Big Food: The Industrialization of What You Eat

What does it mean to be nourished? The word nutrition, related to “nourish,” comes from nutrire (Latin), meaning to feed, support, nurture, and also nurse. “Food,” from foda (Old English), is related to “fodder” and “feed,” and means nourishment or fuel. The purpose of food is to nourish. There is controversy about what constitutes good nutrition, but most successful strategies recommend increasing high-fiber foods like produce, legumes, and whole grains, while simultaneously decreasing ultraprocessed items like chips, commercially baked items, and “fast” food. 

The emergence of ultra processed items as a major component of the American diet derives from several developments. The supply, distribution, preparation, and eating patterns of food have changed markedly in the past century. The drive to decrease consumer costs while maximizing profits has markedly decreased the nutritional quality of the food supply. The majority of items eaten in the United States today — eaten in the home or out — are prepared, processed, or manufactured by individuals unknown to the purchaser. Food preparation has become largely an anonymous enterprise: the consumer does not know the cook, and the cook does not know the consumer. Before the 20th century, virtually everyone ate meals prepared at home by family members, and those meals were composed of fruits, vegetables, legumes, nuts and seeds, fish, eggs, meats, poultry, dairy (milk, cream, yogurt, butter, cheeses), and whole grains. 

Partially hydrogenated fats, developed for the soap and candle industries, entered the commercial baking enterprise in 1911. High-fructose corn syrup erupted as a major ingredient in the early 1970s. Maltodextrin, modified food starch, vegetable shortening, and synthetic coloring agents simply did not exist in food, if at all.

The evolution of ultraprocessing to create the majority of items in the standard American diet is also attributable to changes in advertising and merchandising. Re-appropriating words that once described traditional foodstuffs to describe new inventions is a common theme. Consider the word “wheat.” Whereas “wheat” once meant the entire grain, including bran, endosperm, and germ, revised usage refers only to the white endosperm. The original product is now “whole-grain wheat.” When words are appropriated to describe ultraprocessed versions of foods, traditional staples require new descriptors. Terms like “organic,” “pesticide-free,” “wild,” “free-range,” “whole,” “old-fashioned,” “pastured,” and “hormone-free,” are necessary only because their historic names have evolved to mean something entirely, industrially, different. 

Consider, too, non-dairy creamers, neither of whose first two ingredients, high fructose corn syrup and partially hydrogenated vegetable oil, requires refrigeration. Nevertheless, supermarkets display these items in coolers, adjacent to the dairy products whose use they are meant to replace. The low cost of raw materials for “coffee whiteners,” lowered further by government subsidies, makes them exceedingly profitable, particularly in comparison to milk and cream. Where the system incentivizes profits over nutrition, the public’s health suffers the consequences.

How does one know whether an item is nourishing? “Eat the rainbow, “Eat close to the garden,” and “Eat nothing your ancestors would not have recognized as food” are various ways of saying the same thing: Eat real food.  


The Trouble With Angel Food Cake

Have you ever worked with someone whose actions made you hear your mom’s voice inside your head saying things like “Everyone gets a turn,” or even “Let’s be nice”? When my friend Dee’s kids complained about the seemingly unjust behavior of certain teachers or neighbors, she would suggest they consider them “negative role models.” Just as it’s important to have good examples in your life, it’s also valuable to have examples of behaviors you would rather avoid.

Year in and year out, I post recipes that have a lot going for them. I am always on the lookout for good examples of nourishing recipes made from whole foodstuffs, with plenty of produce, legumes, nourishing fats, and high-quality protein. Today I am trying a different approach: I am dissecting a recipe that has nothing going for it. This angel food cake mix is a negative role model. Its best use is as an example of what not to eat. Continue reading


Michael Pollan Knows What He’s Talking About

From time to time, when my journey into the mysteries of disease prevention was just beginning, I would discover someone whose work really spoke to me, who helped to clarify the things I was beginning to see, and who became a sort of personal mentor to me as I continued on the path. One of these people was Michael Pollan, who was catapulted to fame with his insightful and riveting books, especially The Omnivore’s Dilemma and In Defense of Food. He shared that Carlos Monteiro, a professor of nutrition at the University of São Paulo, was the first to label and define ultra-processed items. He said that whereas processed food could be made at home, ultra-processed items contained ingredients no normal person has at home, and required equipment you would find only in a factory. Touché.  Continue reading


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.  Continue reading


My Favorite Topic: Real Food

Almost all diets have one particular strategy in common, which is to increase the amount of real food that people are eating while simultaneously decreasing the amount of manufactured calories, including both stripped carbohydrates and the ultraprocessed oils invented in the 20th century.

Stripped carbohydrates are processed to remove the most nourishing parts, including the bran and germ. Other stripped carbohydrates include white rice, corn starch, corn syrup, and sugar. It is not a coincidence that white flour, corn starch and powdered sugar look exactly the same. We’ve removed the original identities of these products, so all that is left is a pile of white powder. Continue reading


Self Care is Being Kind to Yourself, plus Lentil-Vegetable Soup

I spent my days as a practicing physician teaching people to be kinder to themselves, and that kindness manifested itself in three spheres: 1) eating patterns, 2) activity patterns, and 3) rest & relaxation patterns. The goal is to make small, incremental changes that result in nourishing your heart and soul with better food, more movement, and quality rest and relaxation.  Continue reading


Fake Fruit Names for Your Breakfast Cereal

A while back I wrote a post about the high profit-margin-to-cost of the breakfast cereal business. Today I have more to say on breakfast cereal, not about the manufacturing process or profit margins, but about the pervasive use of fruit-related words in the naming of these products.

If I had just ten seconds to share advice on improving your nutrition, I suspect you already know exactly what I would say: Eat more fruits and vegetables. And I don’t think that would surprise anyone. We all know that fruits and vegetables are nutritional powerhouses, and we also know that everyone should be eating more of them, especially since most of us don’t eat enough produce to begin with.  Continue reading


Strategies for Improving Your Blood Sugars

This week I’d like to talk about the concept of diet-controlled diabetes. Sometimes, when a patient’s most recent bloodwork demonstrates a mild elevation in their blood sugars, their doctor offers them an opportunity to try to improve their sugars without medication. If the patient is able to bring their blood sugars into the normal range through changes in the way they eat, perhaps along with increasing their activity levels to some extent, the doctor diagnoses this patient with what they term “diet-controlled diabetes.”  Continue reading


An Oatmeal Hierarchy (with recipe)

Like many other messages of its kind, Americans and other consumers of the standard Western diet have internalized the idea that oatmeal is “good for you.” Not all oatmeals are alike, however, and it is no surprise at all that the ultra processed items industry has identified a number of objectionable ways to influence the manufacture of oat-containing edibles. Today’s post provides more information on various kinds of oatmeal and related items available to consumers, beginning with instant oatmeal, the most highly processed product, and ending with steel-cut oats, the least processed form of oatmeal.  Continue reading


Is it Really Food?

While talking with patients about how to improve the nutritional value of their meals, we used to talk about real food that had not been processed, refined, stripped, polished, fortified, enriched or otherwise modified. Fruits, vegetables, legumes, nuts, seeds, grains, fish, eggs, dairy products, and meats. And that’s about it.

Here are some guidelines: The first is not to eat anything you have to be told is food. If you have to be told it’s food, it isn’t. Like “processed American cheese food.” Talk about truth in advertising. Some products at the supermarket have names that have nothing whatsoever to do with food. Like Miracle Whip®. Or Cool Whip®. These are not foods either, and that’s why I’m not buying. Continue reading