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guslohThe discussion of ultra-processed foods (UPFs) holds a prominent place in insights drawn
from Eric Topol's new book Super Agers and his Ground Truths newsletters, particularly
concerning their significant impacts on health and aging. Topol's work emphasizes that while
lifestyle factors are often viewed as "old-fashioned," advancements in knowledge, including
the understanding of UPFs, are transforming how we approach healthspan.
Defining Ultra-Processed Foods and Their Pervasiveness Eric Topol's sources
characterize ultra-processed foods as industrially produced, unnatural substances that are
"not even food," akin to "UFOs" in their alien nature. They are fundamentally different
from what one would use in a standard home kitchen to prepare meals. The detrimental
nature of UPFs stems from two primary dimensions:
Chemical Composition: They contain a long list of additives and industrial
ingredients, such as coloring agents, various forms of sugars (maltodextrin, high-
fructose corn syrup, artificial sweeteners), hydrogenated oils, palm oil, and
emulsifiers (e.g., soy lecithin, xanthan gum).
Physical Processing: Manufacturing involves physical changes like molding,
extrusion, and prefrying, which are designed to maximize digestibility and
accelerate absorption in the digestive tract, leading to rapid spikes in blood glucose
and insulin. This is in stark contrast to dietary fiber, which slows digestion and
mitigates glucose spikes. These foods are largely classified under NOVA Group 4,
distinguishing them from unprocessed, minimally processed, or processed culinary
ingredients. Despite the myriad of diet books, Topol's sources suggest thin evidence
for a universally optimal diet, yet the global "diabesity" epidemic is notably fueled by
diet, with a heavy and often overlooked influence from multinational "Big Food"
corporations.
Profound Health Impacts of Ultra-Processed Foods The consumption of UPFs is linked to
a wide array of severe health consequences:
Increased Mortality: A systematic assessment across 195 countries concluded that a
poor diet, including UPFs, is linked to 22% of all deaths globally, surpassing
tobacco, cancer, or hypertension. Specifically, more than four servings of UPF per
day have been linked to a 62% increase in all-cause mortality.
Weight Gain and Metabolic Dysfunction: Randomized trials have shown that
participants consuming UPFs ate an extra 500 calories a day, primarily from
carbohydrates and fat, leading to significant weight gain. This overeating is likely due
to the disruption of gut-brain signals. UPFs also induce abnormal lipid levels,
insulin resistance, and systemic inflammation. A diet rich in UPFs is associated with
an 80% elevated risk of metabolic syndrome, 40% higher risk of type 2 diabetes,
23% increased risk of hypertension, and 55% risk of obesity.
Cardiovascular and Cerebrovascular Disease: Increased UPF intake leads to a
higher risk of cardiovascular, coronary artery, and cerebrovascular disease.
Cognitive Impairment and Dementia: Even a mere 10% increase in UPF intake
among older adults is associated with a 16% increased risk of cognitive
impairment. Regular consumption of ultra-processed red meat (like bologna, bacon,
sausage, and hot dogs) has been linked to a 14% higher risk of dementia. Notably,
recent studies indicate that microplastics, often found in foods, accumulate in the
brain at concentrations 7 to 30 times greater than in the liver or kidneys, and are
found at significantly higher levels in the brains of individuals with dementia.
Other Conditions: UPFs are associated with fatty liver disease, most types of cancer,
sleep disorders, and depression. The "Western diet," rich in UPFs, is described as pro-
inflammatory and linked to metabolic dysfunction, cardiovascular disease, diabetes,
and colon cancer.
Microplastics and Nanoplastics (MNPs): The broader issue of plastic pervasive in
our environment, including through UPFs, is highlighted. These microplastics carry
over ten thousand chemicals and have been found ubiquitously in food, water, and
human tissues including arteries, brains, blood clots, liver, gut, and placenta. Their
presence in atherosclerotic plaque was linked to a 4.5-fold heightened risk of heart
attack, stroke, or death over three years, demonstrating an aggressive inflammatory
response.
Mechanisms of Harm and Gut Microbiome Connection The detrimental effects of UPFs
are partly mediated through their impact on the gut microbiome. While plant-based diets
promote a healthy gut lining and the production of beneficial short-chain fatty acids (SCFAs)
that reduce inflammation, high red meat intake, often associated with omnivore diets high in
UPFs, can reduce SCFAs, induce a "leaky mucosa," and lead to the production of pro-
inflammatory metabolites like trimethylamine N-oxide (TMAO). This shift in microbial
profiles toward species associated with inflammation and adverse cardiometabolic health is a
key finding.
Societal and Regulatory Challenges Despite the overwhelming evidence of harm, Eric
Topol's sources point out significant barriers to addressing the UPF problem, especially in the
United States. The U.S. has not joined countries like Brazil, Israel, or Chile in issuing
guidelines against UPFs. This inaction is attributed to the "supersized chokehold influence"
of multinational "Big Food" corporations on the Department of Agriculture, with their
lobbying expenditures double that of the tobacco and alcohol industries combined. The Food
and Drug Administration (FDA) is also noted for its slow response in regulating potentially
toxic constituents, as seen with the delayed banning of additives like brominated vegetable
oil, Red Dye No. 3, and propylparaben, which are already prohibited in Europe and Japan.
Topol suggests that over time, UPFs will likely be regarded akin to cigarettes, with their
dangers having been suppressed for decades, advocating for regulations like conspicuous
labeling to spotlight their risks.
Mitigation and the "Lifestyle+" Approach For healthy aging, it is crucial to restrict UPFs
in one's diet to the lowest level possible. Practical advice includes reading food labels to
avoid additives and fake sugars, choosing items with as few ingredients as possible, and
focusing shopping on the perimeter of grocery stores where fresh foods are typically found.
Using resources like the Open Food Facts app can also be helpful.
In essence, Eric Topol views UPFs as a critical component of what he terms "lifestyle+"
factors. This expanded view of lifestyle goes beyond just diet, exercise, and sleep to include
environmental conditions like exposure to toxins. While Topol acknowledges the controversy
surrounding broad screening for conditions like Alzheimer's based on single biomarkers, he
underscores that markers like p-Tau217, whose levels can be influenced by factors including
lifestyle (e.g., exercise reducing p-Tau181, which correlates with p-Tau217), can be valuable
for comprehensive risk assessment and for preventing or significantly forestalling
conditions like Alzheimer's disease at the individual level. The evidence consistently
points toward the overwhelming advantages of a well-guided healthy lifestyle in extending
healthspan, making interventions targeting UPF consumption vital for a healthier future.