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Beyond the calories - is the problem in the processing?

Image: Adam Clark, Baked doughnuts, Flickr, Creative Commons Attribution-ShareAlike 2.0 Generic
Image: Adam Clark, Baked doughnuts, Flickr, Creative Commons Attribution-ShareAlike 2.0 Generic

This review paper argues that obesity and mortality in the United States could be reduced by limiting consumption of sugar-sweetened drinks and processed foods and meats, because of the tendency of processed foods to encourage people to eat more food (based on trials in people), and the inflammatory effect of emulsifiers such as carboxymethylcellulose and polysorbate-80 (based on mouse and in vitro studies, not studies in people).


Purpose of review

The purpose of this review is to describe the trends in dietary patterns and food quality over time along with the possible role of ultra-processed foods in obesity, chronic diseases, and all-cause mortality in the US population.

Recent findings

There is a rising obesity epidemic, corresponding chronic diseases, and increases in ultra-processed food consumption. In mice and in vitro trials, emulsifiers, found in processed foods, have been found to alter microbiome compositions, elevate fasting blood glucose, cause hyperphagia, increase weight gain and adiposity, and induce hepatic steatosis. Recent human trials have found ultra-processed foods as a contributor to decreased satiety, increased meal eating rates, worsening biochemical markers, and more weight gain. In contrast, Blue Zone, indigenous South American, and Mediterranean populations with low meat intake, high fibre, and minimally processed foods have far less chronic diseases, obesity rates, and live longer disease-free.


As the USA continues to industrialise, food has become more processed and cheaper and more convenient along with the coexistent rise in obesity prevalence. This review highlights the overall trends in food: mild improvements in dietary quality in higher socioeconomic populations, but no significant increases in whole fruit, vegetables, legumes, or nuts. Consumption of ultra-processed food is associated with weight gain and may contribute to metabolic syndrome and chronic disease. To combat this epidemic, we must create and disseminate detailed recommendations to improve diet quality and overall nutrition.



Laster, J. and Frame, L.A., 2019. Beyond the Calories—Is the Problem in the Processing?. Current Treatment Options in Gastroenterology, 17(4), pp.577-586.

Read the full paper here. See also the Foodsource building block What is ultra-processed food? And why do people disagree about its utility as a concept?

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