After reading Ultra-Processed People by Chris Van Tulleken, I felt compelled to summarise the key insights regarding ultra-processed food (UPF), its widespread consumption, and its impact on both physical and mental health. One of the most striking revelations from the book is that the primary concern with UPF lies not in its nutritional composition but in the extent of its processing.

What Constitutes Ultra-Processed Food (UPF)?

The definition of UPF can be complex, but in simple terms, it refers to food products that are packaged in plastic and contain at least one ingredient not commonly found in a standard home kitchen. Notably, even products labelled as organic, free-range, or ethically produced can fall into the category of UPF.

The Science Behind UPF’s Stability and Appeal

One reason UPF is so prevalent is its ability to maintain a consistent texture, taste, and appearance over time. For example, fast-food burgers appear resistant to decomposition due to the presence of emulsifiers and preservatives. Store-bought ice cream can be transported across various locations while maintaining its perfect consistency, thanks to the addition of gums, emulsifiers, and glycerine, which prevent ice crystal formation. Similarly, supermarket bread often contains added wheat protein to enhance its consistency and reduce production time, making it significantly cheaper than artisanal alternatives.

A particularly interesting case is that of Pringles, which were once classified as a cake rather than a crisp due to their manufacturing process. Since Pringles are made from a dough rather than whole sliced potatoes, they initially qualified for a value-added tax (VAT) exemption. However, this classification was overturned in 2009, and Pringles are now correctly taxed as crisps.

The Hidden Dangers of UPF Additives

Many UPFs contain artificial sweeteners, which are often assumed to be a healthier alternative to sugar. However, research suggests that sweeteners can disrupt insulin response in a manner similar to type 2 diabetes. Consuming artificially sweetened foods may also increase cravings for sweet flavours, ultimately leading to higher UPF consumption.

Other additives, such as emulsifiers (which prevent ingredient separation) and maltodextrins (which enhance texture and shelf life), may negatively impact gut microbiota. Some studies suggest these substances contribute to inflammatory bowel disease and other chronic inflammatory conditions.

Health Risks Associated with UPF Consumption

The primary health risks linked to UPF consumption include cardiovascular disease, depression, cancer, type 2 diabetes, high blood pressure, fatty liver disease, irritable bowel syndrome, and weight gain. While much research focuses on obesity, studies have shown that UPF consumption is strongly associated with these conditions, independent of caloric intake.

Between 1980 and 2015, obesity rates in the UK and USA doubled, while in China and Mali, they increased by 800% and 1,550%, respectively. While multiple factors contribute to these trends, the global fast-food industry expanded by 30% between 2011 and 2016, further increasing UPF consumption.

A British Medical Journal study found that a 10% increase in UPF consumption correlated with a 10% increase in overall cancer risk and breast cancer. Even after adjusting for sugar, salt, and fat content, the link between UPF consumption and cancer remained statistically significant. Similarly, a study published in Neurology found that increasing UPF intake by 10% was associated with a 25% higher risk of dementia and a 14% increased risk of Alzheimer’s disease. Another large Italian study indicated that individuals in the highest quartile of UPF consumption had a 26% increased risk of mortality compared to those with the lowest intake. A UK-based study of 60,000 participants found a 22% increase in all-cause mortality among high UPF consumers.

The Economic and Social Challenges of Reducing UPF Intake

Eliminating UPF from one’s diet is a significant challenge. Even with conscious effort, most individuals may still derive approximately 20% of their calories from UPF. Currently on average, 60% of the population’s diet consists of UPF, with one in five individuals obtaining 80% of their calories from such foods.

Cost remains a major factor in UPF consumption. A 2,000-calorie diet based on minimally processed foods is approximately 50% more expensive than one consisting primarily of UPF. Research indicates that if lower-income households adhered to national healthy eating guidelines, they would need to allocate nearly 30% of their disposable income to food.

The Addictive Nature of UPF

Many experts compare UPF consumption to addiction. The author’s own experience supports this notion; when he eliminated UPF from his diet, he experienced intense cravings and found UPF-laden foods to be highly desirable, similar to a smoker yearning for a cigarette. His comparison to the sensation of eating Coco Pops is particularly telling: the first spoonful brought immense pleasure, but by the third, the enjoyment had faded, leaving only the compulsion to satisfy the craving.

During a four-week diet consisting predominantly of UPF, he experienced increased salt intake, leading to excessive thirst and frequent urination. He also struggled with sleep disturbances, anxiety, constipation (due to low fibre intake), and weight gain. By the end of the experiment, he had gained 6 kg. If such a diet had been maintained for a year, his body weight could have doubled. MRI scans of his brain following the experiment indicated changes in neural pathways associated with food intake, reinforcing the theory that UPF alters brain function and potentially leads to long-term changes.

Environmental Impact of UPF

Beyond its health consequences, UPF production has significant environmental implications. The demand for UPF has contributed to carbon emissions, deforestation, and a loss of agricultural biodiversity. To maximise efficiency and profitability, food production has become increasingly centralised around a limited number of crops and livestock. Today, 75% of the world’s food supply is derived from just twelve plant species and five animal species.

The environmental cost of meat production is particularly concerning. Ultra-processed meat accounts for 7% of the average UK diet, whereas fresh or minimally processed meat accounts for only 5%. The industrial farming of chickens, for instance, has drastically reduced their lifespan, 95% of chickens consumed in the UK are slaughtered at just six weeks old, whereas pet chickens can live for up to six years. 

The heavy reliance on antibiotics in animal farming has also contributed to rising antimicrobial resistance. According to the English Surveillance of Antibiotic Prescribing and Utilisation Report (ESPAUR), published on November 14, 2024, there has been a 3.5% increase in antimicrobial resistance in England. While policies exist to reduce antibiotic use in UK livestock, imported meat is not subject to the same regulations.

Conclusion

The findings from Ultra-Processed People highlight the significant health, economic, and environmental consequences of UPF consumption. While eliminating UPF entirely is impractical for most individuals, reducing intake where possible may offer significant health benefits. As awareness of UPF’s effects grows, policymakers, researchers, and consumers must collaborate to promote healthier and more sustainable food choices.

Dr Krishan Joseph