Oct 23, 2023, 3:00 AM ETInterview

The Junk Food Doctor: "THIS Food Is Worse Than Smoking!" - Chris Van Tulleken Ultra-Processed People

Ultra-processed food (UPF) has overtaken tobacco as the leading cause of early death globally, responsible for 22% of all deaths.
In the UK, 25% of children are living with obesity, and the average five-year-old is 9 centimeters shorter than their peers in countries with healthier diets.
A pandemic of diet-related diseases (obesity, diabetes, dementia, depression, cardiovascular disease, and cancers) is driven by a food system where 75% of global calories come from six companies.
Dr. Chris Van Tol argues that the "calories in, calories out" model is scientifically redundant for population health because sustained activity does not significantly increase total daily energy expenditure due to the body's "fixed energy model."
Personal responsibility and willpower are deemed "morally, scientifically, and economically redundant" as primary solutions, as the ability to resist food correlates more strongly with poverty and deprivation than innate character.

UPF is defined by an industrial process that reduces commodity ingredients (corn, soy, rice) into powders, pastes, and oils, which are then recombined with additives, colors, and texturants to create products with intellectual property value and long shelf lives.
Unlike traditional processed foods (e.g., butter, cheese, fermentation), which have existed for millennia, UPF is engineered to be consumed to excess by manipulating "bliss points" of salt, sugar, and fat.
Products are subjected to a "Darwinian" focus group evolution where formulations are tweaked until they are eaten 5% faster than competitors, prioritizing speed of consumption over nutritional value.
UPF is mechanically soft and energy-dense, allowing consumers to ingest large volumes of calories before satiety signals (hormones released during chewing) can trigger the brain to stop eating.
The food industry's primary incentives are financialized (share buybacks, debt) rather than public health, leading to the suppression of health proposals at shareholder meetings.
Many products marketed as healthy (e.g., Cheerios, Diet Coke, Actimel) are classified as UPF due to ingredients like modified starches, artificial sweeteners, and added vitamins used to make false health claims.
Artificial sweeteners are metabolically confusing, often failing to aid weight loss and potentially being more harmful than sugar itself, while also negatively impacting the microbiome.

In a controlled experiment, Dr. Van Tol increased his UPF intake from 20% to 80% of calories, resulting in rapid weight gain; had the diet continued for a year, he estimates he would have doubled his body weight.
Brain scans from the experiment showed increased connectivity between automatic habit centers and reward/addiction centers in the brain after a UPF diet.
The experiment disrupted hormonal satiety responses, leaving hunger hormones "sky high" at the end of meals, forcing the subject to eat despite fullness.
Dr. Van Tol developed a visceral disgust toward UPF midway through the experiment, a psychological shift he compares to the "uncanny valley" where the food no longer registers as edible.
The diet caused a vicious cycle of sleeplessness, anxiety, and constipation, driving further overeating as a coping mechanism for stress and physical discomfort.
Twin studies cited by Dr. Van Tol demonstrate that obesity genes are expressed at much higher rates in low-income households, suggesting poverty triggers the genetic predisposition to obesity.
A historic study by Clara Davis (1920s) showed that children given only whole, unprocessed foods self-regulated their intake to meet nutritional needs, with one child drinking cod liver oil until rickets healed, then stopping completely.

Poverty is identified as the primary driver of poor diet, with 60% of diet-related disease potentially resolved by eliminating poverty.
Low-income populations often lack the infrastructure (fridges, stoves, pots, knives) and time required to cook whole foods, making UPF the only viable option.
The food environment is described as a "nanny state" run by transnational corporations that exert control through 360-degree marketing, including direct messages to children's phones.
Current traffic light labeling systems are deemed insufficient and confusing, often highlighting low sugar/fat content while ignoring the UPF status of the product.
Major health charities (e.g., Diabetes UK, British Nutrition Foundation) are significantly funded by UPF manufacturers, creating a conflict of interest that stifles public health policy.

Dr. Van Tol proposes treating the food industry like the tobacco industry, suggesting an end to corporate funding of health policy and the implementation of mandatory health warnings on UPF packaging.
He advocates for "light regulation" focused on labeling, removing industry influence from policy-making, and ensuring real food is affordable and available to the poor.
While acknowledging individual agency, he suggests that for those with an addiction to UPF, the most effective strategy may be abstinence or achieving a state of "disgust" similar to quitting smoking.
Optimism is derived from the existing model of tobacco control, the existence of non-profit food companies, and the growing public rage regarding the physical and intellectual stunting of children.
A key psychological strategy for families is to stop "nagging" loved ones about their weight, as nagging creates stress and disempowerment, whereas stopping the nagging allows individuals to regain agency over their own health.
The book concludes with a call to view food preparation not as a chore, but as a connection to ancestral culture and a way to foster family bonds, contrasting the "scramble" of modern life with the intentionality of traditional cooking.