The next thing to think about is residual confounding. As I said, these were excellent, well-done studies However 16/pic.twitter.com/WyE7KmyqTH
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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/
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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
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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
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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/
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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
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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/
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Ultimately, what do these results mean? Well, for governments, they are pretty impactful 23/
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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/
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Absolutely true but incredibly hard to implement. Food may be more manageable an intervention
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