Dr. van Tulleken’s Ultra-Processed People

Chris van Tulleken, MD, PhD is an infectious diseases physician at the Hospital for Tropical Diseases in London. He trained at Oxford and has a PhD in molecular virology from University College London. He is best known in England for his interest in food science and the harms caused by corporations making ultra-processed foods (UPF). He has won two British Academy of Film and Television Arts (BAFTA) awards and is a frequent broadcaster on the BBC covering how UPF affects children and adults. 

In his book Ultra-Processed People, Dr. van Tulleken argues that the ultra-processing of foods is the primary reason that diets result in the many health problems we face today including metabolic dysfunction and other chronic diseases. 

While his work is backed by significant science, a difficulty with this topic is a precise definition of ultra-processed food. Foods with five or more ingredients is often referenced, but this is lacking in specifics about the ingredients. Van Tulleken recommends use of the NOVA Food Classification System designed by the Center for Epidemiological Studies in Health and Nutrition at the School of Public Health in Sao Paulo, Brazil. In that system, food is divided into four groups: group 1 is unprocessed or minimally processed food such as with vegetables, fruits and meat; group 2 is processed culinary ingredients such as natural oils, butter, sugar, salt, vinegar and honey; group 3 is processed food such as ready-made mixtures of groups 1 and 2 processed for preservation or taste such as tins of beans, salted nuts, smoked meat, canned fish, freshly made bread and chunks of fruit in syrup; group 4 is ultra-processed foods defined as “formulations of ingredients, mostly of exclusive industrial use and made by a series of industrial processes.” Ultra-processed foods have ingredients that you would not find in your kitchen. These ingredients are foreign to our body and cause harm.

In the book, van Tulleken describes a long dialogue he had the Gary Taubes, the science writer who exposed that excess sugar and refined carbohydrates – and not fat – is the cause of insulin resistance, metabolic dysfunction and chronic diseases. The carbohydrate/insulin axis leading to visceral fat storage is now widely accepted as the primary cause of overweight, obesity, and their many co-morbidities such as fatty liver and dementia. 

Van Tulleken disagrees and has a chapter arguing, “Why it isn’t about sugar.” I find this binary argument lacking because both are right; most ultra-processed foods are loaded with refined carbohydrates. Van Tulleken does not discuss the epidemic of type 2 diabetes and how insulin resistance leads to it. 

Ultra-Processed People is a very useful and informative book and puts food-processing front and center as to how what we eat can be harmful. It made me throw away a bag of dark chocolates that were over-processed. Integrative gastroenterologist Robynne Chutkan (The Microbiome Solution and The Anti-Viral Gut) discusses how ultra-processed foods wreak havoc with the health of our vitally important microbiome.

“Eat real food” is simple advice and Ultra-Processed People describes why this is vitally important for our health.

Dr. Scherger is founder of Restore Health Disease Reversal in Indian Wells, a clinic dedicated to weight loss and reversing chronic medical conditions. To schedule a consultation, call (760) 898.9663 or visit www.restorehealth.me.

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