New book ‘Ultra Processed People’ is an eye-opening look at why we eat food that isn’t really food

Chris Van Tulleken, author of Ultra-Processed People, Knopf Canada

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When one of the most basic human impulses, hunger, arises in the 21st century, the question of “What shall I eat” is often answered by scrolling through glowing food delivery apps on our phones, or selecting brightly labelled pre-prepared items at the grocery store.

Occasionally, hunger is met by actually assembling raw ingredients into a meal, but more often than not, food has already been processed, seasoned, pre-prepared for our convenience. Chris van Tulleken, asks another question, “What are we eating?” in a new, unsettling and deeply important way.

In the U.K., he tells us, one in five people gets at least 80 per cent of their calories from a category known as ultra-processed food (UPF). In Canada, we share not only a head of state, but a diet heavy in UPF. A third question arises, “What is this doing to us?”

Tulleken, a practising infectious disease doctor, compares the world dominance of UPF to the ascendancy of some bacteria over others.

Dominant microbes are those that outcompete others for nutrients. UPF dominates our food landscape by winning the global race for money. It harnesses factory farming, industrially fractionates whole foods into substances that are modified and reassembled, produces edible products that are low cost, convenient, very tasty and have a long shelf life. These are distributed through the global supply chain, elbowing out less processed and less profitable foods from people’s diets.

As consumers, if we care to evaluate the relative “healthiness” of things we tend to do so in a reductionist way, just as much of dietary science has tried to do. The idea is that the components in the food are what matters. We read labels to identify products containing more substance viewed as laudatory (vitamins!) and less bad stuff (sugar, fat!).

Tulleken’s critique of UPF turns this mode of evaluation on its head, arguing that rather than the reductionist project of isolating out the “good” and “bad” components of food, we need to shift our focus to the degree of processing, industrial manipulation and marketing of what we eat. These may be the most powerful determinants of food’s health impact. Tulleken outlines the science that shows that, independent of nutritional content, ultra-processed foods strongly increase the risk of heart attacks, strokes, cancer, diabetes, dementia, depression and death.

For many of us, the subject of food is fraught territory, bound up in notions of personal responsibility, body image, health and often guilt.

Acknowledging this, Tulleken again wishes to shift our focus: from personal choice to a faulty system.

The most alarming chapter, which could have been an alternate title for the book, is titled “How UPF hacks our brains.” Some of the highlights: since UPF is soft, calorie-dense and convenient, we eat more of it than we would of other foods.

Having evolved in a competition for market share, UPF mismatches taste signals and nutrition content in ways that drive excessive consumption. The additives in UPF affect our satiety system directly and, for some people UPF is addictive, resulting in unavoidable binges. Healthy or unhealthy eating isn’t about sugar, exercise or willpower, Tulleken tells us, it’s largely about a food system.

Tulleken traces personal food journeys, including those of his twin brother and himself. He sketches places such as Eddie Rixon’s Oxfordshire beef farm where cows forage widely to achieve a complete diet, and Muana in northern Brazil, a community in which the arrival of Nestlé coincided with the arrival of pediatric type 2 diabetes.

Ultimately, both the food science and the critique of globalization are essential to understanding his argument: that UPF is a damaging, addictive product that exists within the context of a system and is not simply “food.”

The chapter, “What to do if you want to stop eating UPF” is short, a mere two pages at the end of the book. This is consistent with the overall ethos of the book: that the problem of UPF is systemic, and that the most important solutions must come from governments, scientists, and doctors holding the food industry to account.

However, one does feel that Tulleken is not completely resolved on the “what to do” piece. On one hand, he argues that policymakers, doctors and scientists need to see themselves as regulators, and that “The rules of the road have to be set by governments.” Yet, surprisingly, he writes that he doesn’t think the aim of policy should be for people to eat less UPF, but rather to have a better set of food choices.

One presumes that he holds a rationalist belief that given the right information and choices, people will choose what is good for them. There is a tension between this and his assessment that UPF is a harmful addictive substance, since liberal democracies do routinely regulate such substances — one of the aims being for people to consume less of them.

The great strength of “Ultra-Processed People” is to integrate concepts of detailed food science and global market forces, showing how these affect individual humans. Tulleken weaves these threads together in a way that is evidence-based, compelling and humane.

“Ultra Processed People” is a tremendously important book that will help readers choose less processed, better food.

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