The conclusion of a provocative, March 2017 commentary in JAMA Pediatrics is short and to the point – “…processed food is an experiment that failed.”
The author, Dr. Robert Lustig, is a pediatric endocrinologist at U.C. San Francisco. He has carried out multiple studies on the impact of diet on children’s growth, development, and metabolic diseases.
Lustig lists 11 nutritional properties that “distinguish” processed food from fresh food:
- Too little fiber;
- Two few omega-3 fatty acids;
- Excessively high levels of omega-g (and hence a highly skewed omega-6/omega-3 ratio);
- Too few micronutrients (especially antioxidants);
- Too much transfat;
- Too many branched-chain proteins;
- Too many emulsifiers;
- Too many nitrates;
- Too much salt;
- Too much ethanol, and
- Too much sugar.
After listing these negative attributes found in various combinations in most processed food, Lustig then connects the dots in four major areas between the prominent role of processed foods in the U.S. diet and diet-related chronic diseases, adverse impacts on health, and the economics of food and health care.
First, food consumption patterns. He notes the low share of gross domestic product spent on food (7%), which makes food affordable and removes a meaningful economic brake on overall food intake. He stresses that the growth in average per capita caloric intake has not come from fat, the favored target of most government-sponsored dietary advice, and of course, the sugar industry.
Second, health/disease. “Sugar consumption predicts metabolic syndrome in adolescents, regardless of calories or body mass index.” He also noted the key finding in one of his nutrition-intervention studies. When kids with metabolic syndrome where given starches instead of sugars, their symptoms subsided (Lustig et al. 2016).
Third, environment. Where and how food is grown impacts human health indirectly via numerous pathways. He specifically singles out corn-soy monocultures, atrazine use, and the impact of glyphosate-resistant weeds on herbicide use and exposures.
Fourth, cash flow. Lustig points out that processed food costs about one-half as much per calorie as fresh food. Health care costs rose from around 2% of GDP in 1965 to 18% in 2015, and is projected to reach 21% of GDP in 2020.
He argues that chronic diseases with roots in poor dietary choices and excessive intakes of processed foods account for a large share of the increase in health care costs. According to Lustig, “75% of metabolic syndrome costs could be prevented if we changed our collective diet.” Lustig estimates these health care costs at $1.8 trillion, out of total health care costs of $3.2 trillion.
So, according to Lustig, diseases that clearly are triggered by poor diets composed of too much processed foods are the root cause of chronic diseases that account for 56% of health care costs. Furthermore, he states that “fixing” the U.S. diet is the only realistic way to substantially reduce the burden of metabolic disease across the population.
His bottom line is that reducing the number of people afflicted with metabolic syndrome, as well as helping people stop the progression of disease, will depend on people eating less processed and more fresh food.
An editorial note — Commentaries like this are becoming more common in the biomedical and public health literature, but the message has failed to alter a core message from the USDA and most of the conventional food industry — the U.S. has the safest, most nutritious food supply in the world.
Lustig, RH, “Processed Food – An Experiment That Failed.” JAMA Pediatrics, 2017, Vol 171(3): 212-214.
Lustig RH, Mulligan K, Noworolski SM et al.,“Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome,” Obesity (Silver Spring), 2016, 24(2): 453-460.