Is Ultra-Processed Food…Even Food?

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I'm your host, Dr. Abdul El-Sayed.

It's Halloween, which, I have to admit, has always been a bit complicated for me. For one, it's my birthday, which, as anyone with a holiday birthday knows, kinda sucks. In this case, everyone's generally more amped about the holiday, where you get to arbitrarily dress up and get candy from folks, than well, my birthday. But also this holiday kicks off what I'm going to call the food end of the year. Every month features another food-themed holiday.

Halloween is all about the candy, of course, and then there's Thanksgiving, which I don't have to explain, and then the end-of-the-year holidays. Whether Christmas or Hanukkah, or Kwanzaa or Diwali, all of them have their own food themes. And then, of course, there's New Year's Eve. To appreciate just how culturally determined our food choices are, I want you to think through the foods you associate with each of these holidays.

I bet if I asked you what your favorite Halloween candy, you'd be able to immediately come up with two or three. And if they're Reese's cups, you're correct. And no matter which one it is, it probably brings back a warm, fuzzy feeling about a time you ate that candy. When I say Thanksgiving, I'm sure that conjures up a very specific meal, probably featuring Turkey or characterized by Turkey's conspicuous absence. And, of course, if I asked you what your favorite side was, I'm sure you could immediately name it.

In our family, it's scalloped oysters, odd, I know, but delicious. The point I'm making here is that we often think of food as an individual choice that someone makes about what to put in their body. But food, like so much of public health, is a lot more about the environment, both the space, but also the time in which we're exposed to it. Simply put, food is one of the most important ways that the outside world gets into our bodies.

But as much as food is environmentally mediated, our preferences are still the final gateway. And here again, society and culture play a part. How many times have you heard you are what you eat? Or an apple a day keeps the doctor away, or milk it does your body good. It's what our moms and dads told us when we were young, but then there was the stuff we heard from our third parent, the television.

No one out pizzas, the hut tricks are for kids and, of course, live mass. Because there are literally billions of dollars to be made. Making sure that we lower our gates and let cheaply produced food in. The food industry spends billions trying to get us to lower these gates. Even at times, making fantastical health claims about why we should. This won't be the first time we've talked about food here. But given how big the topic is, we wanted to create some space to talk about it with some nuance.

This is the first of several episodes we'll be doing on food this season. And I wanted to start with a topic that's a far cry from daily apples, milk or other raw ingredients. From the old adages, we'll be talking about something probably all of us have eaten, maybe even eat regularly. But that today's guest, at least, would be hard pressed to consider food, and he doesn't think you should call it food either.

And that's because it's been processed beyond recognition. What starts out as a soybean or a kernel of corn is broken down into its constituent molecular parts. Until it's simply a series of additives, massaged and teased and refined to proffer a specific flavor, texture or shelf life to a product. All of this is designed to keep us coming back for more. Dr. Chris Vantulleken is a physician and health researcher at University College London. And he believes this ultra-processed food is creating ultra-processed people. Which happens to be the title of his new book.

He joined me to talk about food processing, its health implications, and the companies that make billions doing it. Here's my conversation with Dr. Chris Vantulleken.

What does that mean to you, and how does that operationalize, both in food, but then applying the device beyond food?

It's very long. It's housed on the United Nations Food and Agriculture website, it's been used by hundreds of research groups all around the world, it's recognized by lots of governments. But it boils down to this. If something's wrapped in plastic and contains an additive ingredient that you don't typically find in a domestic kitchen, it's almost certainly an ultra-processed food.

Would that be an ultra-processed food?

So that's whole food, then, there's processed food now. Humans have been processing food for well over a million years. It's shaped our guts, our jaws, our teeth. If you compare human beings to any other animal of a similar size, like a pig or another non-human primate. We've got these minuscule little teeth and these tiny jaws, and a very short digestive tract.

That's because we've extended our eating and nutritional apparatus outside of our bodies, so we chop food rather than chew it. We cook it, which makes it easier to digest, we get more energy out of it. So, primarily, female scientists invented modern cuisine.

They did it over more than a million years, in caves, then huts, then domestic kitchens. They did it to nourish their friends, their families and their communities. They created this very wide variety of modern diets, all of which are associated basically with good health. Whether we look at fish diets from East Asia, vegan diets from South Asia, Arctic Sea mammal diets, Mediterranean diets, they're all pretty healthy. There are tiny exceptions to that we can get into, but broadly, traditional food is associated with good diet.

What we have now is the third type of food that makes up most of the calories we eat. It is arguably not food in the sense that I think we don't have a legal or a scientific definition of food. But food, culturally, is about nourishment, the purpose of ultra-processed food. Part of that very long, formal definition is it's about profit. The system that makes it, it's made by quite a small number of companies, is heavily financialized, so all the incentives in that system are about creating more money.

There's this financial axiom, if you show me the incentives, I'll show you the outcome. If you make food essentially for pension funds and for financial growth. You end up with food that is made using extremely cheap ingredients and that has quasi or really addictive properties. So ultra-processed food is a way of describing really a modern American diet. I hate saying this to Americans because I love America.

My folks are from Canada, but I feel very North American. So we could define it using the long definition, we could define it according to the additives. Or we could say this is a way of describing industrial Western foods, the food, the industrial food that's come out of the global north that is fundamentally extractive. If a food has a list of ingredients, it's probably ultra-processed.

If a food has a health claim, like it's low fat, high fiber, high in energy, high in protein, it's probably ultra-processed. If a food is made by a transnational food corporation, it's probably ultra-processed.

And then the second is to think about the scale of production, and then the third is to think about the actual processing. How much breaking down and building, back up and manufacturing goes into it? My daughter and I, we have this habit of watching YouTube videos about how things are made. And so we'll just take a random thing in the kitchen and it'll be like an Oreo. I'm just like, how is it made?

How old is she? and she's about to turn six.

And she's like, he's just shoveling it into this very big machine. And it was this moment of like, Oh wait. I think of my Oreo as this dainty little thing that somebody cooked for me with kindness and love.

And this is why we tell you you can't eat so many oreos. And so it was this natural of just just aversion she had to what processing actually entailed. Like this, this man shoveling her oreo into a thing, and it was it was like, almost picked up. This metaphor of this is unnatural and we shouldn't be treated this way.

But one of the things I try and do is not get too involved in the emotional long grass. Because that's a that's a trap. Where they say, well, we're feeding the world. How do you expect us to make this many cookies? Like, of course, we use a shovel.

But fundamentally, our factory is just a really big kitchen, we just use bigger pots and pans. And so for me, the the technical argument that I lean on very heavily is much less an emotional critique. Although, although that's really useful when I'm speaking to my my reader or the lay public, I do want to discuss them with this food. I think people should be disgusted.

I think that's useful for many people. It comes with a problem because this is the only food that many people can afford, and the only food that's available to them. But we can, we can come on to that, so I try and do that without generating stigma.

But when it comes to the argument with the companies, for me, the really important thing is not that they're using a shovel. Although that is, using a shovel is a proxy for an industrial process that does not have your interests at heart. And so I'm doing. I'm doing a really cool piece of work at the moment, where my academic work shifted from doing molecular biology from studying nutrition at a very kind of basic level to now. I work with economists and one of the things that the team I'm working with, and they're dispersed around the world. The main teams in Australia is they're trying to prove, using financial metrics, that the food companies will say that they care about you, but they really definitely don't.

And we can demonstrate, for example, that when they make money. Instead of using that money to reduce the price, or using that money to make sure that they use higher quality ingredients or make the food healthier. What they do is they use the money to do share buybacks and drive up equity value. So we're using measurements like this, we can say, look, whether or not you use a shovel to make the food. If if my parents were going to cook a meal for a thousand people at some enormous wedding. They might well use a big tool to shovel ingredients into a giant pan. That wouldn't actually be a problem, the problem would be the incentives.

Mm hmm.

I want to ask you, in an average American diet, just how much ultra processed food do we consume in a given day?

So if you, if you bought a ready meal lasagna that had flavoring emulsifiers, xanthan gum, lots of stuff you don't have in your kitchen. It would be ultra processed, it would probably be coded, as in this in the studies, as not ultra processed, so we probably underestimate it. A typical amount for an American teenager or a child would be 70 or 80 percent, so we know it's much higher in younger people.

And, of course, in already disadvantaged people, it's even higher. Still, so if we think about people with very low incomes and and the communities they come from, those people are essentially forced to eat harmful food.

Food venues in, you know, even in, you know, you talk about the lowest income parts of London. And you tend to have large immigrant communities who tend to open up smaller fruit markets. In effect, and they'll have some traditional ethnic foods, but they'll usually have green, leafy vegetables and other kinds of cuisines. You go to communities in the U.S. So, you know, just to compare like a Detroit and a New Castle, which I think are pretty, pretty apt comparison.

There's just not the kind that is going to nourish a brain. And and I want to ask you, you know? As you think about the process by which these corporations have almost dominated the food space, it seems it would seem counterintuitive. When you actually explain the process, you're like, wait, ultra processing The processing itself should cost more money. how come the food that lowest income people in high income societies end up getting is ultra processed?

Can you talk a little bit through that in the ways that corporations have been able to leverage their power to be able to make that the truth?

Then when you get the milk, you've got to pasteurize it, homogenize it, separate it out. It's extremely expensive way of making fat. Now, if you can take some of that dairy fat and replace it with a refined, bleached, deodorized, hydrogenated, and interesterified palm fat, it's way, way cheaper palm.

You don't, you don't need to feed a palm tree anything, you just grow it. You cut down some virgin rainforest, you sell that lumber, and you grow your palm on the Indonesian peat soil.

It grows brilliantly well that it's all fed by the sun. And then by putting it through this RBD process through an edible oil refinery, which looks rather like a crude oil refinery. You can create a fat with any melting point and any texture you want by changing all the bonds between the carbons. So if you can save a little bit of dairy fat, that'll be great. Now. Eggs are a nightmare, eggs have salmonella in them.

You've got to grow the chickens, they, you've got to crack the eggs open and process them. Eggs are just a terrible thing for a food company to deal with. If you can replace the egg with a synthetic emulsifier even 50 percent, or better yet, entirely like mono and diglycerides of fatty acids, then you're onto an absolute winner.

If you use real vanilla, it's expensive. If you use synthesized vanilla in flavor, public don't seem to tell the difference. No one cares, and you can still call it vanilla. So by replacing every ingredient, you sometimes need to use more.

But each one is much, much, much cheaper. And a lot of the logic that, so the industrial logic of UPF is. Some of the time, it's just essentially it's made from five or six plants, right? We eat basically six plants and three animals.

That's that's the human, that's the modern human. American Northwest diet We we rice, corn, soy, wheat, palm and and some sunflower oil. And then we add to that some pork, some beef and some chicken, maybe a bit of fish. We don't eat much fish.

So that's our diet, and a cob of corn will spoil you. go buy a cob of corn. You can keep that in your fridge for a few days, maybe a week. Tops If you get it early, you've got to own a fridge.

You've got to keep it in the fridge and then you've got to heat up water, boil the corn. Now, if you're a corn manufacturer, growing a monoculture crop of corn is very, you know, people only eat cobs of corn once a week. Tops if you can take your corn and you can turn it into bioethanol for running a car. On high fructose corn syrup, you can get the corn oil out of it, you can get a protein isolate out of it. You've now created with your high fructose corn syrup, a liquid that can be added to anything from soda pop to pizza to breakfast cereal.

I mean, it is in everything. You can take the emulsifiers out of soy and the soy protein, you can add it to everything. And those pastes, powders and liquids have a nearly infinite shelf life. So you go from the logic of a commodity crop, which you mainly grow, to feed animals, soy corn, and you take a little fraction of that and you turn it into.

You add it to the human food supply, so there's a way of thinking about this, which we're really eating, the waste that's left over from feeding animals. And you'll see some ingredients are really incredible, so whey protein is a great example of.

We used to spread whey protein on fields, right? It was. It was waste, it was left over from the cheese industry. Now we mix it with vitamins and flavoring and sell it to bodybuilders.

And we've increased the value for five orders of magnitude. I mean, it's the added value and you can do that is incredible. You'll see citrus fiber on a lot of your little nutri bars.

If you, if you work out and you buy those high protein bars. Citrus fiber is an added ingredient, a citrus fiber. There's nothing harmful in it, but it's extracted from the peel that would previously have been thrown away. When you make a can of grapefruit slices or you make orange juice and you're left with all the peel. You can turn that that into a fiber which has some nutritional value.

I suppose it's fibrous, but it's just a way of taking waste and adding it to the food chain. The same is true of all the fats, mango, kernel fat. So that the industrial logic is, take the cheapest ingredient and add it to the human food chain.

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You're eating a whole bunch of, frankly, chemicals that have been fully extracted from a base commodity crop to the point where you actually from on a molecular level. Almost can't know where it came from. And then I'd mix together.

I mean, you? So the the argument becomes devilish because many of these, the definition focuses on the additives, and so I think a common misconception is it's the additives that are harmful. And while we have very good data that, for example, the emulsifiers and the non nutritive sweeteners, and the flavor enhancers and some flavors are harmful. For the most part, the additives are just a proxy for the industrial process. That's about extracting money.

I mean, you asked about corporate power, which is the more complex question. And there is this when we look at already disadvantaged communities in London, so if I go to South London, there's this, this paradox amongst our African and Caribbean communities. That there are whole food markets with very traditional food, and there is a generation of people who still buy that food and cook it. And you then talked about there is.

There is also a culture of using convenient, ready processed chicken, sharp fried chicken, kebab shots. There's a there's a culture of that, I would say, there is not a culture of that. There is the imposition of that food in a predatory way by enormous companies.

And something I worked very hard on in the book was to go to those communities and understand from their perspective. This kind of dissonance, where people you know in in South London will be very defensive about fried chicken. Because you can't live with the dissonance that you are being exploited and extracted from when it's the only food you can eat. But the the voices in my book from I mean, particularly that the Black community were entirely clear. That if you look at the ownership of the kind of major chicken shop chains, this is not.

A culturally appropriate local food producer, this is a company owned by, you know, shareholders. In the global north, with that demographic that is extractive not just of poor communities in London and people of color in London, but it's also extractive of the global South. And we're seeing the the. The huge expansion of the major chains into Ghana, Kenya, into the sort of burgeoning middle class of western Central Africa, in a way that is kind of desperately harmful.

Blaming of people of color, low income people for quote food choices. And your point is a really good one that it's not actually about choices that people are making. It's about the opportunity set that is increasingly being manufactured for them around price structure. And we seem to see a very, very similar thing that's happened here in the U.S.

Well, well before it started to happen, even in Europe, and certainly, as you talked about, in large capitals in, you know, sub-Saharan Africa, lower income Middle East countries, et cetera. I want to move because you make a really important argument in the book that the disastrous consequences of ultra processed foods go well beyond. Calories in, calories out. And that's traditionally what you were taught in medical schools, what I was taught in medical school. That really, it's just about calories in and calories out, and if you have this calorie balance, then you know that that is.

That is just fine, it really doesn't matter what those calories are, and your argument is that actually, that's, that's just not true. Can you tell us a little bit about why UPF are designed to be overconsumed and then how they violate you?

Calories in, calories out.

And there's not much that actually changes. That number of calories per day in activity is a very small part of the picture, and if you consume more calories than you burn, you will gain weight. And so the the the food industry has put two really big emphases on this discussion. First of all, they say, well, everyone has an individual responsibility to monitor their own calories.

You know, and we are the only animal on planet Earth that seems to think that we can read a list of calories and then control our calorie intake. And so when we say to people, when they're surrounded by food that has addictive properties, well, just eat your, you know, you and I will use about 3000 calories a day, just eat your 3000. Keep tabs on it, do the maths on every single mouthful and then stop when you get to 3000. It's the same as saying to smokers, Look, guys, you know, one cigarette a week is fine, you just have to stop at one.

Or to someone who lives with an addiction to alcohol or illicit drugs of abuse. So, you know, we'll just have one line of cocaine, have one shot of heroin, you know, and you won't come to any harm. It's the excessive use that's doing you harm. So there is very good evidence that the food is addictive for many people, but there's also very good evidence that it interrupts our ability to self-regulate. So food is abundant for many, many animals, including for human beings traditionally.

And if you eat real food, your body has a very well evolved set of nerves and hormones inside it. That when you have had enough food, your body will say, OK, you're done, you can stop eating. Now, we know from a huge body of data going back to the 90s. I mean, just we have so much science on this. That when food is manufactured so that it is soft, it is energy dense, it is flavored, it is flavor enhanced.

Those, amongst many other properties, get around that that ability to feel full.

So the other thing the food industry is very skillfully said is, look, if you do eat too much, go for a run. And so there is a very large body of credible looking literature that says if you do more exercise, you can burn off excess calories. And that frames the problem with the pandemic, obesity as being kind of to do with this pandemic of inactivity, and that feels very, I mean, that was the way I learned at medical school.

You know, people could run off that, you know, eat less, do more is the kind of maxim. In fact, the entire network of literature that promotes that, and all the institutions that promoted it, were funded by one company, the Coca-Cola Corporation. So Exercises Medicine was a Coca-cola program in the states, partnered with the American College of Sports Medicine. What we have, I think, very good evidence around now, and this is published in very good journals. It goes back to the 1990s.

There isn't the lead. The sort of. Main author on this is Herman Ponser. But there are a huge number of other scientists saying the same thing, which is that broadly, by increasing your activity in the way that most of us will like. We'll go to the gym a couple of times a week, you know, by walking to work, that will be very, very good for us. It doesn't seem to have a huge impact on the calories we burn. So this is really kind of food industry misinformation in the extent to which is a. I mean, you and I, with P.h.D.s. and medical degrees, had our thinking influenced by this network of research. Is kind of extraordinary to me.

But anyway, this is, you can sound a bit conspiratorial, but the, you know, I put a whole chapter in my book about exercise is good for you. But there is very good evidence it will not really help you lose weight. It might help you keep it off as part of a kind of healthy lifestyle, but it it doesn't seem to very much affect the calories we burn.

And the reason why is because, you know, the Nabisco Corporation, it's probably owned by some other corporation now designed those things, of course, by R.

J.

So just as an aside.

Can you speak to the way that they tend to get engineered specifically around those flavors that we can't? We can't deny ourselves? And then also the way that chemicals get leveraged into sort of disrupting our biological.

Often, you do get some euphoria from it, it seems to satisfy some craving very briefly. But by the time you're approaching the end of the burger, or the bag of chips, or the packet of cigarettes, or the the fifth, the fifth beer, you're no longer really enjoying it. And so there is a big difference in the human brain between liking and wanting. And what? This food and all these products, whether it's booze or or drugs of abuse, they're really good at generating.

Wanting liking? Not so much. That's of very little interest to the food companies. And so I think it's really important when you talk about this food, when anyone to, to not frame it as delicious. Because actually, the trial data is pretty clear that people don't find this food delicious, they find it extremely palatable and unsatisfying.

But it's very close to being disgusting for many people. Which is why I put this invitation in the book to please eat as you read. Because the food can very quickly go through that kind of uncanny valley where it becomes. What was the word you? Simulacrum? It's a it's, it's fake, and once you realize that an oreo is fake. When you start eating an oreo and reading the ingredients and realize how little of it is food, it can become very repulsive.

So yes, OK, so how do they do it? The conversation we have in the UK is what the industry and their intermediaries want us to believe is that the problem with food unhealthy food is high in fat, salt and sugar. Now, it's true that those molecules do drive appetite to some extent, but they're a relatively small part of the picture. What when it comes to obesity is the problem is when we eat too much.

And so the ratios of fat, salt, sugar, sour and bitter are much more important than the absolute amounts. And if you think, if you, if you get a bowl of, you know, UPF cereal, whatever your favorite one would be, you could. You could make it even more unhealthy by adding another three spoonfuls of sugar and adding a spoonful of salt. But because it would become repulsive, you wouldn't eat it and it would actually become healthier. So a big part of what drives a food foods unhealthiness is this palatability is how much we eat.

So a really good example, I think, is to can think about the construction of a soda pop. These used to be called phosphate pops, or they were served at phosphate bars because they all contain phosphoric acid. Now, if you take a glass of water, which I, you know, I have an empty one here. Now, let's imagine adding we fill that with with water. If we added 10 spoonfuls of sugar, it would become more disgusting, not less disgusting, wouldn't it?

No one ever adds sugar to water. But if you add a few drops of synthetic flavor and you make it very bitter with caffeine. And you add sourness from the phosphoric acid and the citric acid, and you make it fizzy and cold. It then becomes addictive, and we understand a little bit about how this works. Part of it is because of the sourness, the bitterness, the coldness and the fizz. You can get all that sugar past your tongue because you, your body should be saying that this is actually too much sugar. This is going to mess up my blood concentration and my water balance.

If you can get, if you can deliver the dose of sugar into the gut, it seems that you get that sudden reward, the nutritional reward. You link that reward to the flavor pattern, which is patented in the in the recipe. And that's what brings you back to that soda pop wanting more. So, there is so much more to the addiction of these drinks than just the sugar. If sugar was addictive, we'd all put, we'd all eat sugar with a spoon, or we'd, you know, but none of us ever, ever are addicted to sugar.

We're addicted to sugar mixed with emulsifiers, acid sourness and chewy, weird textures wrapped in plastic, branded to us that, in that context, sugar delivers a reward. So it's kind of like speedballing, you know, with with, there was a there's a when I worked as a physician, and you may have seen this. In emergency rooms, patients will often take stimulant drugs like cocaine or methamphetamine, and then they'll take sedative drugs at the same time, like heroin or benzodiazepines. And the more heroin you take, the more crack cocaine you can take. And so you can kind of overdose on both, but feel OK and get a high in two directions.

And it's a little bit like, what's happening? The more sour and bitter you add, the more sugar and salt you add.

Technological manufacturing process that that really is designed to to to just load you with this stuff and to make you come back and want more.

And Dana discovered that the non-nutritive sweeteners seem to have this very weird effect, where they they would drive excess consumption, but they they caused a lot of metabolic imbalance. So we, we would. The food industry argues that we can make ultra processed food healthier by taking out the sugar calories or the fat calories and replacing them with gums or non-nutritive sweeteners. The non-nutritive sweeteners seem to cause this real metabolic confusion, and somehow they can be addictive to without any calories.

So we don't. The only research ever done funded by Pepsi. Once Dana tried to publish it, you know, Pepsi got quite unhappy. Some of it is out there, but we we barely understand how this stuff works from an academic perspective.

I don't think that people will look better, they may not even feel better. Most of the harms of excess weight come from the fact that doctors marginalize and abuse patients and stigmatize patients who live with excess weight. Living with excess weight does have some health problems, but. But most of it is probably the health problems that come from the diet that drives excess weight rather than the weight itself. So I don't feel anyone should look different.

And I don't judge anyone for eating this food, we eat the food that's around us. I do think that people who live with an addicted relationship may find that abstinence is much more helpful than trying to reduce. And I think the the evidence around how to become abstinent is that I draw on is the evidence around this famous book The Easy Way to Quit Smoking? And it's it's the only self-help book that is recommended by the World Health Organization.

And the proposal in that book is you smoke while you read the book. And there's loads of randomized trials on it versus nicotine, gum and other behavioral interventions, and it works really, really well. So if you live with addiction, learn about ultra processed foods. See if you can shift to being disgusted. But my caution will be is your life will become inconvenient and expensive.

Eating real food is incredibly expensive because we we subsidize ultra processed food in in all kinds of ways. Like direct crop subsidy and all the external costs of climate change and the cost to our health. You know, you're going to pay those costs at some point, but you're not going to pay them when you pay for the food. So the food is artificially cheap. And for someone who just wants to align their groceries, you know, if they're feeding it? I mean, I've got, I've got the six year old and a three year old, and my wife's pregnant, and I don't want to eat this stuff.

But I also want my kids to be normal. I want, you know, food binds us to the people around. All their friends eat this stuff all day, so I don't ban it. When they go to parties, they can eat anything they want.

We don't have much in the house, so a big deal is it's like cigarettes. If you have them in the house, or if you have booze in the house, you will tend to smoke or drink it. So not buying it, not having it in the house is useful, or treating it as as exceptional.

You know, we're all allowed indulgence, and many people can enjoy two cigarettes a week. A glass of wine on a Friday night, you know, that can be a perfectly healthy part of a lifestyle. The problem with that stuff is that many of us find it hard to not experience the mission creep where you are enjoying that stuff. At 9 a...m.

I'm a humanitarian doctor and I do work in our public NHS service, so what I advocate for and what the charities I work with advocate for is not. We're not taking away anyone's fun, we don't want to ban anything, I'm not even proposing taxes on anything.

What we want is people to have increased freedom and increased choice. We want them to have freedom from misleading marketing, freedom from aggressive packet claims, freedom from misleading PAC claims. And and to be able to afford real food, because we know that when people with low incomes get money, they buy real food. There is the gulf between what rich people eat and what poor people eat. It's not because poor people don't have information.

It's because when people have lots of money, they want to buy healthy food, so it's. We have to use that language. And the other thing is not to allow it to be framed as neo-marxist, as anti-capitalist. We're talking about regulating an industry that is the leading cause of early death on Earth, right?

This isn't, it's not controversial. We did it with tobacco, we did it with seatbelts, we did it with leaded petrol.

You know, light touch regulation works fantastically well, the companies can deliver fantastic growth to their shareholders. Everyone can remain employed. We're talking about bringing in some regulation that will incentivize the companies to produce really good food. So I, I refuse to be pigeonholed as an as an anti-capitalist.

This is, this is all, you know, can all be done across the political divide. Because I think we all agree that children should be able to eat healthy food, regardless of the household they're born into.

There is a long list of conditions, cancer, early death from all causes, so with this needs to go in the national nutrition guidance. Now, that sounds a bit finickety and technical. No one ever reads that, but that is the lever that then allows you to to do other steps.

And that's what the food industry are resisting. We need to take all the cartoon characters off the packs, that's completely obvious. We did it with cigarettes, you know, cigarettes were aggressively marketed to kids, all the cartoon characters off the packs.

And we need to follow the example of Chile, Colombia, Brazil, Mexico, Argentina. If you buy a can of cola in Argentina, the warning labels are bigger than the logo of the manufacturer. And that's how Fizzy Pop should be sold. Pretty obviously. We have absolutely irrefutable evidence that Fizzy Pop drives all kinds of terrible harms to children and adults. And it should have a great, big warning label on it.

Same with the breakfast cereals, and then we change institutional food, so this is started. Just as the food companies are using the tobacco industry playbook to spread misinformation to fund policymakers, we need to use the regulatory playbook that we use to regulate tobacco, limit the marketing.

And perhaps more than anything else, industry money is dirty money. You cannot be a food charity or a food policy organization and take any money from the companies who profit from creating the problem you are trying to solve. And in the UK, the situation is just terrible. Where we get these supposedly independent groups who are all funded by Kraft, Heinz, Pepsi, Coca-Cola, McDonald's, Cargill, and they have huge sway over policy.

So it, perhaps, if there's that, that is my second to the top is stop the conflicts of interest. And the absolute number one thing is reduce poverty. If all you do is get rid of poverty. Then people with money buy healthy food, they can all afford refrigerators and cutting boards, and they all have time, and they they buy good food. And the market will correct itself. So perhaps that's, that's the number one thing.

And I think poverty is a is a political choice, it's not a natural state of people.

You look at the agricultural industry in the United States, it's largely gigantic agro corporations that are funded by government incentives to grow really, really artificially cheap corn or soy, or some of these other commodity crops. And that tends to create an artificial setting where, you know, these food prices are artificially low, which allow them to undercut some of the whole foods that people could otherwise be eating. And I, you know, don't want to paint all farmers with broad, broad brushstrokes. There are some heroes out there, small farms who are still growing whole foods.

But, you know, if you just look at the sector and you analyze it by size of farm, it has been consolidated like so many of the other industries in our society have been.

And partly because I think when it comes to the granular detail of those policies. So I am very good on like how we need to label a pack, how we need to warn people. I think when it comes to the long term effects of food subsidy, it requires really, really nuanced technical input. I mean, basically, yes, it's disgraceful and disgusting, and we have a very similar situation. That's slightly less exaggerated.

Or we're just 10 years behind you in the UK, so changing those subsidies? I don't have an immediate mechanism for interrupting that corporate power other than I think that there needs to be. Before they can, before politicians can start saying we are going to tackle a problem, you need a grassroots momentum to say, you know what, we're sick of eating this garbage and we want the system changed. And I do have some faith that the food system, that many of those small producers could meet demand. But look, look, basically, you're entirely right.

And we need a revolution in the way we grow, produce, and process food. And for me, the place to start is with the the, the human being, the voting public going. I really don't want to eat this. I'm fully aware of the harms, I want this taken away from me, or I want this, I want to be warned about this.

And I demand that real food is available, and so that's that's my starting point. Because until you have a population asking that. I think that the politicians are stuck because they they're industry funded. And if the voter isn't saying, please help me here, then then they are stuck. Does that? Is that a cop out?

Well, you anyway, through your taxes, pay for the corn subsidy, you then pay all the health insurance costs, you pay the environmental costs. Like we're constantly paying for it. We pay for the lawsuits they bring against our governments when the governments do attempt regulation. So, yeah, I never think this point is. Cheap is actually spot on, right? is we?

And and that's the thing is, it's beyond the scope of a book. And I deeply appreciate the profound, immense work that you put into educating consumers on both sides of the Atlantic and, frankly, around the world, about what this food is doing to us. And that is the work. But, you know, in our country, it's just so frustrating to know that this is part of our global export. You know, when people think about the impact of America on the world. We don't take it back to the notion that these corporations that our pensions, if only we had pensions, our 401ks are invested in. Right? That that they are incentivized to drive our government to allow them to make shit that we then sell all over the world, making people unhealthier.

And we end up bearing the cost on every side of it. And so, you know, it's important that that folks really take this and what I'm what I'm going to ask, given that, you know, we're going to be talking about this right up to Thanksgiving, which traditionally is a moment where people actually do eat whole foods for, like, the one meal of the year, maybe the other one is at Christmas. And as you're talking to your auntie and your uncle and your cousin about the things you're thinking about, I hope this is one of them, right?

Because, look, you're eating a delicious turkey, and that turkey was probably fed on corn that was itself subsidized. So maybe not perfect, but like, close.

I just really appreciate the work that you're doing and appreciate you coming on today to share it with us. Our guest today was Chris Fantolikian. He is both an infectious diseases doctor and he is associate professor at University College London, where he studies the impact of corporations on health. Chris, thank you so much for taking the time.

The government is now focused on making sure that the corporations that manufacture these vaccines can make more money off of it than they are. In making sure that people actually get the vaccines. So, rather than anyone being able to get any vaccine anywhere vaccines are offered, instead, there is a piecemeal approach to who can get vaccines. Where, if you're insured, don't bother going to your local health department, their supply is relegated to uninsured and Medicaid eligible people.

But if you're uninsured or Medicaid eligible, then don't bother going to the local pharmacy. You can't afford it. See the problem here. What's even worse is the fact that many nursing homes can't crack the absurd bureaucracy this created. Meaning that only 7 percent of the country's most vulnerable people to Covid have gotten the booster for it. It's a perfect demonstration of just how broken health care incentives can be.

We've made it harder to get a vaccine. That for years we've been saying, is absolutely critical. Simply so that the manufacturers can make more money. And you know what the outcome will be. Not only won't the vast majority of Americans get their booster, but the companies won't make much money either. And you know what it serves them, right?

The second issue, though, here, is simply apathy. Look, we're just not experiencing nearly the number of cases that we had been at this time last year, or certainly not the few years before, in 2020 and 2021. But 3 percent coverage, that's a real problem, considering that we simply don't know where this virus is headed. And there's still the risk that it's got one last evolutionary gasp inside it.

And that, I don't have to tell you, could be catastrophic. So look, if you're one of those 93 percent of Americans who are eligible who have not gotten vaccinated, what are you doing? Go get your booster, please.

That's the business model. But there are ultimately two questions that the attorneys general have to prove. That meta specifically and knowingly targeted kids, and that there was demonstrated harm. The harm part is where I want to focus here, as we discussed in an episode on this topic a few months ago. American teens, and to a less extent, teens around the world, are facing a mental health crisis. And while it's en vogue to blame the pandemic, it started far further back.

Rates of depression, anxiety, isolation and suicidal thoughts began to hockey stick upwards in the mid 2010s, just as teen social media also began to skyrocket. And it's not just individual use, it's the way that social media has fundamentally reshaped the circumstances of teen social dynamics. Pulling more and more of their lives into the online simulacrum. I'm glad that government leaders are pushing back. I just wish that instead of 42 attorneys general, that well, the federal government could get its stuff together and move on this.

And finally, as of this Sunday, more than 7,000 people, 3,000 of them children, had died in Israel's aerial assault on Gaza leading up to their ground invasion over the weekend. Every single life deserves its dignity, and that's why I condemned and will continue to condemn Hamas's brutal attacks on Israel on October 7th. It was vile and wrong. But what of the lives of innocent Palestinians? Hamas's attack took 1400 lives.

Even before the ground invasion, Israel's attacks took 7,000.

Five times as many. The only way the loss of a life justifies the loss of five others is if you devalue those five others. And I'm afraid that as these bombardments have taken place, the conversation that's been had about them has done just that. I'm particularly ashamed by the way our leaders have engaged in this.

But you know why we don't? Israel has either driven them out or attacked them in their indiscriminate destruction of Gaza. Since October 7th, Israel has killed 57 U...N. staffers and 29 journalists. In any other circumstance, you'd probably have heard about this already.

Chances are this is the first time you're hearing about it. Or the 500 American citizens that are stuck on the border with Egypt that cannot get out. And if you're outraged by it, there's one answer that we should be calling for a ceasefire now. This is a public health podcast, and I try to leave the international affairs work to folks like Tommy and Ben, who are far better versed on this than me. But I'm a doctor and a public health official. And I have to remind us all that war is the single most frustrating public health problem because it almost always can be avoided.

And it should be, and it must be, and if we have a voice, we have a responsibility to call for its avoidance. So it's shocking and shameful to me that our leaders seem to be walking us into yet another Middle Eastern war with no end in sight. It could cost us tens of thousands of lives, decimate what's left of our reputation abroad, and could even cost young American servicemen and women their lives.

We don't have to take it, we could choose another way. And that's why we need a ceasefire now, if only our leaders had the courage to call for it. And that's it for today.

America dissected is a product of crooked media. Our producers, Austin Fisher, our associate producers are Tara Terpstra and Emma Lecfranc. Vasilis Fotopoulos mixes and masters the show. production support from Ari Schwartz. Our theme song is by Takai Azizawa and Alex Uguera. Our executive producers are Leo Duran, Sarah Geismer, Michael Martinez and me. Dr. Abdul El-sayed, your host.

Thanks for listening.

This show is for general information and entertainment purposes only. It's not intended to provide specific health care or medical advice and should not be construed as providing health care or medical advice. Please consult your physician with any questions related to your own health. The views expressed in this podcast reflect those of the host and his guests, and do not necessarily represent the views and opinions of Wayne County, Michigan, or its Department of Health, Human and Veteran Services.