Once nuance is that they seem to have grouped together all ultra-processed plant foods into one category, everything from tomato sauce to tofu to sodas (see supplement: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7...). The nutritional profile of tofu and soda are quite different, but the study measures total consumption in calories, so sodas are going to heavily skew that number.
I wonder if that makes enough of a difference (e.g. is someone who eats a lot of ultraprocessed noodles with tofu and tomato sauce going to have similar cardiovascular outcomes as someone who chugged a 2L of coke a day?)
I'm someone who's been vegan for 15+ years, but lately I shifted about 50%-70% of my meals to a super-artificial ultra-processed food product (https://huel.com/products/huel-instant-meal-pots) that is supposed to "healthy" in that it contains all the macro and micro nutrients a person supposedly needs, in a relatively tasty and satiating 400kcal meal. I wonder if that would still have the same risk as drinking 400kcal of soda or eating potato chips? Heh, maybe it'll save me from diabetes only to kill me from heart disease. Alas.
They consider tofu as ultra-processed food? That doesn't make much sense - it's just boiled soybeans which are then ground and mixed with coagulants (such as magnesium chloride, which you can get from seawater). It's about as much "processed" as cheese.
Hmm. I can't tell whether this is a mistake, disagreement, or ambiguity in the NOVA classification system that the paper claims to use. Their Appendix A, Table S1 clearly lists as ultra-processed foods: "Meat alternatives: Vegetarian sausage/burger; Tofu/tempeh/TVP/soya mince; Quorn". I would think all those things are quite different to each other, but not to this study's classifications.
I was unable to find an authoritative source on what the NOVA classification of tofu actually is, or how the NOVA classification system methodology even works. Secondary and tertiary sources on the internet disagree with each other, and ChatGPT cites Brazilian institutions like "NUPENS" whose websites are on Google but seem to be either dead or inaccessible from the US.
Edit: There seems to be a third-party database, https://world.openfoodfacts.org/cgi/search.pl?search_terms=t..., that lists many tofus in category 3, "processed" (because they have salt and oil added) or 4, "ultraprocessed" (because of gelling agents).
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But even excluding tofu, they also consider things like bread (yeast and wheat?) to be ultra-processed, or potato wedges, or fruit juices, or canned vegetable soups, along with ketchup.
To be sure, many of those CAN be commercially processed, but I think this particular study might be trying a bit too hard to lump together a bunch of ambiguous foods in order to try to find power in their stats? It's hard to trust a dietary analysis that treats sugary sodas the same as pasta sauce or whole-grain bread...
This paper is based on garbage data: 2-4 voluntary food surveys per participant, reflecting 24-hour windows, separated by a median of 9 years from the outcome.
Try to recall everything you ate in the last 24 hours, including quantities of calories by food group. Accurate? Now, imagine trying to correlate this with a health outcome a decade from now. On top of that, imagine that your study participants can just skip reporting anything at all if they don't feel like it. Do you think there might be a bias in the people who respond? That there might be a bias in the people who "remember" eating large quantities of plant-based foods? That there might be a bias in the people who respond to follow-up?
In a just world, these kinds of nutritional epi papers wouldn't be publishable. No matter how many co-variates you put in the regression, there's simply no way to eliminate the bias.
I think you are approaching this from the wrong direction.
Small complex long-term effects in humans are fundamentally inaccessible to the kind of science that collects and analyzes data. Either the necessary data cannot be collected at all, or collecting it would be too expensive, time-consuming, and/or unethical to be worth it.
When the truth is inaccessible, science focuses on establishing the boundaries of what can be known. You collect the data that can be collected and see what can be determined from that. Or you reuse data that already exists and try to make new justifiable conclusions from that.
> Small complex long-term effects in humans are fundamentally inaccessible to the kind of science that collects and analyzes data. Either the necessary data cannot be collected at all, or collecting it would be too expensive, time-consuming, and/or unethical to be worth it. When the truth is inaccessible, science focuses on establishing the boundaries of what can be known.
That requires reliable data. If the only data you have is hopelessly confounded, then you don't just shrug and accept it as "truthy" because it's dressed up like science and is published in a journal, and hey, that's the best you can do anyway.
Science is about the quality of the methodology you use, not the grandeur of the institution that surrounds it. If your data doesn't answer the question, then it doesn't answer the question.
(For whatever it's worth, I'm biased in favor of the hypothesis, but crap experiements are crap no matter what I believe.)
This was not an experimental study, as the word "biobank" in the abstract should have made clear.
Biobanks are about collecting more detailed data on more individuals than would be possible for any particular study, and spending a lot of effort to ensure the quality and consistency of the data. Any conclusion you can make from biobank data is a hypothesis likely worth investigating. And publishing, because further studies would likely take years.
You would then collect new data designed to answer the specific question in your subsequent study. But due to financial constraints, that new data would likely be less detailed, smaller in scale, and of lower quality.
I'm thankful that the paper clearly defines exactly what UPF food is, with a reference, which is something sorely lacking from popular media on the topic:
> UPF, the fourth group of the Nova classification system, are industrial formulations made by deconstructing whole foods into chemical constituents, altering and then recombining them with additives into products that are alternatives to the other three Nova groups and freshly prepared dishes and meals based on them.12 While these three Nova groups (unprocessed/minimally processed foods, culinary ingredients, and processed foods) include foods commonly found in traditional diets worldwide, some of which are associated with health and longevity, UPF is identified as a distinct group that poses health risks.
Its the Nova classification, something that I have previously only noticed in comments on news articles, rather than in the news articles themselves.
I feel like when people hear 'ultra-processed plant origin foods' people are thinking stuff like Beyond/Impossible meat, but really this study is saying people who eat lots of bread and confectionaries (by far the highest source of UPF in this study) have higher cardiovascular risk.
The participants of the study were recruited between 2009 - 2012, before most fake meat was a thing. Presumably it will get its own category in some future studies.
The other interesting thing is that soft drinks & confectionary were in the same category as packaged breads/buns. Are they so similar in terms of nutrition?
>>“Plant-sourced dietary patterns, as characterized by low consumption or complete omission of eggs, dairy products, fish, and meat, have been associated with a reduced risk of several chronic diseases, as well as a substantial reduction in impacts on the environment.4 There has been an increase in the consumption of plant-sourced alternative foods in recent years, with a two-fold increase in the proportion of people reporting consuming these products in the UK.5 In 2019, the UK Climate Change Committee recommended a 20% reduction in high-carbon meat and dairy products by 2030, with an increased consumption of plant-sourced products.6 These recommendations are in line with national and international guidelines for a healthy diet that guide the reduction of meat consumption, especially red meat.7 However, plant-sourced dietary patterns are heterogeneous and may differ widely in their dietary composition, type, and quality,8 and evidence has shown the potential protective effect of plant-sourced diets on CVD may vary accordingly.9, 10, 11
Modern plant-sourced diets may incorporate a range of ultra-processed foods (UPF), such as sugar-sweetened beverages, snacks, confectionery, but also the ‘plant-sourced’ sausages, nuggets, and burgers that are produced with ingredients originating from plants and marketed as meat and dairy substitutes.“
This contradicts the oft-cited truism that increase in PUFAs invariably leads to better metabolic outcomes. Much of what makes UPFs high-calorie is their fat content (normally, vegetable/canola oil). It seems like there are other mechanisms involved.
Pivot to the whole food plant based diet. 0
There’s some free recipes on forks over knives that I’ve made that were pretty good to cook in less than 30 minutes. Easy to meal prep too.
Does this control for total energy intake because it's a way more interesting result if it's not "people who eat plants eat less and non-overweight people have less risk of CVD?"
Now, from an individual’s and philosophical perspective, given probability of death is 1, of what use is small changes in cross-sectional rates of mortality?
I'm guessing you're young. One day surprisingly soon you'll hear about someone your age dying from something entirely preventable, and you'll get real interested in those small changes.
Your advice is a generation or two off, unfortunately.
Most people's grandparents were running households in the middle of the 20th century or later, and were already deep in the transition towards processed foods. Box cake, TV dinner, casseroles made from canned soup, canned/bottled soda, margarine... it all starts with the boom of consumerism, advertising, and expanded workforce in the second quarter of the 20th century and essentially becomes completely normalized by the fourth.
Your grandparents may still have known how to cook and eat the old way, and might have done it sometimes. but they were told they didn't need to bother and that the days of needing to were behind them, so they didn't do it as much and they didn't make sure their kids or grandkids even knew how.
Hell no my grandparents ate like crap compared to what's available today in the supermarket! Modern agriculture and transportation gives me far better options than they had.
Your advice will probably work for some age groups, but it doesn't for mine, unfortunately.
Absolutely not, my grandparents all had diabetes, heart disease, and just generally poor health for many decades. They all ate like complete shit and we're super stubborn about it - wearing it like a badge of honor.
I don’t know why anyone would find this surprising. Ultra processed foods are practically devoid of any meaningful nutrition. It’s not the calories We need to worry about, but the lack of vitamins and minerals that power the enzymes in our body that we need to worry about.
Edit to add: I guess people are down voting this because they’re misinterpreting what I’m saying. I’m not saying that you can eat all the calories you want, but you can’t metabolize calories if you don’t have the nutrition that powers the enzymes for the metabolism of the calories.
The reality is that a lot of modern folk knowledge around nutrition carries a legacy of the essentialism characteristic of 20th century science because that's both when "food science" was born and when advertising and consumerism changed everything about kitchens and dining tables.
Scientists during that period naively distilled hugely complex food traditions and foodstuffs to a conveniently quantifiable, finite list of essential "nutrients". Meanwhile, product designers began to call themselves food scientists and formulated consumer products that could be honestly said to deliver these nutrients and their marketing teams took that vision straight to the bank. Science figured out what all you really needed, and Nestle (et al) had product that gave it to you with the most convenience and flavor.
That sweeping and extensive cultural reprogramming, which came at the expense traditional food practices and the generational transfer of them, doesn't just shake off again because a few research studies suggest that gut biomes matter, or that whole foods matter, etc
It took 2-3 generations for it to normalize processed food and it'll likely take at least 2-3 generations to meaningfully recover. Hundreds of millions of households now exist without someone who even knows how to cook being a part of them. Trying to convince those households to give up on cans and boxes of convenient, tasty mush in favor of food that they have to actually handle and prepare is a big big task.
Devoid of meaningful nutrition would actually be super healthy all things considered given that for most of the developed world the #1 thing you can do for your health is eat less.
Vitamins and minerals can be replaced with supplements, the more interesting result is "are the foods we get a large portion of our calories from actively bad, why, and can we fix that like we did for trans fats?
Vitamins and minerals can't just be replaced with supplements, bioavailability is a massive part of nutrition. One can't just take pills and assume your GI tract will be able to absorb a majority of that like you're eating real food.
Many nutrients require other nutrients to even be absorbed in the first place. Many vitamins are fat-soluble, meaning they get to you through something fatty. Calcium is worthless if you don't get the vitamin D to help put it to use, things like that
and even further: some can't be absorbed by us directly at all and the bacterial flora in our gut must do that for us before we can benefit from it. Those bacteria must be supported and replenished, too.
Vitamins and minerals can 100% be replaced by supplements, but not all phytonutrients and fiber can. If you take cheap worthless forms of vitamins or minerals when better forms are available, that's on you.
Yes, the microbiotia need feeding, mainly via fiber. They synthesize whatever else they need on their own.
> If you take cheap worthless forms of vitamins or minerals when better forms are available, that's on you.
Is there some sort of readily available system/metric/standard that a normal consumer can use to evaluate the bio-absorbability in a bottle of vitamins? I know some of them have higher-than-recommended FDA daily values, presumably to make up for the availability, but... as with so much of the supplements industry, it all seems like mostly untrustworthy marketing?
Shouldn't it be possible to calculate (and label) dosage * absorbability of a particular source in pill form = effective dosage?
I don't know of any singular resource, but if you ask me here or in r[eddit]/FoodNerds about a specific vitamin or mineral, I will be happy to share what I know. You can message the mods there if you want with a specific question.
The FDA doesn't set the values, and be glad they don't because they're very corrupt in ways you wouldn't realize. If it were up to the FDA, every product that doesn't pay the FDA a bribe of $1 million for "certification" would be banned, and then everything would cost the consumer 10x. You would also then have to pay a useless licensed practitioner for the privilege of buying anything, typically at a dose that would be too low to improve health. The NIH ODS sets them, and you can read them at https://ods.od.nih.gov/factsheets/
There is no standard because each vitamin and mineral is unique and special. There are some heuristics, but they only go so far. For example, an ideal dose is often (but not always) close to the average of the minimum and maximum limits.
And believe me when I say that I do my best to keep the cost as low as possible while keeping the quality good enough.
Thank you! I swear people are acting like one, no one has ever thought of this before, and two that whole foods and the ways we prepare them are magically ideally bioavailable to us like plants give a shit.
> Vitamins and minerals can be replaced with supplements
No, you can't. Supplements often have either bad absorption or risk of overdose, because need to be associated with some other nutrient (fat, fiber, etc) or the absorption is regulated by something else.
If you're a reckless person who overdoses, or if you don't know a good form from a bad form, then your answer is no. If you are well informed and know how to safely seek effective products, then the answer is yes.
Like you don't even have to know all that much and the bar is crazy low. Even if your diet is absolute garbage it's unlikely you're actually deficient in anything.
I've just been accumulating daily supplements from dr recommendations over the
years — the good fish oil for my dry eyes, b12 because I don't eat much meat, high-dose turmeric because mild jaw inflammation, d3 because I'm light sensitive and don't go out in the sun enough, and a women's multivitamin.
I don't really think about my diet at all outside of roughly total calories and haven't gotten a bad bloodwork yet.
P.S. For dry eyes, besides decent omega-3s, these also help me:
* Dry vitamin A: 6667 IU per day in the summer, and 10k IU per day in the winter. Test its blood level every two years.
* Taurine: 2g/day before bed.
* Vitamin D3: 4000-5000 IU per day to prevent further damage to tear glands due to subclinical autoimmune attacks. Test its blood level every year or two.
Once nuance is that they seem to have grouped together all ultra-processed plant foods into one category, everything from tomato sauce to tofu to sodas (see supplement: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7...). The nutritional profile of tofu and soda are quite different, but the study measures total consumption in calories, so sodas are going to heavily skew that number.
I wonder if that makes enough of a difference (e.g. is someone who eats a lot of ultraprocessed noodles with tofu and tomato sauce going to have similar cardiovascular outcomes as someone who chugged a 2L of coke a day?)
I'm someone who's been vegan for 15+ years, but lately I shifted about 50%-70% of my meals to a super-artificial ultra-processed food product (https://huel.com/products/huel-instant-meal-pots) that is supposed to "healthy" in that it contains all the macro and micro nutrients a person supposedly needs, in a relatively tasty and satiating 400kcal meal. I wonder if that would still have the same risk as drinking 400kcal of soda or eating potato chips? Heh, maybe it'll save me from diabetes only to kill me from heart disease. Alas.