Ultraprocessing Hits the Popular Press

I am thrilled to report that the discussion about ultraprocessed items has finally reached the popular press in a big way. This past week Jancee Dunn, a wellness columnist for the New York Times, wrote a week-long series about different aspects of ultra processing, beginning with her love of sprinkle-covered sheet cake. Then Reuters covered California governor Gavin Newsom’s recent executive order focusing on reducing consumption of packaged snacks and sugar-containing beverages, and investigating the effects of synthetic food dyes. This order cited a 2025 Dietary Guidelines Advisory Committee report showing that 73% of American adults aged 20 or older are overweight and/or obese, and 38% of children and youth aged 12-19 are pre-diabetic. 

These numbers have been breaking my heart for a long time, and so I am glad that they are finally being shared more broadly. 

Jancee Dunn defines ultraprocessed items as those which cannot be made in a home kitchen, whether due to a requirement for ingredients or machinery that are not normally found in the home kitchen. I have written about various definitions for ultra processed items, including this one, on many previous occasions.   

If your ancestors would not recognize a particular item as food (e.g., artificial sweetener), it probably isn’t. If your ancestors didn’t eat it, it is unlikely to be food (e.g., maltodextrin). If the edibles industry has to tell you what time to eat it or how to use it (e.g., breakfast syrup), it probably isn’t food.

Ms. Dunn reports that “these kinds of foods” have become ubiquitous in the United States, and states that “experts say they appear to be taking a toll on our health.” I would take issue with both of these statements. Firstly, as my regular readers know well, I have recommended for some time now that reporters, writers, journalists, editors, cooks, and other food professionals stop calling them food. Food nourishes. And secondly, at this point the research has shown unequivocally that they are taking a serious toll on our health. 

She reports that the journal Nature Communications estimates that close to three-quarters of the food supply in the U.S. is ultraprocessed. One study showed that individuals whose diets consisted primarily of ultraprocessed items (i.e., most Americans) consumed 500 more calories daily than those who ate a more nourishing diet. And an extensive study that I reviewed in these pages in the past year showed that a diet high in ultraprocessed items showed a strong connection to heart disease, type 2 diabetes, and mental illness. 

In response to these efforts, I decided to send a letter to the editor:

“Dear Jancee Dunn — I am so glad to see this conversation entering the popular press. Ultraprocessed items are not “kinds of food,” and they do not “appear to be taking a toll.” The research shows that they are in fact taking an enormous toll. I would urge you to consider not calling them food at all. Food nourishes; manufactured calories entertain. 

I agree that it is not necessary to remove them all from our diets all at once, especially if they currently take up a large percentage of the calories you eat on a daily basis. Small changes are best, probably because they are likely to be more sustainable. And failure is stressful, which may end up erasing any progress you’ve made. 

So entertainment is fine. It’s just not food.”


Giving Your Body the Help it Needs

Some years ago, when my patient, Mrs. Price, heard me say that her blood sugar measurement had come back from the lab at 204, a single tear ran down her cheek as she said,  “My eldest granddaughter is getting married next year.” A blood sugar measurement over 200 is one way to confirm a diagnosis of diabetes. Both of Mrs. Price’s parents had died in their 60’s from complications of uncontrolled diabetes, or chronically elevated high blood sugars. This is what I told her. Continue reading


Learning to Keep Your Blood Sugars Normal

As a doctor, it’s easy enough for me to think I understand a disease state, and then to know how to manage it with medication to be taken two or three times daily. I spent hours and hours studying that problem. I talked with patients who were diagnosed with that illness, and learned how it changed their lives. But it’s still not the same as having someone close to you diagnosed with it. Continue reading


Defining Diabetes

Diabetes is a complex disease whose hallmark is elevated blood sugars. Persistently uncontrolled diabetes causes devastating and costly complications. My former patients knew that I would pay any price, whether it involved medication or not, to keep their blood sugars in the normal range. No matter what it costs to keep blood sugars normal, let’s be honest: It costs a lot more not to. We continue to see skyrocketing costs of medical care for patients with diabetes and associated complications. But prevention is not just the most economical approach; it’s also the most humane one.  Continue reading