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The Dose Transcript for May 2, 2024

Host: Brian Goldman

BRIAN GOLDMAN: Hi, I'm Dr. Brian Goldman. Welcome to The Dose. Here is a fact about the food we eat. We Canadians consume nearly half of our daily calories from ultra-processed foods. That's according to recent research commissioned by Heart and Stroke. Some of it may surprise you, but before you eat another bite, let's consider the implications. So this week, we're asking, how do ultra-processed foods affect my health? Hi, Jean-Claude. Welcome to The Dose.

JEAN-CLAUDE MOUBARAC: Hi, Brian.

BRIAN GOLDMAN: What is a surprisingly ultra-processed food that some of us don't know about?

JEAN-CLAUDE MOUBARAC: Well, a lot of juices and drinks on the market are ultra-processed or filled with colours and flavours. And most of those seem to be only juices, but they're not. They're ultra-processed drinks.

BRIAN GOLDMAN: Well, I want to hear a lot more about this. But before we begin, can you give us a hi, my name is? Tell us what you do and where you do it.

JEAN-CLAUDE MOUBARAC: Hi, my name is Professor Jean-Claude Moubarac. I'm a Canadian researcher, expert on ultra-processed food, and I work at the Department of Nutrition at University of Montreal.

BRIAN GOLDMAN: Let's start with the basics. What are ultra-processed foods?

JEAN-CLAUDE MOUBARAC: These are not the regular foods you process and you find on the market. These are formulation of industrial substances and additives that are carefully selected to create a product of consumption. So these substances are a lot of salt, sodium and fat, but also flavours, colours that are selected to make a product very appealing. Think, Brian, of a Dorito or a Coke or a box of cracker Jack or McNuggets. These products are easy to overconsume. They're very appealing, but nutritionally speaking, their products have a very low quality.

BRIAN GOLDMAN: The one that surprised me when I started looking at the list was alcoholic beverages.

JEAN-CLAUDE MOUBARAC: According to our latest work, alcoholic beverages are not anymore classified according to Nova. So this is something we need to cut out.

BRIAN GOLDMAN: Can you tell us about Nova?

JEAN-CLAUDE MOUBARAC: Yeah. So Nova is a classification of food that is using nutrition to classify the food according to the way they are processed. See, up to recently, the way we have classified food in nutrition was with the old ways, separating fruits from vegetables and grains and meat. But today, on the market, meat is not meat anymore. Yoghurt is not yoghurt anymore. So Nova allows us to consider the way industry process food before it gets into your kitchen. And so Nova will make the distinction between minimally processed yoghurt made with milk and an ultra-processed yoghurt made with colours, flavours and a lot of sugar.

BRIAN GOLDMAN: When we're talking about ultra-processed foods, how do fast foods figure into the conversation?

JEAN-CLAUDE MOUBARAC: Fast food like McDonald's and Kentucky Fried Chicken are places where you're going to find a lot of ultra-processed products. For example, the meat, the bread in the McDonald's burger are not the same type, the same bread and meat you will buy from supermarket and bake at home. McDonald burgers, Kentucky Fried Chicken are loaded with additives, and hence, they are ultra-processed and specifically crafted to make them irresistible.

BRIAN GOLDMAN: Before we start talking about the health effects, there's another term that I think we need to unpack, and that is nutrient density. What does that mean?

JEAN-CLAUDE MOUBARAC: Nutrient density is a term coined to talk about the amount of nutrients you will find in a food. For example, fruits, vegetables are natural food that contain a lot of nutrients such as vitamins, minerals. Think of nutrients as the alphabet. And in fruits, we find a lot of those nutrients. Now, in ultra-processed food, you will find a lot of nutrients as well, but they're of a different type than the one that you find in fruits and vegetables. So for example, you might find added minerals and vitamins to a breakfast cereal that is loaded with sugar. So nutrients are very important. But in nutrition, we need to go beyond nutrients to think about not just nutrients, but about food and food products. Because we don't buy nutrients, we buy food products at a store.

BRIAN GOLDMAN: Is it fair to say that ultra-processed foods tend to be high in calories and low in nutritional value?

JEAN-CLAUDE MOUBARAC: Yes, absolutely. Research we've done in Canada and elsewhere in the world shows very clearly that the more ultra-processed food you consume, the more energy you're going to consume, the more added sugar, salt and fat you're going to consume, and the less vitamins and minerals you're going to consume. So the more ultra-processed food that’s consumed, the less the general quality of your diet.

BRIAN GOLDMAN: What's the difference nutritionally, say, between a homemade cake, you know, a cake that's baked at home, and, say, one that's baked from a Betty Crocker cake mix or a Pillsbury cake mix or name your favourite cake mix?

JEAN-CLAUDE MOUBARAC: Will be honest, Brian, both version are high in sugar, right? We don't bake cakes and cookies, you know, because of their content in salt. So they're, you know, sugary food. But the difference is that the one that you'll buy from the store will contain a lot of additives and substances that you don't find in a regular cake. Your cake at home will be made with basic ingredients, ingredients like flour, sugar, milk, ingredients with which we have cooked for a very long time. Whereas the Betty Crocker or the commercial cake will contain gluten, will contain maybe mono glycerin, other types of additives that are not necessary in a cake and that will make you eat more. And so we have to be careful, looking at the list of ingredients and trying to buy a cake that is as close as the one that we would bake at home.

BRIAN GOLDMAN: Now, I want to ask you, how do ultra-processed foods or consuming ultra-processed foods affect our physical health?

JEAN-CLAUDE MOUBARAC: Research has shown in Canada and elsewhere that the more ultra-processed food is consumed, the higher is your risk of being obese, diabetic and having hypertension. Also, the higher your ultra-processed foods consumed, the higher is your risk for overall mortality. Ultra-processed foods also have been associated with depression, anxiety, different type of cancer. So overall, Brian, I would say that the more ultra-processed foods consumed, the less healthy people are. And the end result will depend on the type of ultra-processed food you're consuming. If you buy a lot of ultra-processed products that are sweet, you might develop diabetes. If you buy a lot of ultra-processed that are salty, you might develop hypertension. The baseline is that those products are loaded with salt, sugar and fat, and have a very low content in vitamins and minerals. So the impact on the body is highly detrimental.

BRIAN GOLDMAN: Jean-Claude, you mentioned several times the chemicals that are placed into ultra-processed foods. And I'm wondering, which is worse for your health? Those chemicals or the sugar and salt and fats that you've just talked about?

JEAN-CLAUDE MOUBARAC: It's neither. It's something else. It's the purpose. It's why are we ultra-processing food? Because fruits and vegetables, they have chemicals. You know, there's chemicals in every food we eat. But the purpose explains why industry is choosing certain type of additives and why it is using so much sugar in the food. The purpose is to make a product so appealing that you, Brian, and I will eat more and more. And hence, this is why they put so much sugar and salt. And this is why they use flavour and colours to really create a product that is appealing in taste, in colour, and one that we don't chew much on it. You know, ultra-processed food, they melt into your mouth, so you want to eat more and more. So I would say the purpose is the problem, the purpose of making a product so appealing that people will over consume it. Nature makes food for the purpose of life. And I think here, industry makes ultra-processing for the sole purpose of selling and making profit.

BRIAN GOLDMAN: Over consumption is the biggest risk based on what you're saying.

JEAN-CLAUDE MOUBARAC: That's what I think. Because, you know, sugar might be the problem today. But what happens if industry replaces the sugar with artificial sweetener? Well, we're going to have another problem associated with the replacement. So I think the purpose of creating a product that is appealing, this is something we need to think about and change because they're going to keep changing the ingredients to fulfil the same purpose.

BRIAN GOLDMAN: You mentioned briefly the impact of consuming ultra-processed foods on our mental health. Can you say more about that?

JEAN-CLAUDE MOUBARAC: This is something that is fairly new in research. We do see correlation between eating a lot of ultra-processed food and being depressive or very anxious, and we don't know which is causing what. For example, we know that when people are depressed, they tend to eat a lot of product that are high in sugar because it does have an effect on their mood. So we don't know if people are consuming a lot of those products because they feel depressed or eating a lot of those products end up creating depression. But there is a very close relationship between the type of food we eat and our moods and anxious and depressive symptoms. That's for sure. So we still need to know more about it. But I would ask people at home to think about the type of food they choose when they feel stressed or anxious. It's never fruits and vegetables, my friend.

BRIAN GOLDMAN: For me, it's chocolate, potato chips. You know, when we're talking about mental health effects, I'm also thinking about the addictive quality of some of these ultra-processed foods. Can you say more about that? How addictive are ultra-processed foods?

JEAN-CLAUDE MOUBARAC: That's a very good question because we still don't know for sure. But some researchers are proposing that ultra-processed foods have addictive properties and they affect our behaviour. And for example, the amount of sugar, salt and fat in those products are very well selected so that the products are easy to overconsume. So I'm convinced that in the purpose, there is an intention to make the product super appealing. We don't know for sure if those products are addictive by itself. So more research are needed. What is clear, Brian, is that people like you and I and people listening to us, we lose control over these products now and then. I mean, it's really easy to go through a bag of chips even if we don't want to. So there are products that are easy to lose control over. It remains to see if they are addictive by itself. But if we want to help people to eat less of those products, we need to think about the way they're affecting our behaviour beyond just the nutrition.

BRIAN GOLDMAN: What advice do you have for people looking to cut out ultra-processed foods from their diets? How should they do it? What should they do instead?

JEAN-CLAUDE MOUBARAC: The first and the most empowering thing you can do is to cook or to cook more, because cooking is the way we can choose our food better. When we cook and we choose food that are minimally processed, then we don't buy ultra-processed products. So the best way to avoid those products is to cook and then select foods that are either fresh or minimally processed. And this brings us closer to nature, closer to food. And it helps us developing a more, let's say, human relationship with food. Because if you think about ultra-processed food, it's not just in nutrition. It's also, like I said, the behaviour and how we act around those products. If people have kids at home, we know that when we show kids candies, they don't have the same reaction than when we show them fruits and vegetables. And this is of high concern to me, is that we as a society have lost sense of what food is, of what food comes from. And as we eat ultra-processed food, we distance ourselves from food and from nature. So I would say cooking, sharing cooking, talking about cooking to your friends and neighbours is what will, I think bring us back to a more human and healthy relationship with food. And it doesn't mean, Brian, that we need to cut ice cream or cake or cookies. It means that you need to cook them or buy them in places where people are cooking for real. Go to a restaurant where there's actually a cook, where there's real food being prepared, and shop in those places like where you’re going to find a lot of fresh food so you can support that sector of the market as well. People need to understand that when we buy ultra-processed products, the farmers, they get less profit than when we buy real food. And so our dietary choices have an impact on the economy of farmers. And we know in Canada, they're suffering a lot.

BRIAN GOLDMAN: Can you name a few examples of unprocessed foods that have high nutrient density that you would recommend?

JEAN-CLAUDE MOUBARAC: It's important to understand that in terms of diet, we need to eat a combination of food. So no food by itself will give you all the nutrient needed. So we need to talk about recipes and meals. And so when you combine fruits and vegetables and grain with meat and legumes, you have all the nutrients you need. If you combine rice with legumes and you put vegetables on it, you're good to go. See, the secret in cooking is the sauce, is all the vegetables that you'll find in sources that are less visible to the eye, but are so tasty and nutritious. So I would say herbs, plants, and combined food into a healthy recipe.

BRIAN GOLDMAN: Is it possible to avoid ultra-processed foods completely?

JEAN-CLAUDE MOUBARAC: It depends. If you like chocolate, for example, I would recommend to buy a real chocolate, not a Kit-Kat bar, which is a candy. If you like juice, I would say buy freshly squeezed juices. Because the thing is that ultra-processed are imitation of food. So if people crave and love yoghurt or chocolate or cookies, well, I would say go buy the real version of it. Then if the question is can we afford it, I would say yes, because the cheapest food are the one that are minimally processed, such as legumes and grains. Ultra-processed products are expensive when you think about it. Now, do we have the ability to cook? Well, it depends. But as a society, we do still have those skills. We need to share them, celebrate them, and maybe understand, Brian, that ultra-processed products are, like I said, they're imitation of foods. So once people understand that and start reading the label and reading the list of a product, they start understanding that we're being fooled. Nutella is not made of chocolate. It's made of sugar and oil. So I think ultra-processing is ultimately a parenthesis, I think, in our history, and hopefully, we can get around it sooner than later. But we'll see.

BRIAN GOLDMAN: Jean-Claude, you said that unprocessed foods are less expensive than ultra-processed foods, but that doesn't seem to be everybody's experience. And one of the reasons why they like, for instance, fast food, is that they perceive it's cheaper. They perceive that these mass produced products are less expensive than other less processed foods. Are you saying that that's incorrect?

JEAN-CLAUDE MOUBARAC: I think that's incorrect. Of course, Brian, there are certain types of fruits that would be very expensive, you know, during certain moment of the year. We can also say, honestly, that meat is expensive. But there are some foods that are much less expensive, such as rice, beans, vegetables. If you eat vegetables that are from the season and fruits, you'll find that it is much cheaper to buy all those foods and combine them into a meal than to buy the ultra-processed version, because the difference is that you need to put time and energy into your cooking. So industry doesn't tell you that when you buy an ultra-processed product, you also buy for the time and energy that you don't spend. Just to conclude, when I was young, my father used to bring me to McDonald's, and we could buy a Happy Meal for less than a buck. Today, a family of five goes to McDonald's. It costs, what, $60, $80. So I think it's much less. I mean, unless you go and buy just the ones that are on discount. So it's a question that remains to understand, but it's not necessarily more expensive to cook.

BRIAN GOLDMAN: We've been talking about what individuals should do. What steps do we need to take as a society to reduce our consumption of ultra-processed foods?

JEAN-CLAUDE MOUBARAC: That's a great question because we know that as people, we have limited power as long as the environment is unfavourable to healthy choices. So we need to ask government to put food and cooking at the centre of food politics. Because if we understand and agree that ultra-processing is detrimental to our health and to our economic system, then we need government to design policies so that kids have access to healthy meal in schools, so that we have access to a healthy meal in hospitals, at work. We need to think of ways so that we can make cooking more appealing, more interesting, more sustainable, more fair. And we need to have government to start thinking about policies, because there's so many contradiction in our food system that makes ultra-processed food more appealing, more abundant, highly marketed. And I think it's coming to kind of this reflection on how we change the food system so that we people can navigate a more healthy food environment.

BRIAN GOLDMAN: Well, Jean-Claude, I want to thank you for coming on to The Dose to talk to us about ultra-processed foods and the health effects and how to change your diet.

JEAN-CLAUDE MOUBARAC: My pleasure. And Brian, thank you for the invitation.

BRIAN GOLDMAN: Jean-Claude Moubarac is an associate professor in the University of Montreal's Department of nutrition. Here's your dose of smart advice. The term ultra-processed foods comes from the Nova Food Classification system, which was developed by researchers at the University of Sao Paulo, Brazil. Ultra-processed foods are ubiquitous in the Canadian diet. Examples include ice cream, potato chips, mass produced breads, breakfast cereals, cookies, carbonated beverages, flavoured yoghurts, instant soups, processed deli meats and fast foods. Ultra-processed foods have several issues that could affect your health. They tend to be high in calories from sugar and fats, but low in what experts call nutrient density. They lack vitamins and minerals unless those are added after the fact. These low nutrition foods also contain additives and ingredients including preservatives, emulsifiers, sweeteners, artificial colours and flavours. Research suggests that Western diets are rich in calories and poor in nutrients. Studies indicate that the higher the intake of ultra-processed foods, the higher the likelihood of obesity, type two diabetes and heart disease. A high intake of ultra-processed foods is also associated with an increased risk of death from cardiovascular disease. That kind of diet also increases the risk of sleep problems, anxiety and depression. You can decrease those risks by consuming more unprocessed foods. These include raw fruit and vegetables and whole grains. Healthy sources of protein include legumes and nuts, fish and seafood, skinless poultry, fat free or low fat dairy, and lean cuts of unprocessed meats. One of the best ways to lower the risk is to cook your own food using natural whole ingredients. It may take more effort on your part to eat healthy, but the benefits are well worth it. If you have topics you'd like discussed or questions answered, our email address is thedose@cbc.ca. If you liked this episode, please give us a rating and review wherever you listen. This edition of The Dose was produced by Sameer Chhabra. Our senior producer is Colleen Ross. The Dose wants you to be better informed about your health. If you're looking for medical advice, see your health care provider. I'm Dr. Brian Goldman. Until your next dose.

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How do ultra-processed foods affect my health? - Transcript

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