Stem the Tsunami of Suffering From Metabolic Disease – Limit Ultra-Processed Foods in Our Food Supply
I am troubled watching an ever-increasing number of my friends, family, and colleagues suffering from debilitating illnesses. My observations are supported by facts: Americans have experienced a dramatic increase in chronic health conditions over the last 30 years. A 2019 study revealed that 88% of Americans are metabolically unhealthy, causing conditions that impact the quality of their lives. I am not a medical professional or credentialed nutrition expert – just a normal person looking for recommendations to improve my lifespan and my “health span.” My comprehensive search keeps pointing me to the same culprit at the root of this suffering – our suboptimal and degraded food supply.
Research shows a strong nexus between the poor nutritional value of our food supply and chronic metabolic diseases. Our standard American diet is dominated by ultra-processed food (UPF). UPF impacts hormones and the human gut microbiome causing inflammation in our bodies. Inflammation drives metabolic diseases including diabetes, non-alcoholic fatty liver disease, and heart disease. It is also correlative for cancer, dementia, autoimmune disease, anxiety, and many mental health conditions. These conditions lead to unnecessary suffering from diminished quality of life, aggressive behavior and early death.
Today, UPFs make up over 70% of the food items in a typical grocery store. Government policies – most notably subsidies on corn and other grains – incentivize increased production of high-fat meat and dairy products, seed oils, processed grains, sugar-sweetened beverages, and processed foods. The availability of cheap substandard ingredients influences food production practices that are not aligned with good nutrition. Moreover, processed food manufacturers manipulate foods to be hyper-palatable and have long shelf life, thus increasing UPF’s allure and affordability. These less nutritious food options are not obviously unhealthy – changes to food processing methods that make the standard American diet dangerous are often invisible to the consumer and are cloaked with sugar, salt, flavorings, and chemicals to make the food especially appetizing.
There are downstream impacts from the nutritionally deficient standard American diet. One is the cost to the health care system. The yearly cost of treating diet-related cardiometabolic diseases in the United States is estimated conservatively at $50 billion. Currently, 75% of all health care dollars are spent treating chronic metabolic disease and the associated disabilities. Obesity related absenteeism alone costs our nation an estimated $8.65 billion per year.
Our overprocessed food supply has especially negative impacts in low-income and food insecure communities. UPFs cost less because of the low-cost fillers and preservatives used in their manufacture. Not surprisingly, food options in disadvantaged neighborhoods are dominated by UPFs and generally make up a larger part of the diet of low-income families. As a consequence, the negative health impacts and suffering in these communities is magnified, further exacerbating existing inequities. Reducing the amount of UPF in our food supply and the resulting nutritional inequality is not just a medical and economic issue; it is also a social justice and quality-of-life issue.
Relying solely on encouraging personal responsibility to cut back on UPFs and eat a more whole food diet is not likely to be a successful strategy. Recent studies show that UPFs are highly addictive, activating the same brain reward pathways as tobacco and alcohol. The speed at which UPFs deliver carbohydrates and fats to the gut, and the combination of refined carbohydrates and fats have a supra-additive effect on brain reward systems which increases the addictive potential of these foods.
Similar to the education, regulation and litigation that helped to reduce consumption of other addictive substances such as tobacco, it is time to act boldly and swiftly to reduce UPF availability and consumption in the United States. Countries including Brazil, Chile, Mexico, and South Africa are implementing aggressive policies to reduce UPF consumption, and we should watch closely to see which policies are most effective and implement them in the United States. Some of these policies include taxes on sugar sweetened beverages and high-calorie nonessential foods, restricting UPF marketing to children including banning cartoon characters or animations on UPFs, prominent warning labels in advertising and on packages to identify UPFs, prohibiting sale or marketing of UPFs in schools, and increasing the proportion of whole food from local farmers available in schools.
Set forth below are interventions that should be implemented by government, the health care system, and individuals to reduce UPFs in our diets.
Government/Regulator Interventions:
Classify UPFs as addictive to support regulatory and policy efforts to reduce UPFs in our food supply chain.
Develop public health nutritional harm reduction strategies to address food addiction.
Require nutrition and food preparation education in schools beginning in primary school.
Reduce UPF purchases by government entities such as the Department of Defense, Veteran’s Administration, correctional facilities, public schools, publicly funded medical facilities, and employee cafeterias located in government-owned or leased facilities. Replace UPFs with less processed food in these facilities.
Regulate UPF advertising and sponsorships directed to children.
Require prominent front of package labeling to easily identify UPFs.
Health Care System Interventions:
Classify UPF food addiction as a behavioral addiction in the DSM-5.
Cover preventive medical exams and diagnostic tests to regularly evaluate metabolic health.
Cover treatment programs for food addictions.
Increase focus and resources on metabolic disease prevention.
Individual Interventions:
Significantly reduce sugar and refined carbohydrate consumption.
Reduce or eliminate alcohol consumption.
Choose grass-fed meat and dairy products, wild-caught fish, and pasture-raised eggs.
Reduce overall consumption of processed food, opt for whole food choices instead.
The current state of the metabolic health of Americans is a tragedy. Metabolic disease is causing unnecessary suffering and reduced quality of life, especially in the elderly and at-risk communities. We need to act boldly, and swiftly, to regain our nation’s health and one significant pathway to regain health is to reduce UPF in our food supply.
About the Author:
Virginia Gleason was a member of the 2022 Harvard Advanced Leadership Initiative Leadership cohort. Virginia applies wide industry experience to helping public entities create solutions to help alleviate suffering and promote public safety and wellness. A graduate of University of Oregon Law School, she began her career as a lawyer in private practice but moved to pursue her passion in public service, serving at four different law enforcement agencies. Virginia now focuses on organizational compliance with laws, regulations, professional standards, and ethical practices; utilization of data to increase the value and credibility of public services; practices that support inclusion; and risk management. She is an adjunct professor at the Seattle University Department of Criminal Justice and Forensics and an instructor for FBI-LEEDA. She is an avid soccer fan and long-time player in adult soccer leagues.