This attention is because of two recent studies - one from France, one from Spain - both of which showed that "ultra-processed" food was linked to poor health 2/pic.twitter.com/2axOOujE8t
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To put this into context, the "62% increased risk" of death that a lot of people reported on relates to an absolute increase of about 0.01% in absolute terms 13/pic.twitter.com/k1cBZ2UoEQ
To put it another way, this means that the number of people who die rises from 2/10,000 to 3/10,000 when they quadruple their intake of these foods A bit less scary than a "62% increase" I think 14/
Similarly, the risk of heart disease of any kind increases by less than 1% per 5 years when you go from eating very few of these foods to eating a lot of them /15
The next thing to think about is residual confounding. As I said, these were excellent, well-done studies However 16/pic.twitter.com/WyE7KmyqTH
The problem with these sorts of trials is that it's impossible to entirely eliminate external factors It's possible that something other than processed foods caused the observed relationships 17/
For example, we KNOW that social factors like poverty and other forms of disadvantage impact who gets heart disease and who dies in our society These studies might have controlled for that enough to infer causality. They also might not 18/pic.twitter.com/oNwFgZvKs8
I'm not saying they did anything at all wrong - quite the opposite. And if you read the studies themselves, the authors are appropriately cautious about what this might all mean 19/pic.twitter.com/aFfF6UcGjl
That being said, the fact that a recent study demonstrated a convincing link between processed food and weight gain in a controlled laboratory setting lends weight to the argument that "processing" is a decent marker for how healthy foods are 20/
The other issue in all of this is that we know that people are terrible at self-reporting what food they eat Both studies controlled for this as well, but it's hard to know if that was entirely effective 21/pic.twitter.com/hFxnTFVsF5
Also, if you look at the statistical models, the risk only becomes really apparent at the highest intakes of ultra-processed foods It's hard to say if there's a big impact of eating just a bit more of these foods 22/
Ultimately, what do these results mean? Well, for governments, they are pretty impactful 23/
If you wanted to prevent heart disease and death in your country, it looks like one realistic way of doing that is discouraging people from eating ultra-processed foods 24/
(Whether this is possible is another question entirely, and personally I'd argue that social influences will always dictate what people get to eat far more than the health of foods themselves - you have to fix society to fix these issues) 25/
But to an individual? To you and me? I don't think these results mean all that much 26/
If your diet is currently more than a quarter ultra-processed foods like fast food, prepackaged meals, and biscuits, it might be a good idea to cut back You probably already knew that, though 27/
If, like most of us, you have the occasional sneaky cookie, you probably don't have to worry all that much 28/pic.twitter.com/zderkojK9C
This thread got a bit long, so to sum up: - processed foods may be bad for health - we aren't sure if it's the food or society - the impacts are important to governments, not as much for individuals 29/
P.S. I forgot to mention, I did write about another almost identical study last year (using the same cohort of people as the French one) here https://medium.com/@gidmk/processed-food-isnt-killing-you-43556b943bd6 … 30/
In this piece, I go through the same issues, but my conclusion is a bit different As any scientist will tell you, evidence moves on! 31/
I'm still not entirely convinced that ultra-processed foods are independently bad - or indeed that this is always a useful category at all - but these studies and @KevinH_PhD's recent work has changed my mind a bit 32/
I would still argue that societal changes are almost certainly the bigger issue here, but I suspect that reducing our consumption of ultra-processed foods would be a good first step 33/
P.P.S. I think this point from @Botanygeek is also very important - "processed" and "unprocessed" are heavily culturally influenced, which is one of the biggest issues with talking about the results of these studieshttps://twitter.com/Botanygeek/status/1133997826399186944 …
Pocast is now out on the studies in this thread - have a listen!https://twitter.com/GidMK/status/1134628919938822145 …
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