My first "NHS health check" showed so many "marginal" risk factors that just looking at the blood test results made me feel weak. Even normal exercise suddenly became taxing.
While trying to find out what was happening to me, I discovered that it was not just me. Major chronic diseases had increased in most of the developed and developing world, US life expectancy had fallen (Even before COVID), and life expectancy in the UK had ceased increasing. Of the many suggested causes, the rapid increase in the consumption of ultra processed foods seemed the one having the largest effect.
Given the suspicion surrounding many of the ingredients and processes that go into making these new types of food, I thought that a count of the number of suspect ingredients and processes would be the best estimate I could hope to make of the risks of eating different foods. So as to be able to compare counts of different foods made at different times, I standardized the count as follows...
Add 1 to this sum for each of the following characteristics which apply ...
Foods commonly eaten in low death rate "Blue Zone" areas of the world, and those which have been consumed for 50 years or more without problems and whose consumption has not doubled are also regarded as having evidence in favour of them. This applies to ...
Water (sometimes termed Aqua) counts as zero
Chopped vegetables, fruit, grains, legumes, fish, white meat, nuts, and eggs, where the individual pieces can still be seen, count as zero. The same ingredients, liquidized at home where the process can be monitored, can also be counted as zero.
Added vitamins and minerals count as zero, since they are assumed to have evidence supporting their addition.
Certain herbs and spices, for which positive evidence outweighs the negative, such as Garlic, Turmeric, and Cumin count as zero. Indeed, such spices or herbs could be kept in stock for adding to food as appropriate. However, the use of spices trebled from 1961 to 2017, and they can be toxic, so spices without positive evidence of health have a SIC-count of "1".
Each occurrence of an "E" number is counted as a 1. This is particularly important because of the way food manufacturers use these codes to disguise ingredients which shoppers see - perhaps rightly - as unhealthy. Examples of this include the use of E250, instead of its chemical name "Sodium Nitrate.
Even a healthy food can contain compounds which are unhealthy when extracted, purified, or converted and used for the benefit food manufacturers. However, this processing may not be obvious and the resulting ingredients list is likely to quote only the original healthy ingredient.
An example of this is "Cultured Celery Extract". Apparently, celery contains nitrates. While eating whole celery, these tend to be buffered by the Vitamin C it contains. However, some food manufacturers treat celery juice with a bacterial culture, which converts the nitrates into nitrites, which they then extract. This not only avoids then having to put nitrites on the ingredients list, but it also allows them to make various "pseudo" health claims. This is in spite of research showing that eating cured meat, is associated with a lower life expectancy and arguments relating this to the nitrites present in these foods.
Although "Cultured Celery Extract" is not allowed in the EU, and some manufacturers do genuinely respond to health problems, some fear Brexit will allow "Cultured Celery Extract" into the UK. I can't even be sure that manufacturers have not been pressurized into using other ingredients in unhealthy ways. Thus celery extract and any other ingredients which are not known to be healthy and cannot be seen in the product, have to be counted as a 1.
Where foods have data showing them to be particularly harmful, such estimates of harm are likely to be more accurate than the SIC-score. It is therefore better to make decisions on the basis of this more direct evidence. As more research is completed, this will hopefully include more and more areas. However, as far as I am aware, it currently only includes...
Life expectancy in the US has dropped and that in the UK almost stagnated!
Since life expectancy is the most objective measure of overall well being, that I can think of, I thought that changes in it should be among the easiest, and perhaps most important, problems to identify, and avoid.
For instance, the drop in the US "Period Life Expectancy" from 78.94 in 2013 to 78.81 in 2018 is a strong indication that things must have been happening to increase US death rates. Over the same period, life expectancy in the UK almost stagnated. Although specific and possibly temporary causes explain most of the US reduction, this still implies that something has been negating the effects of both the advances in medicine, and the increases in the real-terms cost of medical system during this period.
I therefore looked at the case for several likely causes, and the one that best fits the evidence is the proportion of Ultra Processed food in the diet.
I found Ultra-processed food intake and animal-based food intake and mortality in the Adventist Health Study-2 Concluded that "Greater consumption of ultra-processed foods was associated with higher all-cause mortality..."
A defining characteristic of ultra-processed foods is the number and type of substances that the manufacturers disperse within them.
They do this for a wide range of purposes,
from "acids" to impart taste", to "thickeners" to provide body.
The EU currently approves
407 EU food additives
as safe.
However, given the evidence against ultra-processed foods, it is reasonable to suspect that some proportion of these have started affecting long-term health.
In the US, additive manufacturers have switched from claiming a history of common use in food prior to January 1, 1958 changed foods Generally Recognized As Safe (GRAS), have undergone rapid change.
Instead of manufacturers
Unfortunately, all the definitions of ultra-processed I have seen are fuzzy. This makes it impossible to be sure I am avoiding ultra-processed food without sacrificing the most available, easiest to prepare, and often cheapest foods. I therefore suggest ignoring markers of ultra-processing less related to suggested mechanisms, and concentrating instead on factors which could have a more direct effect such as the actual ingredients and characteristics in the food.
In a recent study, TV watching, but not computer use was found to be associated with Coronary Heart Disease" Assuming causality, not due to confounders, the paper concludes that approximately 11% of CHD could be averted if TV viewing time were reduced from ≥2h/day to ≤1h/day.
Food texture trumps food processing in the regulation of energy intake
Well for me initially. In particular, am hopping that lowering my SIC-counts will help me reduce my risk of medical problems.
It is not designed to tackle problems, once they are established ( even if they may have originally been caused by diet). When these eventually strike, it is likely to be much more important to direct my diet towards these. for instance by controlling intake of carbs if diagnosed with diabetes.
It is also not designed specifically for weight control. For someone with a tendency to put on weight, or is already of above optimum weight, approaches designed specifically to tackle this problem are likely to be more effective.
Although I don't think that foods are the only cause of the deterioration in health, I do think it is the aspect of our lives which has the biggest potential for improvement. Also, I realize that health is not the only area where things have deteriorated. However, bad food clearly has the potential to acerbate many other problems. Health inequalities, for instance, must make economic inequality worse, with reduced labour participation and
There is evidence that ultra-processed foods are a major cause of the reduction in life expectancy, and foods with a large number of ingredients are generally counted as ultra-processed, for instance in the NOVA classification. In fact, the large number of ingredients and the short time over which they have been introduced makes if likely that some are better for us than others.
One of the major ways in which it is suggested that these ingredients and processes causes illness is by encouraging the over consumption of calories, with its consequent weight gain. However, this does not appear to be the only pathway. A 2021 study said... The results [positive association between high levels of ultra-processed food intake and prevalence of diabetes] remained statistically significant even after adjustment for several markers of dietary quality, other metabolic comorbidities, and weight change.
Of other pathways, if just one ingredient was having the major effect, then it is reasonable to think that the industry would have identified and eliminated it. It is therefore more likely that the problem concerns a class of ingredients which the industry finds difficult to do without. Alternatively, there may be several ingredients, whose individual harm is hard so small it is difficult to detect, but which in aggregate are having the observed effect. Either way, it is likely that many process foods will contain at least one of the offending ingredients. Minimizing the number of such ingredients consumed should therefore reliably reduce the amount consumed.
If instead, evidence shows that some factor is harmful, then products containing that factor should simply not be consumed.
Examples of this so far include ...
People other than...
Note that since the Bogalusa Heart Study showed that weight gain and heart lesions is now affecting children, the SIC-count or something like it is important for children as well as adults.
It is also meant to help people like me, who have remained thin all their lives, but are now putting on abdominal fat, and whose blood markers have become "marginal". These are sometimes described as lean diabetics or "fat on the inside", and have worse prognosis than the overweight.
It doesn't. I think it would be more effective to pick a specific, suspect factor affecting only a limited number of foods, and name and boycott some of the manufacturers who are using it. If consumers are receptive, food manufacturers should be able to respond, and if the food-pick was valid, their food would improve. However, it is going to be difficult to prove, and perhaps unlikely, that any one factor is responsible for all the observed ill-health. It would therefore still be worth consumers minimizing the SIC-count of the remaining foods they buy.
Certain countries are beginning to sugared drinks, which has caused manufacturers to reformulate by reducing the amounts of the suspect ingredients. If these taxes could be widened, then there might be pressure from food manufacturers to put more money into research designed to show that certain factors were safe, thereby removing the justification for taxing foods which were "clean", apart from those factors.
The nutrient deficiency explanation of deteriorating health, suggests that forcing plants to grow faster by using increasing use of fertilizers on increasingly impoverished soil has reduced the nutrient content of our diet. This risk is represented in the SIC-count by scoring the added sugar and fat. A low SIC-count diet, constructed by replacing foods with high counts with lower ones, plus zero scoring vegetables and fruit should therefore be a high nutrient density diet. This is especially so, since the alignment between ultra processed food and the nutrient deficiency is close. Of course, if the nutrient deficiency explanation were shown to be the main cause of the increase in health problems, then it may be better to remedy that directly. However, the point of the above is that we don't yet know whether it is the case. Hence the need to balance this possibility with others.
Minimizing likely new risks to health, should not get in the way of making novel improvements. There is considerable amount of evidence for making vegetable, fruit, whole grains, legumes, and fish the largest part of the diet, with smaller amounts of milk/dairy, nuts, eggs, and added plant oils. There is also evidence from a randomised prospective trial for fermented foods, such as cottage cheese, kombucha, yogurt, kefir, buttermilk, kvass, kimchi, sauerkraut, and vegetable brine drinks.
This document is still being written, and this section in particular will be added to shortly. Date of last modification 2022-04-15