AMA with Dr Chris van Tulleken, expert on Ultra-Processed Food and award-winning broadcaster

[NicolaDMumsnet]

Hi everyone,

We’re pleased to announce that award-winning broadcaster, author and practicing NHS doctor Chris van Tulleken will be doing an AMA this evening. Following his BBC One documentary ‘What Are We Feeding Our Kids?’ and the chart-topping podcast ‘A Thorough Examination – Addicted to Food’, Chris has become the UK’s go-to expert on Ultra-Processed Food (UPF). In his most recent book ‘Ultra-Processed People’ Chris marshals the latest evidence to reveal what UPF is really doing to our bodies and the planet.

Ultra-Processed People
‘Drawing on his own experiment of eating an 80% UPF diet for one month, Chris explores the invention of UPF and its impact on our health and weight – from altering metabolism and appetite, to an increased risk of serious health problems like cardiovascular disease and dementia. He shows that almost all our staple foods are ultra- processed – bread, cereal, biscuits, desserts, dairy products and condiments; explains why exercise and willpower cannot prevent obesity and ill health due to UPF; and provides solutions for individuals, policy makers and the food industry.’

Please post your questions below. Chris will be answering questions this evening.

As always, please remember our guidelines - one question per user, follow-ups only if there’s time and most questions have been answered, and please keep it civil.

Thanks,
MNHQ

Hi Chris,

Thanks for you book. My entire extended family have read it and are now clearing their cupboards of UFP and stuffing them with Kilner jars of Komucha, Kefir and Kimchi! Is there anyway to stop food producers from advertising food as homemade when its clearly UFP and made in a factory? I was looking for Gelato in London on the weekend and when I questioned the sellers on ingredients they were all full of rubbish and clearly not homemade or 100% natural!!!! I hate being conned but it seems that Ice Cream when out is no longer possible.

Brilliant question

1 bananas
2 broccoli
3 salmon
4 soy sauce
5 honey
6 vinegar
7 rice
8 gallician rib-eye steak from turner and george

Bee Wilson's The Secret of Cooking. Or anything by Bee Wilson

Chin-up bar as a luxury item

I don't have any advice for anyone. You have my love and support. I think the evdience shows that for some people, if you can find a way to be abstinent from UPF then there will be a significant health benefit and some people will lose significant weight. I don't promise this and I don't think in a literal sense that you SHOULD do it because I don't think there is an ideal or perfect body. Most of the health problems associated with obesity and overweight come from stigma not weight.

What my brother did and what I did - was to stop forbidding ourselves UPF - indulge whilst learning about it and then we stopped wanting it. This thought does not endorse your desire to lose wieght. You should do that if you want to.

Sending much love and luck - Cx

Music to my ears, that is exactly what I wanted it to do. Thank you

I have done some research on milk allergies, it is over diagnosed so please take expert, independent, non-industry, clinical advice. I'm afraid that i can't give clinical advice here. Bob boyle at imperial is an expert in this area.

Wow. People have told me many amazing effects but you are the first to mention this. It's very plausible from microbiome and inflammatory effects. Godo luck and thanks so much for your kinds words!

Sorry for the ambiguity, there are many UPF dairy products but obviously not all. Your distinction is correct here and milk, plain yoghurt and cheddar are all not UPF

I can't give clinical advice - my kids LOVE UPF so I try not to have it in the house (though we have a bowl of treat junk). I also make sure that when they are bored and hungry they get freshfruit and veg as a snack - they'll munch on anything whilst they watch a bit of CBBC after school. And if you make veg a bit more interesting - boc with soy sauce, salt and oil on tomatoes then they prefer it. We all prefer a carrot dipped in Hummus!

Hi there -following your work (and antics a la operation ouch) a long time.
my question is on disease-such as irritable bowel syndrome. Do you think avoidance of UPFs could improve IBS?
also allergies-is there a theory that UPFs could be adding to the increased numbers of those affected by allergies? Thinking… of the mum during pregnancy eating high levels of UPFs. Gums stripping the gut of mucus. Baby is exposed to allergen…
Also.. questioning… our skin. We are putting so much more on our skins these days-“ultra processed skin-products” is that also a thing? And could this be affecting our skin microbiome, thereby And having an input to increased allergy levels? (“From the skin allergy begins”)

I feel for you but don't panic about the gluten free bread - eating less UPF is more important than eating none! Also home baking with gluten free flour if you can be bothered might add variety?
Also I love east and south asian food and they have a million ways to make gluten free carbs delicious?

This is a really important question. Avoiding UPF is extremely hard for people like you and that is one of the things I am trying to work with policy makers on so that healthy food can be affordable and available. Fresh fruit and raw vegetables are very expensive but don't take too much time to prep and if you have dips for the raw veg they become much more enjoyable. There are lots of non UPF ready meals at M&S, Waitrose, Sainsburys and Tescos but I acknowledge that these are expensive. It is a huge injustice that eating well is so hard for someone like you and please know that I am working with policy makers to try and bring about change, though I can't promise anything soon.

I probably cook more than Dinah but we are in a very privileged position. I'm conscious that convenience food enabled women to enter the workplace but it would be very possible to imagine a food system and social structure that provided good convenient food and where everyone shouldered the burdens of family life much more equally Cx

and dont' panic about the bread. It sounds like you're doing a great job xxx

I don't have too much dogmatic advice here - if you love the bread and it saves you time and you don't think it's doing you too much harm then go for it!

If you want to be abstinent from UPF then it's tricky but remember you cannot make UPF at home by definition!.

Yes we can sue food companies. There is a New Yorker article about this here https://www.newyorker.com/magazine/2023/09/11/the-lies-in-your-grocery-store which we should do more of in the UK. The marketing of UPF is a major problem here and needs to be regulated.

I am glad to hear you are feeling better and healthier, that does happen when reducing the intake of UPF,at least in my experience. There have been a few questions about stock cubes on here. I tend to think that if you are reducing UPF substantially then don't stress too much about things like stock cubes if the rest of your diet is made from real ingredients. Processed food like cheese, butter and milk are not upf.

Love this question I'll quote from a thing I'm working on at the moment below. I would mainly avoid emulsifiers and low cal sweeteners!"Inevitably, most studies focus on obesity 2,11, but there is also evidence that increased UPF intake is strongly associated with an increased risk of:· death – so called all-cause mortality 12–16· cardiovascular disease (strokes and heart attacks) 14,15,17· cancers (all cancers overall, as well as breast cancer specifically) 18· type two diabetes 19,20· high blood pressure 21–23· fatty liver disease 24· inflammatory bowel disease (ulcerative colitis and Crohn’s disease) 25,26· depression 27· worse blood fat profile 28· frailty (as measured by grip strength) 29,30· irritable bowel syndrome and dyspepsia (indigestion) 28· dementia 31This evidence is robust and importantly it shows that UPF is not simply salty, fatty, sugary food low in fibre."References are here:11. Dicken, S. J. & Batterham, R. L. The Role of Diet Quality in Mediating the Association between Ultra-Processed Food Intake, Obesity and Health-Related Outcomes: A Review of Prospective Cohort Studies. Nutrients 14, (2021).12. Schnabel, L. et al. Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-aged Adults in France. JAMA Intern. Med. 179, 490–498 (2019).13. Rico-Campà, A. et al. Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ 365, l1949 (2019).14. Kim, H., Hu, E. A. & Rebholz, C. M. Ultra-processed food intake and mortality in the USA: results from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). Public Health Nutr. 22, 1777–1785 (2019).15. Bonaccio, M. et al. Ultra-processed food consumption is associated with increased risk of all-cause and cardiovascular mortality in the Moli-sani Study. Am. J. Clin. Nutr. 113, 446–455 (2021).16. Chen, X. et al. Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies. Nutr. J. 19, 86 (2020).17. Srour, B. et al. Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé). BMJ 365, l1451 (2019).18. Fiolet, T. et al. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ 360, k322 (2018).19. Llavero-Valero, M. et al. Ultra-processed foods and type-2 diabetes risk in the SUN project: A prospective cohort study. Clin. Nutr. 40, 2817–2824 (2021).20. Srour, B. et al. Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort. JAMA Intern. Med. 180, 283–291 (2020).21. Jardim, M. Z., Costa, B. V. de L., Pessoa, M. C. & Duarte, C. K. Ultra-processed foods increase noncommunicable chronic disease risk. Nutr. Res. 95, 19–34 (2021).22. Silva Meneguelli, T. et al. Food consumption by degree of processing and cardiometabolic risk: a systematic review. Int. J. Food Sci. Nutr. 71, 678–692 (2020).23. Mendonça, R. de D. et al. Ultra-Processed Food Consumption and the Incidence of Hypertension in a Mediterranean Cohort: The Seguimiento Universidad de Navarra Project. Am. J. Hypertens. 30, 358–366 (2017).24. Zhang, S. et al. Ultra-processed food consumption and the risk of non-alcoholic fatty liver disease in the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. Int. J. Epidemiol. 51, 237–249 (2022).25. Narula, N. et al. Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study. BMJ 374, n1554 (2021).26. Lo, C.-H. et al. Ultra-processed Foods and Risk of Crohn’s Disease and Ulcerative Colitis: A Prospective Cohort Study. Clin. Gastroenterol. Hepatol. 20, e1323–e1337 (2022).27. Gómez-Donoso, C. et al. Ultra-processed food consumption and the incidence of depression in a Mediterranean cohort: the SUN Project. Eur. J. Nutr. 59, 1093–1103 (2020).28. Schnabel, L. et al. Association Between Ultra-Processed Food Consumption and Functional Gastrointestinal Disorders: Results From the French NutriNet-Santé Cohort. Am. J. Gastroenterol. 113, 1217–1228 (2018).29. Mariath, A. B., Machado, A. D., Ferreira, L. do N. M. & Ribeiro, S. M. L. The possible role of increased consumption of ultra-processed food products in the development of frailty: a threat for healthy ageing? Br. J. Nutr. 1–6 (2021).30. Zhang, S. et al. Ultra-processed food intake is associated with grip strength decline in middle-aged and older adults: a prospective analysis of the TCLSIH study. Eur. J. Nutr. 61, 1331–1341 (2022).31. Li, H. et al. Association of Ultraprocessed Food Consumption With Risk of Dementia: A Prospective Cohort. Neurology (2022) doi:10.1212/WNL.0000000000200871.

Thank you for the suggestion, and we are thinking hard about this. It is an incredibly difficult one as we want Operation Ouch to be as broad as possible and make sure families who cannot afford to avoid UPF are also considered when we talk about diet on the show.

Yes, I would eat that. Frozen veg is ok under these definitions. More info here:
https://www.fao.org/3/ca5644en/ca5644en.pdf

Tinned food is generally not UPF (unless it contains things like modified starches or maltodextrin).
If you're making bread at home you're doing a wonderful thing - don't sweat about the yeast at all. Yeasts is a naturally occurring fungus so some are just yeast but others do contain emulsifiers - it may be worth avoiding them.
Gluten has been extracted from wheat for a long time esp in East Asia. If you're cooking at home you basically can't ultra process food. UPF has to be made for profit as part of the formal definition.

Thanks for the kind words nice to hear about the library.

IgE allergies are complex - I think you're doing the right thing. Some UPF is needed. I can't really give clinical advice but I think if you look you'll be able to find alternatives to some but perhaps not all. Don't worry about essential UPFs. And he may grow out of some of the allergies! Good luck

Breakfast: coffee, eggs, real bread, porridge, some muesli, yoghurt, honey, jam, peanut butter, bananas, fruit, bacon

Lunch: nuts, fruit, home-made sandwich, home-made salad especially hearty salads with beans in them, leftovers from last night's home-cooked dinner

Dinner: my favourite quick dinner is microwaveable packet rice, boiled broccoli, roast chicken thighs all covered in a dressing of soy sauce, honey, vinegar and sesame oil (it is gluten free if you use tamari soy sauce and veg/vegans can use tofu)

Never mind - just noticed this is ancient...

Can you DM me (doctorchrisvt) and dolly (dollyvant) on Twitter and we can help point you in the right direction. Great that you are interested in this area

I really worry about getting the healthy eating message across, and introducing any sort of strict dietary restrictions, without risking food becoming a battleground and (particularly for girls) leading to eating disorders. Do you have any suggestions for how to approach it, with teenagers in mind?