is simple. You don’t have to choose radical diets that eliminate whole food groups to lose weight successfully. They are hard to follow and may not be healthy long-term. Just ditch the sodas, junk foods, and highly processed foods. Rediscover the pleasures of whole unprocessed foods. You will lose weight gradually and safely. You will be healthier.

Of course, it is not quite that simple.

  • Portion control is essential. You can eat too much unprocessed food.
  • Caloric density (calories per serving) is important. This is one reason why primarily plant-based diets are generally more successful for long-term weight control.
  • Practice mindful eating. Savor your food and eat it slowly. You will be less likely to overeat.
  • And, of course, don’t neglect the exercise component.

For a more detailed analysis of the pros and cons of popular diets, read my book, “Slaying The Food Myths.”

 

The Bottom Line

 

It seems like everyone has a magical weight loss diet. You just follow their diet and the pounds will melt away. The problem is that everyone’s recommendations are different. What is the average consumer to think? Is the best diet low fat, low carb, low sugar, Paleo, Keto, or vegan? Or is intermittent fasting the secret to successful weight loss?

What if the secret to weight loss was none of the diets mentioned above, yet was something common to all of them? The one common feature of every popular diet is they cut out sodas and processed foods and replace them with whole unprocessed foods.

For years experts have claimed that the consumption of highly processed foods is responsible for the obesity epidemic and replacing  ultra-processed foods with unprocessed foods was the secret to successful weight loss. However, those claims are based on associations, and association studies do not prove cause and effect.

Finally, the first randomized controlled trial to test this hypothesis has been published. The study showed:

  • Subjects ate an additional 508 calories per day when on the ultra-processed diet.
  • Subjects gained 2 pounds in just two weeks on the ultra-processed diet and lost 2 pounds in two weeks on the unprocessed diet.

My recommendation is simple. Just ditch the sodas, junk foods, and highly processed foods. Rediscover the pleasures of whole unprocessed foods. You will lose weight gradually and safely. You will be healthier.

Of course, it’s not quite that simple. I discuss other aspects of successful weight loss in the article above.

For a more detailed analysis of the pros and cons of popular diets, read my book, “Slaying The Food Myths.”

For more details read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Are Pregnant Women and Children Dangerously Deficient in Omega-3s?

Posted August 13, 2019 by Dr. Steve Chaney

What Is The Omega-3 Status Of The American Population?

Author: Dr. Stephen Chaney

 

pregnant women omega 3 deficient fishIt is no secret that the American population is deficient in omega-3s. Numerous studies have documented that fact. There are many reasons for Americans’ low intake of omega-3s:

  • The high price of omega-3-rich fish.
  • Concerns about sustainability, heavy metal contamination, and/or PCB contamination of omega-3 rich fish.
  • Misleading headlines claiming that omega-3 supplements are worthless and may even do you harm.

Of course, the questions you are asking are probably?

  • How deficient are we?
  • Does it matter?

The latest study (M Thompson et al, Nutrients, 2019, 11: 177, doi: 10.3390/nu11010177) goes a long way towards answering those important questions.

How Was The Study Done?

scientific studyThis study used data on 45,347 Americans who participated in NHANES surveys between 2003 and 2014. (NHANES or National Health and Nutrition Examination Surveys is a program run by the CDC that is designed to assess the health and nutritional status of adults and children living in the United States).

EPA and DHA intake from foods was based on the average of two 24-hour dietary recall interviews. Trained dietary interviewers collected detailed information on all foods and beverages consumed during the past 24 hours.

To assess EPA and DHA intake from supplements study participants were asked what supplements they had taken in the past 30 days, how many days out of 30 they had taken it, and the amount that was taken on those days.

 

What Is The Omega-3 Status Of The American Population?

 

omega 3 statusThe results of the NHANES surveys were shocking.

In terms of total EPA+DHA intake:

  • EPA+DHA intake across all age groups was lower than recommended.
  • Toddlers (ages 1-5), children (ages 6-11), and adolescents (ages 12-19) had lower EPA+DHA intakes than adults (ages 20-55) and seniors (ages > 55).
  • Women had lower EPA+DHA intakes than men.
  • Pregnant women and women of childbearing age did not differ in their EPA+DHA.
  • Pregnant women consumed less fish than women of childbearing age (perhaps because of concerns about heavy metal contamination).
  • Pregnant women consumed more omega-3 supplements.

In terms of EPA+DHA from supplements:

  • Less than 1% of the American population reported using omega-3 supplements.
  • The one exception was pregnant women. 7.3% of pregnant women reported taking an omega-3 supplement.
  • People taking omega-3 supplements had significantly higher EPA+DHA intake than people not taking omega-3 supplements.
  • This was also true for pregnant women. Those taking omega-3 supplements had higher EPA+DHA intake.

Of course, like any clinical study, it has strengths and weaknesses.

The biggest weakness of this study is that omega-3 intake is based on the participants recall of what they ate. The strengths of the study are its size (45,347 participants) and the fact that its estimate of omega-3 intake is consistent with several smaller studies.

 

Are Americans Deficient In Omega-3s?

 

pregnant women omega 3 deficient questionsNow we are ready to answer the questions I posed at the beginning of this article. Let’s start with the first one: “How deficient are we?”

You would think the answer to that question would be easy. It is not. This study provides a precise estimate of American’s omega-3 intake. The problem is there is no consensus as to how much omega-3s we need. There is no RDA for omega-3s.

There are, in fact, three sets of guidelines for how much omega-3s we need, and they disagree.

  • The World Health Organization (WHO) recommendations for EPA+DHA intake range from 100-150 mg/day at ages 2-4 years to 200-500 mg/day for adults.
  • The US National Institute of Medicine (IOM) recommendations for EPA+DHA intake range from 70 mg/day for ages 1-3 to 110 mg/day for adult females and 160 mg/day for adult males.
  • As if that weren’t confusing enough, an international group of experts recently convened for a “Workshop on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids” (Workshop). This group recommended an EPA+DHA intake of 440 mg/day for adults and 520 mg/day for pregnant and lactating women.

Using these recommendations as guidelines, this study reported that:

  • EPA+DHA intake for children 1-5 years old was ~25% of the WHO recommendations and ~40% of IOM recommendations.
  • EPA+DHA intake for children 6-11 years old was ~27% of WHO recommendations and ~40% of IOM recommendations.
  • EPA+DHA intake for adolescents 12-19 years old was ~50% of IOM recommendations (The WHO did not have a separate category for adolescents.
  • EPA+DHA intake for adults 20-55 years old was ~30% of WHO recommendations, and ~65% of IOM recommendations.
  • EPA+DHA intake for seniors >55 years old was 38% of WHO recommendations and 82% of IOM recommendations.
  • EPA+DHA intake for pregnant women was ~20% of Workshop recommendations (The WHO and IOM did not have a separate category for pregnant women).

While the percentage deficiency varied according to the EPA+DHA guidelines used, it is clear from these results that Americans of all age groups are not getting enough omega-3s from their diet.

The authors concluded: “We found omega-3 intakes across all age groups was lower than recommended amounts.”

 

Are Pregnant Women and Young Children Dangerously Deficient In Omega-3s?

 

danger symbolWhile the authors concluded that all age groups were deficient in omega-3s, they were particularly concerned about the omega-3 deficiencies in pregnant women and young children.

The authors said: “Taken together, these findings demonstrate that low omega-3 fatty acid intake is consistent among the US population and could increase the risk for adverse health outcomes, particularly in vulnerable populations (e.g., young children and pregnant women).”

In part, the focus on young children and pregnant women was based on their very low omega-3 intake. With intakes at 20-27% of recommended levels, I would consider these groups to be dangerously deficient in omega-3s.

pregnant women omega 3 deficient pregnancyHowever, the focus on young children and pregnant women was also based on the seriousness of the adverse health outcomes associated with low omega-3 intake in these population groups. This answers the second question I posed at the beginning of this article: “Does it matter?”

According to the authors low intake of EPA and DHA during pregnancy and early childhood is associated with maternal depression, pre-term births, low birth-weight babies, increased risk of allergies and asthma, problems with learning and cognition, and other neurocognitive outcomes.

None of these associations between low omega-3 intake and adverse health outcomes have been proven beyond a shadow of a doubt, but the evidence is strong enough that we should be alarmed by the very low omega-3 intake in pregnant women and young children.

There is, however, a simple solution. The authors of this study concluded: “Individuals taking EPA/DHA containing supplements had significantly elevated intake compared to individuals not taking omega-3 fatty acid-containing supplements or not reporting any supplement use.”

omega 3 supplementsThey went on to say: “As supplement use is associated with increased omega-3 intake, supplementation could be an important source of EPA/DHA, particularly for pregnant women given their lower fish consumption compared to non-pregnant women of childbearing age.”

I agree. Given the low omega-3 intake in these population group and current guidelines for omega-3 intake. I recommend:

  • Pregnant & lactating women (and women of childbearing age who might become pregnant) take an omega-3 supplement providing around 520 mg of EPA+DHA/day.
  • Young children (ages 1-5) take an omega-3 supplement providing around 100 mg of DHA/day.

Of course, this study also confirmed that Americans of all age groups are not getting enough omega-3s from their diet, and low omega-3 intake may increase the risk of heart disease. Furthermore, recent studies have shown that high purity omega-3 supplements may reduce heart disease risk.

You will find my recommendations for omega-3 supplementation for adults in a previous issue of “Health Tips From the Professor.”

 

The Bottom Line

 

The largest study to date (45,347 participants) measured omega-3 intake for Americans of all ages and compared that to current recommendations for omega-3 intake.

The authors of the study concluded:

  • “We found omega-3 intakes across all age groups was lower than recommended amounts.”
  • “Low omega-3 fatty acid intake … could increase the risk for adverse health outcomes, particularly in vulnerable populations (e.g., young children and pregnant women.”

In part, the focus on young children and pregnant women was based on their very low omega-3 intake. With intakes at 20-27% of recommended levels, I would consider these groups to be dangerously deficient in omega-3s.

However, the focus on young children and pregnant women was also based on the seriousness of the adverse health outcomes associated with low omega-3 intake in these population groups.

  • According to the authors low intake of EPA and DHA during pregnancy and early childhood is associated with maternal depression, pre-term births, low birth-weight babies, increased risk of allergies and asthma, problems with learning and cognition, and other neurocognitive outcomes.

There is, however, a simple solution. The authors of this study also concluded:

  • “Individuals taking EPA/DHA containing supplements had significantly elevated intake compared to individuals not taking omega-3 fatty acid-containing supplements or not reporting any supplement use.”
  • “As supplement use is associated with increased omega-3 intake, supplementation could be an important source of EPA/DHA, particularly for pregnant women given their lower fish consumption compared to non-pregnant women of childbearing age.”

For more details on the study and my recommendations for omega-3 supplementation, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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