Ultra-Processed People: The Science Behind Food That Isn't Food

Monteiro is a Brazilian-born scientist; professor at the University of Sao Paulo, Brazil; and author of 260 scientific articles. In 2010, Monteiro formalized the NOVA scale for classifying food according to the degree of its processing, as well as the definition of “ultra-processed food” as food made wholly or partly with chemicals and processes of an exclusively industrial nature. Monteiro developed the UPF concept from trying to solve an apparent paradox in the diets and health of communities in his native Brazil. Namely, between the 1980s and 2010, there had been an explosion in obesity rates and diet-related diseases. This was despite an increase in consumption of food conventionally recommended as healthy, such as grains and cereals. Monteiro postulated that rising obesity was not due to any changes in macronutrients consumed. Rather, Brazilians were increasingly eating a new type of highly processed, industrially produced food and eschewing traditional diets.

Van Tulleken builds on Monteiro’s work in Ultra-Processed People. He utilizes and develops Monteiro’s idea that the distinction between “good” and “bad” food, in terms of its impact on our health, should not be understood primarily in terms of nutrients. Instead, the health effects of food should be understood by the degree of a food’s processing and whether it has been made using novel chemicals and processes. In this way, van Tulleken is influenced by the challenge posed by Monteiro’s work to the nutritional philosophy of “nutritionism,” the idea that food can be seen primarily in terms of its macro- and micronutrient content. Relatedly, van Tulleken builds on Monteiro’s suggestion that food should also be understood according to its purpose. Van Tulleken explores in the text how the health impact of food transcends its specific nutritional content. Specifically, if a food is made for the sake of profit, it will also exist and be eaten within a context designed to promote excess consumption of that food. For example, that food product will be heavily marketed in a way that attaches it to certain subconscious and unrealizable ideals of human connectedness.

Hall is a British scientist and nutritionist. He devised a 2019 experiment involving 20 men and women to test Monteiro’s hypothesis that UPF causes obesity. Half of the participants ate an 80% UPF diet for two weeks while the other half ate a diet containing no UPF food at all. They then swapped so that the first group had the non-UPF diet and the second group had the UPF diet for a further two weeks. Each diet contained the same amount of salt, sugar, fat and fiber, and each participant was allowed to eat as much as they liked of their diet. After a month, the results showed that those on the UPF diet had eaten an extra 500 calories per day and had gained weight accordingly. In contrast, those on the non-UPF diet lost weight.

These findings gave scientific legitimacy to Monteiro’s NOVA scale for assessing food and his contention that UPF is responsible for diet-related disease. The findings were especially robust in light of the fact that Hall had initially been skeptical of Monteiro’s claims and had set out to disprove him. Hall’s research and this study influenced van Tulleken to investigate the UPF phenomenon in more depth. Specifically, Hall’s work led van Tulleken, in Ultra-Processed People, to ask why UPF might cause weight gain, as shown in Hall’s study, and to explore the causal mechanisms responsible.

Nestle is a Swiss-based multinational food and drinks corporation and one of the world’s leading producers of UPF. As highlighted in Ultra-Processed People, Nestle became notorious in the 1970s for its aggressive marketing of baby formula to mothers in low-income nations, suggesting that formula was superior to, and a replacement for, breast milk. Nestle had given formula to mothers for low prices or for free and then hiked up prices once mothers had stopped lactating and become formula dependent. These practices led to thousands of infant deaths due to infection and malnutrition, as many mothers were unable to find uncontaminated water to mix with the formula or afford enough of the formula to feed their children. Less well-known is how, in 2010, Nestle launched a “floating supermarket” along the Amazon River, selling its products to the towns and villages along the way. According to van Tulleken, this project caused serious diet-related health problems, such as diabetes and obesity, in communities previously unexposed to UPF.

Van Tulleken emphasizes how Nestle, and these two incidents particularly, epitomize what is wrong with UPF companies and the profit motive that drives them. In its pursuit of profits, Nestle disregarded the broader social costs of its actions and how its products would impact the health of its targeted communities. It did so with full knowledge of the vulnerability of these people to its marketing claims and to the quasi-addictive character of its products. Van Tulleken suggests that we can learn something from Nestle and its scandals. Namely, we can learn to properly regulate marketing claims and campaigns by UPF companies. 

Corn Oil ONE is an Iowa-based company that produces edible corn oil, COZ corn oil, from the “mash” used to make biofuel for cars. Corn Oil ONE is used by van Tulleken in Ultra-Processed People to highlight the serious deficiencies in the regulatory system governing the introduction of new chemicals into the US food supply. In theory, COZ corn oil could have been subjected to a full review by the FDA and formally recognized as a food additive. However, companies can also apply to have their new product admitted as GRAS, or generally recognized as safe, a far less stringent process.

Since 1997, companies can opt for “self-determination,” whereby they simply decide whether the product is safe themselves, without FDA tests. Corn Oil ONE chose this option after the FDA raised health concerns following Corn Oil ONE’s application for COZ corn oil to be accepted as GRAS. What this means is that COZ corn oil can be used as an additive in food in the US, even though it contains chlorine dioxide, a chemical with unknown health effects. Using this example, van Tulleken argues that the current system in the US of voluntary self-regulation is dangerous to consumers and needs overhauling.