Podcast appearances and mentions of ashley gearhardt

Lots of talk these days about ultra-processed foods (UPFs). Along with confusion about what in the heck they are or what they're not, how bad they are for us, and what ought to be done about them. A landmark in the discussion of ultra-processed foods has been the publication of a book entitled Ultra-processed People, Why We Can't Stop Eating Food That Isn't Food. The author of that book, Dr. Chris van Tulleken, joins us today. Dr. van Tulleken is a physician and is professor of Infection and Global Health at University College London. He also has a PhD in molecular virology and is an award-winning broadcaster on the BBC. His book on Ultra-processed People is a bestseller. Interview Summary Chris, sometimes somebody comes along that takes a complicated topic and makes it accessible and understandable and brings it to lots of people. You're a very fine scientist and scholar and academic, but you also have that ability to communicate effectively with lots of people, which I very much admire. So, thanks for doing that, and thank you for joining us. Oh, Kelly, it's such a pleasure. You know, I begin some of my talks now with a clipping from the New York Times. And it's a picture of you and an interview you gave in 1995. So exactly three decades ago. And in this article, you just beautifully communicate everything that 30 years later I'm still saying. So, yeah. I wonder if communication, it's necessary, but insufficient. I think we are needing to think of other means to bring about change. I totally agree. Well, thank you by the way. And I hope I've learned something over those 30 years. Tell us, please, what are ultra-processed foods? People hear the term a lot, but I don't think a lot of people know exactly what it means. The most important thing to know, I think, is that it's not a casual term. It's not like 'junk food' or 'fast food.' It is a formal scientific definition. It's been used in hundreds of research studies. The definition is very long. It's 11 paragraphs long. And I would urge anyone who's really interested in this topic, go to the United Nations Food and Agricultural Organization website. You can type in NFAO Ultra and you'll get the full 11 paragraph definition. It's an incredibly sophisticated piece of science. But it boils down to if you as a consumer, someone listening to this podcast, want to know if the thing you are eating right now is ultra-processed, look at the ingredients list. If there are ingredients on that list that you do not normally find in a domestic kitchen like an emulsifier, a coloring, a flavoring, a non-nutritive sweetener, then that product will be ultra-processed. And it's a way of describing this huge range of foods that kind of has taken over the American and the British and in fact diets all over the world. How come the food companies put this stuff in the foods? And the reason I ask is in talks I give I'll show an ingredient list from a food that most people would recognize. And ask people if they can guess what the food is from the ingredient list. And almost nobody can. There are 35 things on the ingredient list. Sugar is in there, four different forms. And then there are all kinds of things that are hard to pronounce. There are lots of strange things in there. They get in there through loopholes and government regulation. Why are they there in the first place? So, when I started looking at this I also noticed this long list of fancy sounding ingredients. And even things like peanut butter will have palm oil and emulsifiers. Cream cheese will have xanthum gum and emulsifiers. And you think, well, wouldn't it just be cheaper to make your peanut butter out of peanuts. In fact, every ingredient is in there to make money in one of two ways. Either it drives down the cost of production or storage. If you imagine using a real strawberry in your strawberry ice cream. Strawberries are expensive. They're not always in season. They rot. You've got to have a whole supply chain. Why would you use a strawberry if you could use ethyl methylphenylglycidate and pink dye and it'll taste the same. It'll look great. You could then put in a little chunky bit of modified corn starch that'll be chewy if you get it in the right gel mix. And there you go. You've got strawberries and you haven't had to deal with strawberry farmers or any supply chain. It's just you just buy bags and bottles of white powder and liquids. The other way is to extend the shelf life. Strawberries as I say, or fresh food, real food - food we might call it rots on shelves. It decays very quickly. If you can store something at room temperature in a warehouse for months and months, that saves enormous amounts of money. So, one thing is production, but the other thing is the additives allow us to consume to excess or encourage us to consume ultra-processed food to excess. So, I interviewed a scientist who was a food industry development scientist. And they said, you know, most ultra-processed food would be gray if it wasn't dyed, for example. So, if you want to make cheap food using these pastes and powders, unless you dye it and you flavor it, it will be inedible. But if you dye it and flavor it and add just the right amount of salt, sugar, flavor enhancers, then you can make these very addictive products. So that's the logic of UPF. Its purpose is to make money. And that's part of the definition. Right. So, a consumer might decide that there's, you know, beneficial trade-off for them at the end of the day. That they get things that have long shelf life. The price goes down because of the companies don't have to deal with the strawberry farmers and things like that. But if there's harm coming in waves from these things, then it changes the equation. And you found out some of that on your own. So as an experiment you did with a single person - you, you ate ultra-processed foods for a month. What did you eat and how did it affect your body, your mood, your sleep? What happened when you did this? So, what's really exciting, actually Kelly, is while it was an n=1, you know, one participant experiment, I was actually the pilot participant in a much larger study that we have published in Nature Medicine. One of the most reputable and high impact scientific journals there is. So, I was the first participant in a randomized control trial. I allowed us to gather the data about what we would then measure in a much larger number. Now we'll come back and talk about that study, which I think was really important. It was great to see it published. So, I was a bit skeptical. Partly it was with my research team at UCL, but we were also filming it for a BBC documentary. And I went into this going I'm going to eat a diet of 80% of my calories will come from ultra-processed food for four weeks. And this is a normal diet. A lifelong diet for a British teenager. We know around 20% of people in the UK and the US eat this as their normal food. They get 80% of their calories from ultra-processed products. I thought, well, nothing is going to happen to me, a middle-aged man, doing this for four weeks. But anyway, we did it kind of as a bit of fun. And we thought, well, if nothing happens, we don't have to do a bigger study. We can just publish this as a case report, and we'll leave it out of the documentary. Three big things happened. I gained a massive amount of weight, so six kilos. And I wasn't force feeding myself. I was just eating when I wanted. In American terms, that's about 15 pounds in four weeks. And that's very consistent with the other published trials that have been done on ultra-processed food. There have been two other RCTs (randomized control trials); ours is the third. There is one in Japan, one done at the NIH. So, people gain a lot of weight. I ate massively more calories. So much so that if I'd continued on the diet, I would've almost doubled my body weight in a year. And that may sound absurd, but I have an identical twin brother who did this natural experiment. He went to Harvard for a year. He did his masters there. During his year at Harvard he gained, let's see, 26 kilos, so almost 60 pounds just living in Cambridge, Massachusetts. But how did you decide how much of it to eat? Did you eat until you just kind of felt naturally full? I did what most people do most of the time, which is I just ate what I wanted when I felt like it. Which actually for me as a physician, I probably took the breaks off a bit because I don't normally have cocoa pops for breakfast. But I ate cocoa pops and if I felt like two bowls, I'd have two bowls. It turned out what I felt like a lot of mornings was four bowls and that was fine. I was barely full. So, I wasn't force feeding myself. It wasn't 'supersize' me. I was eating to appetite, which is how these experiments run. And then what we've done in the trials. So, I gained weight, then we measured my hormone response to a meal. When you eat, I mean, it's absurd to explain this to YOU. But when you eat, you have fullness hormones that go up and hunger hormones that go down, so you feel full and less hungry. And we measured my response to a standard meal at the beginning and at the end of this four-week diet. What we found is that I had a normal response to eating a big meal at the beginning of the diet. At the end of eating ultra-processed foods, the same meal caused a very blunted rise in the satiety hormones. In the 'fullness' hormones. So, I didn't feel as full. And my hunger hormones remained high. And so, the food is altering our response to all meals, not merely within the meal that we're eating. Then we did some MRI scans and again, I thought this would be a huge waste of time. But we saw at four weeks, and then again eight weeks later, very robust changes in the communication between the habit-forming bits at the back of the brain. So, the automatic behavior bits, the cerebellum. Very conscious I'm talking to YOU about this, Kelly. And the kind of addiction reward bits in the middle. Now these changes were physiological, not structural. They're about the two bits of the brain talking to each other. There's not really a new wire going between them. But we think if this kind of communication is happening a lot, that maybe a new pathway would form. And I think no one, I mean we did this with very expert neuroscientists at our National Center for Neuroscience and Neurosurgery, no one really knows what it means. But the general feeling was these are the kind of changes we might expect if we'd given someone, or a person or an animal, an addictive substance for four weeks. They're consistent with, you know, habit formation and addiction. And the fact that they happened so quickly, and they were so robust - they remained the same eight weeks after I stopped the diet, I think is really worrying from a kid's perspective. So, in a period of four weeks, it re-altered the way your brain works. It affected the way your hunger and satiety were working. And then you ended up with this massive weight. And heaven knows what sort of cardiovascular effects or other things like that might have been going on or had the early signs of that over time could have been really pretty severe, I imagine. I think one of the main effects was that I became very empathetic with my patients. Because we did actually a lot of, sort of, psychological testing as well. And there's an experience where, obviously in clinic, I mainly treat patients with infections. But many of my patients are living with other, sort of, disorders of modern life. They live with excess weight and cardiovascular disease and type two diabetes and metabolic problems and so on. And I felt in four weeks like I'd gone from being in my early 30, early 40s at the time, I felt like I'd just gone to my early 50s or 60s. I ached. I felt terrible. My sleep was bad. And it was like, oh! So many of the problems of modern life: waking up to pee in the middle of the night is because you've eaten so much sodium with your dinner. You've drunk all this water, and then you're trying to get rid of it all night. Then you're constipated. It's a low fiber diet, so you develop piles. Pain in your bum. The sleep deprivation then makes you eat more. And so, you get in this vicious cycle where the problem didn't feel like the food until I stopped and I went cold turkey. I virtually have not touched it since. It cured me of wanting UPF. That was the other amazing bit of the experience that I write about in the book is it eating it and understanding it made me not want it. It was like being told to smoke. You know, you get caught smoking as a kid and your parents are like, hey, now you finish the pack. It was that. It was an aversion experience. So, it gave me a lot of empathy with my patients that many of those kinds of things we regard as being normal aging, those symptoms are often to do with the way we are living our lives. Chris, I've talked to a lot of people about ultra-processed foods. You're the first one who's mentioned pain in the bum as one of the problems, so thank you. When I first became a physician, I trained as a surgeon, and I did a year doing colorectal surgery. So, I have a wealth of experience of where a low fiber diet leaves you. And many people listening to this podcast, I mean, look, we're all going to get piles. Everyone gets these, you know, anal fishes and so on. And bum pain it's funny to talk about it. No, not the... it destroys people's lives, so, you know, anyway. Right. I didn't want to make light of it. No, no. Okay. So, your own experiment would suggest that these foods are really bad actors and having this broad range of highly negative effects. But what does research say about these things beyond your own personal experience, including your own research? So, the food industry has been very skillful at portraying this as a kind of fad issue. As ultra-processed food is this sort of niche thing. Or it's a snobby thing. It's not a real classification. I want to be absolutely clear. UPF, the definition is used by the World Health Organization and the United Nations Food and Agricultural Organization to monitor global diet quality, okay? It's a legitimate way of thinking about food. The last time I looked, there are more than 30 meta-analyses - that is reviews of big studies. And the kind of high-quality studies that we use to say cigarettes cause lung cancer. So, we've got this what we call epidemiological evidence, population data. We now have probably more than a hundred of these prospective cohort studies. And they're really powerful tools. They need to be used in conjunction with other evidence, but they now link ultra-processed food to this very wide range of what we euphemistically call negative health outcomes. You know, problems that cause human suffering, mental health problems, anxiety, depression, multiple forms of cancer, inflammatory diseases like Crohn's disease and ulcerative colitis, metabolic disease, cardiovascular disease, Alzheimer's and dementia. Of course, weight gain and obesity. And all cause mortality so you die earlier of all causes. And there are others too. So, the epidemiological evidence is strong and that's very plausible. So, we take that epidemiological evidence, as you well know, and we go, well look, association and causation are different things. You know, do matches cause cancer or does cigarettes cause cancer? Because people who buy lots of matches are also getting the lung cancer. And obviously epidemiologists are very sophisticated at teasing all this out. But we look at it in the context then of other evidence. My group published the third randomized control trial where we put a group of people, in a very controlled way, on a diet of either minimally processed food or ultra-processed food and looked at health outcomes. And we found what the other two trials did. We looked at weight gain as a primary outcome. It was a short trial, eight weeks. And we saw people just eat more calories on the ultra-processed food. This is food that is engineered to be consumed to excess. That's its purpose. So maybe to really understand the effect of it, you have to imagine if you are a food development engineer working in product design at a big food company - if you develop a food that's cheap to make and people will just eat loads of it and enjoy it, and then come back for it again and again and again, and eat it every day and almost become addicted to it, you are going to get promoted. That product is going to do well on the shelves. If you invent a food that's not addictive, it's very healthy, it's very satisfying, people eat it and then they're done for the day. And they don't consume it to excess. You are not going to keep your job. So that's a really important way of understanding the development process of the foods. So let me ask a question about industry and intent. Because one could say that the industry engineers these things to have long shelf life and nice physical properties and the right colors and things like this. And these effects on metabolism and appetite and stuff are unpleasant and difficult side effects, but the foods weren't made to produce those things. They weren't made to produce over consumption and then in turn produce those negative consequences. You're saying something different. That you think that they're intentionally designed to promote over consumption. And in some ways, how could the industry do otherwise? I mean, every industry in the world wants people to over consume or consume as much of their product as they can. The food industry is no different. That is exactly right. The food industry behaves like every other corporation. In my view, they commit evil acts sometimes, but they're not institutionally evil. And I have dear friends who work in big food, who work in big pharma. I have friends who work in tobacco. These are not evil people. They're constrained by commercial incentives, right? So, when I say I think the food is engineered, I don't think it. I know it because I've gone and interviewed loads of people in product development at big food companies. I put some of these interviewees in a BBC documentary called Irresistible. So rather than me in the documentary going, oh, ultra-processed food is bad. And everyone going, well, you are, you're a public health bore. I just got industry insiders to say, yes, this is how we make the food. And going back to Howard Moskovitz, in the 1970s, I think he was working for the Campbell Soup Company. And Howard, who was a psychologist by training, outlined the development process. And what he said was then underlined by many other people I've spoken to. You develop two different products. This one's a little bit saltier than the next, and you test them on a bunch of people. People like the saltier ones. So now you keep the saltier one and you develop a third product and this one's got a bit more sugar in it. And if this one does better, well you keep this one and you keep AB testing until you get people buying and eating lots. And one of the crucial things that food companies measure in product development is how fast do people eat and how quickly do they eat. And these kind of development tools were pioneered by the tobacco industry. I mean, Laura Schmidt has done a huge amount of the work on this. She's at University of California, San Francisco (UCSF), in California. And we know the tobacco industry bought the food industry and for a while in the '80s and '90s, the biggest food companies in the world were also the biggest tobacco companies in the world. And they used their flavor molecules and their marketing techniques and their distribution systems. You know, they've got a set of convenience tools selling cigarettes all over the country. Well, why don't we sell long shelf-life food marketed in the same way? And one thing that the tobacco industry was extremely good at was figuring out how to get the most rapid delivery of the drug possible into the human body when people smoke. Do you think that some of that same thing is true for food, rapid delivery of sugar, let's say? How close does the drug parallel fit, do you think? So, that's part of the reason the speed of consumption is important. Now, I think Ashley Gearhardt has done some of the most incredible work on this. And what Ashley says is we think of addictive drugs as like it's the molecule that's addictive. It's nicotine, it's caffeine, cocaine, diamorphine, heroin, the amphetamines. What we get addicted to is the molecule. And that Ashley says no. The processing of that molecule is crucially important. If you have slow-release nicotine in a chewing gum, that can actually treat your nicotine addiction. It's not very addictive. Slow-release amphetamine we use to treat children with attention and behavioral problems. Slow-release cocaine is an anesthetic. You use it for dentistry. No one ever gets addicted to dental anesthetics. And the food is the same. The rewarding molecules in the food we think are mainly the fat and the sugar. And food that requires a lot of chewing and is slow eaten slowly, you don't deliver the reward as quickly. And it tends not to be very addictive. Very soft foods or liquid foods with particular fat sugar ratios, if you deliver the nutrients into the gut fast, that seems to be really important for driving excessive consumption. And I think the growing evidence around addiction is very persuasive. I mean, my patients report feeling addicted to the food. And I don't feel it's legitimate to question their experience. Chris, a little interesting story about that concept of food and addiction. So going back several decades I was a professor at Yale, and I was teaching a graduate course. Ashley Gerhardt was a student in that course. And, she was there to study addiction, not in the context of food, but I brought up the issue of, you know, could food be addictive? There's some interesting research on this. It's consistent with what we're hearing from people, and that seems a really interesting topic. And Ashley, I give her credit, took this on as her life's work and now she's like the leading expert in the world on this very important topic. And what's nice for me to recall that story is that how fast the science on this is developed. And now something's coming out on this almost every day. It's some new research on the neuroscience of food and addiction and how the food is hijacking in the brain. And that whole concept of addiction seems really important in this context. And I know you've talked a lot about that yourself. She has reframed, I think, this idea about the way that addictive substances and behaviors really work. I mean it turns everything on its head to go the processing is important. The thing the food companies have always been able to say is, look, you can't say food is addictive. It doesn't contain any addictive molecules. And with Ashley's work you go, no, but the thing is it contains rewarding molecules and actually the spectrum of molecules that we can find rewarding and we can deliver fast is much, much broader than the traditionally addictive substances. For policy, it's vital because part of regulating the tobacco industry was about showing they know they are making addictive products. And I think this is where Ashley's work and Laura Schmidt's work are coming together. With Laura's digging in the tobacco archive, Ashley's doing the science on addiction, and I think these two things are going to come together. And I think it's just going to be a really exciting space to watch. I completely agree. You know when most people think about the word addiction, they basically kind of default to thinking about how much you want something. How much, you know, you desire something. But there are other parts of it that are really relevant here too. I mean one is how do you feel if you don't have it and sort of classic withdrawal. And people talk about, for example, being on high sugar drinks and stopping them and having withdrawal symptoms and things like that. And the other part of it that I think is really interesting here is tolerance. You know whether you need more of the substance over time in order to get the same reward benefit. And that hasn't been studied as much as the other part of addiction. But there's a lot to the picture other than just kind of craving things. And I would say that the thing I like about this is it chimes with my. Personal experience, which is, I have tried alcohol and cigarettes and I should probably end that list there. But I've never had any real desire for more of them. They aren't the things that tickle my brain. Whereas the food is a thing that I continue to struggle with. I would say in some senses, although I no longer like ultra-processed food at some level, I still want it. And I think of myself to some degree, without trivializing anyone's experience, to some degree I think I'm in sort of recovery from it. And it remains that tussle. I mean I don't know what you think about the difference between the kind of wanting and liking of different substances. Some scientists think those two things are quite, quite different. That you can like things you don't want, and you can want things you don't like. Well, that's exactly right. In the context of food and traditional substances of abuse, for many of them, people start consuming because they produce some sort of desired effect. But that pretty quickly goes away, and people then need the substance because if they don't have it, they feel terrible. So, you know, morphine or heroin or something like that always produces positive effects. But that initial part of the equation where you just take it because you like it turns into this needing it and having to have it. And whether that same thing exists with food is an interesting topic. I think the other really important part of the addiction argument in policy terms is that one counterargument by industrial scientists and advocates is by raising awareness around ultra-processed food we are at risk of driving, eating disorders. You know? The phenomenon of orthorexia, food avoidance, anorexia. Because all food is good food. There should be no moral value attached to food and we mustn't drive any food anxiety. And I think there are some really strong voices in the United Kingdom Eating Disorder scientists. People like Agnes Ayton, who are starting to say, look, when food is engineered, using brain scanners and using scientific development techniques to be consumed to excess, is it any wonder that people develop a disordered relationship with the food? And there may be a way of thinking about the rise of eating disorders, which is parallel to the rise of our consumption of ultra-processed food, that eating disorders are a reasonable response to a disordered food environment. And I think that's where I say all that somewhat tentatively. I feel like this is a safe space where you will correct me if I go off piste. But I think it's important to at least explore that question and go, you know, this is food with which it is very hard, I would say, to have a healthy relationship. That's my experience. And I think the early research is bearing that out. Tell us how these foods affect your hunger, how full you feel, your microbiome. That whole sort of interactive set of signals that might put people in harmony with food in a normal environment but gets thrown off when the foods get processed like this. Oh, I love that question. At some level as I'm understanding that question, one way of trying to answer that question is to go, well, what is the normal physiological response to food? Or maybe how do wild animals find, consume, and then interpret metabolically the food that they eat. And it is staggering how little we know about how we learn what food is safe and what food nourishes us. What's very clear is that wild mammals, and in fact all wild animals, are able to maintain near perfect energy balance. Obesity is basically unheard of in the wild. And, perfect nutritional intake, I mean, obviously there are famines in wild animals, but broadly, animals can do this without being literate, without being given packaging, without any nutritional advice at all. So, if you imagine an ungulate, an herbivore on the plains of the Serengeti, it has a huge difficulty. The carnivore turning herbivore into carnivore is fairly easy. They're made of the same stuff. Turning plant material into mammal is really complicated. And somehow the herbivore can do this without gaining weight, whilst maintaining total precision over its selenium intake, its manganese, its cobalt, its iron, all of which are terrible if you have too little and also terrible if you have too much. We understand there's some work done in a few wild animals, goats, and rats about how this works. Clearly, we have an ability to sense the nutrition we want. What we understand much more about is the sort of quantities needed. And so, we've ended up with a system of nutritional advice that says, well, just eat these numbers. And if you can stick to the numbers, 2,500 calories a day, 2300 milligrams of sodium, no more than 5% of your calories from free sugar or 10%, whatever it is, you know, you stick to these numbers, you'll be okay. And also, these many milligrams of cobalt, manganese, selenium, iron, zinc, all the rest of it. And obviously people can't really do that even with the packaging. This is a very long-winded answer. So, there's this system that is exquisitely sensitive at regulating micronutrient and energy intake. And what we understand, what the Academy understands about how ultra-processed food subverts this is, I would say there are sort of three or four big things that ultra-processed does that real food doesn't. It's generally very soft. And it's generally very energy dense. And that is true of even the foods that we think of as being healthy. That's like your supermarket whole grain bread. It's incredibly energy dense. It's incredibly soft. You eat calories very fast, and this research was done in the '90s, you know we've known that that kind of food promotes excessive intake. I guess in simple terms, and you would finesse this, you consume calories before your body has time to go, well, you've eaten enough. You can consume an excess. Then there's the ratios of fat, salt, and sugar and the way you can balance them, and any good cook knows if you can get the acid, fat, salt, sugar ratios right, you can make incredibly delicious food. That's kind of what I would call hyper palatability. And a lot of that work's being done in the states (US) by some incredible people. Then the food may be that because it's low in fiber and low in protein, quite often it's not satiating. And there may be, because it's also low in micronutrients and general nutrition, it may be that, and this is a little bit theoretical, but there's some evidence for this. Part of what drives the excess consumption is you're kind of searching for the nutrients. The nutrients are so dilute that you have to eat loads of it in order to get enough. Do you think, does that, is that how you understand it? It does, it makes perfect sense. In fact, I'm glad you brought up one particular issue because part of the ultra-processing that makes foods difficult for the body to deal with involves what gets put in, but also what gets taken out. And there was a study that got published recently that I think you and I might have discussed earlier on American breakfast cereals. And this study looked at how the formulation of them had changed over a period of about 20 years. And what they found is that the industry had systematically removed the protein and the fiber and then put in more things like sugar. So there, there's both what goes in and what gets taken out of foods that affects the body in this way. You know, what I hear you saying, and what I, you know, believe myself from the science, is the body's pretty capable of handling the food environment if food comes from the natural environment. You know, if you sit down to a meal of baked chicken and some beans and some leafy greens and maybe a little fruit or something, you're not going to overdo it. Over time you'd end up with the right mix of nutrients and things like that and you'd be pretty healthy. But all bets are off when these foods get processed and engineered, so you over consume them. You found that out in the experiment that you did on yourself. And then that's what science shows too. So, it's not like these things are sort of benign. People overeat them and they ought to just push away from the table. There's a lot more going on here in terms of hijacking the brain chemistry. Overriding the body signals. Really thwarting normal biology. Do you think it's important to add that we think of obesity as being the kind of dominant public health problem? That's the thing we all worry about. But the obesity is going hand in hand with stunting, for example. So, height as you reach adulthood in the US, at 19 US adults are something like eight or nine centimeters shorter than their counterparts in Northern Europe, Scandinavia, where people still eat more whole food. And we should come back to that evidence around harms, because I think the really important thing to say around the evidence is it has now reached the threshold for causality. So, we can say a dietary pattern high in ultra-processed food causes all of these negative health outcomes. That doesn't mean that any one product is going to kill you. It just means if this is the way you get your food, it's going to be harmful. And if all the evidence says, I mean, we've known this for decades. If you can cook the kind of meal, you just described at home, which is more or less the way that high income people eat, you are likely to have way better health outcomes across the board. Let me ask you about the title of your book. So, the subtitle of your book is Why We Can't Stop Eating Food That Isn't Food. So, what is it? The ultra-processed definition is something I want to pay credit for. It's really important to pay a bit of credit here. Carlos Montero was the scientist in Brazil who led a team who together came up with this definition. And, I was speaking to Fernanda Rauber who was on that team, and we were trying to discuss some research we were doing. And every time I said food, she'd correct me and go, it is not, it's not food, Chris. It's an industrially produced edible substance. And that was a really helpful thing for me personally, it's something it went into my brain, and I sat down that night. I was actually on the UPF diet, and I sat down to eat some fried chicken wings from a popular chain that many people will know. And was unable to finish them. I think our shared understanding of the purpose of food is surely that its purpose is to nourish us. Whether it's, you know, sold by someone for this purpose, or whether it's made by someone at home. You know it should nourish us spiritually, socially, culturally, and of course physically and mentally. And ultra-processed food nourishes us in no dimension whatsoever. It destroys traditional knowledge, traditional land, food culture. You don't sit down with your family and break, you know, ultra-processed, you know, crisps together. You know, you break bread. To me that's a kind of very obvious distortion of what it's become. So, I don't think it is food. You know, I think it's not too hard of a stretch to see a time when people might consider these things non-food. Because if you think of food, what's edible and whether it's food or not is completely socially constructed. I mean, some parts of the world, people eat cockroaches or ants or other insects. And in other parts of the world that's considered non-food. So just because something's edible doesn't mean that it's food. And I wonder if at some point we might start to think of these things as, oh my God, these are awful. They're really bad for us. The companies are preying on us, and it's just not food. And yeah, totally your book helps push us in that direction. I love your optimism. The consumer facing marketing budget of a big food company is often in excess of $10 billion a year. And depends how you calculate it. I'll give you a quick quiz on this. So, for a while, the Robert Wood Johnson Foundation was by far the biggest funder of research in the world on childhood obesity. And they were spending $500 million a year to address this problem. Just by which day of the year the food industry has already spent $500 million just advertising just junk food just to children. Okay, so the Robert V. Wood Foundation is spending it and they were spending that annually. Annually, right. So, what's, by what day of the year is the food industry already spent that amount? Just junk food advertising just to kids. I'm going to say by somewhere in early spring. No. January 4th. I mean, it's hysterical, but it's also horrifying. So, this is the genius of ultra-processed food, of the definition and the science, is that it creates this category which is discretionary. And so at least in theory, of course, for many people in the US it's not discretionary at all. It's the only stuff they can afford. But this is why the food industry hate it so much is because it offers the possibility of going, we can redefine food. And there is all this real food over there. And there is this UPF stuff that isn't food over here. But industry's very sophisticated, you know. I mean, they push back very hard against me in many different ways and forms. And they're very good at going, well, you're a snob. How dare you say that families with low incomes, that they're not eating food. Are you calling them dupes? Are you calling them stupid? You know, they're very, very sophisticated at positioning. Isn't it nice how concerned they are about the wellbeing of people without means? I mean they have created a pricing structure and a food subsidy environment and a tax environment where essentially people with low incomes in your country, in my country, are forced to eat food that harms them. So, one of the tells I think is if you're hearing someone criticize ultra-processed food, and you'll read them in the New York Times. And often their conflicts of interest won't be reported. They may be quite hidden. The clue is, are they demanding to seriously improve the food environment in a very clear way, or are they only criticizing the evidence around ultra-processed food? And if they're only criticizing that evidence? I'll bet you a pound to a pinch of salt they'll be food-industry funded. Let's talk about that. Let's talk about that a little more. So, there's a clear pattern of scientists who take money from industry finding things that favor industry. Otherwise, industry wouldn't pay that money. They're not stupid in the way they invest. And, you and I have talked about this before, but we did a study some years ago where we looked at industry and non-industry funded study on the health effects of consuming sugar sweetened beverages. And it's like the ocean parted. It's one of my favorites. And it was something like 98 or 99% of the independently funded studies found that sugar sweetened beverages do cause harm. And 98 or 99% of the industry funded studies funded by Snapple and Coke and a whole bunch of other companies found that they did not cause harm. It was that stark, was it? It was. And so you and I pay attention to the little print in these scientific studies about who's funded them and who might have conflicts of interest. And maybe you and I and other people who follow science closely might be able to dismiss those conflicted studies. But they have a big impact out there in the world, don't they? I had a meeting in London with someone recently, that they themselves were conflicted and they said, look, if a health study's funded by a big sugary drink company, if it's good science, that's fine. We should publish it and we should take it at face value. And in the discussion with them, I kind of accepted that, we were talking about other things. And afterwards I was like, no. If a study on human health is funded by a sugary drink corporation, in my opinion, we could just tear that up. None of that should be published. No journals should publish those studies and scientists should not really call themselves scientists who are doing it. It is better thought of as marketing and food industry-funded scientists who study human health, in my opinion, are better thought of as really an extension of the marketing division of the companies. You know, it's interesting when you talk to scientists, and you ask them do people who take money from industry is their work influenced by that money? They'll say yes. Yeah, but if you say, but if you take money from industry, will your work be influenced? They'll always say no. Oh yeah. There's this tremendous arrogance, blind spot, whatever it is that. I can remain untarnished. I can remain objective, and I can help change the industry from within. In the meantime, I'm having enough money to buy a house in the mountains, you know, from what they're paying me, and it's really pretty striking. Well, the money is a huge issue. You know, science, modern science it's not a very lucrative career compared to if someone like you went and worked in industry, you would add a zero to the end of your salary, possibly more. And the same is true of me. I think one of the things that adds real heft to the independent science is that the scientists are taking a pay cut to do it. So how do children figure in? Do you think children are being groomed by the industry to eat these foods? A senator, I think in Chile, got in hot water for comparing big food companies to kind of sex offenders. He made, in my view, a fairly legitimate comparison. I mean, the companies are knowingly selling harmful products that have addictive properties using the language of addiction to children who even if they could read warning labels, the warning labels aren't on the packs. So, I mean, we have breakfast cereals called Crave. We have slogans like, once you stop, once you pop, you can't stop. Bet you can't just eat one. Yeah, I think it is predatory and children are the most vulnerable group in our society. And you can't just blame the parents. Once kids get to 10, they have a little bit of money. They get their pocket money, they're walking to school, they walk past stores. You know, you have to rely on them making decisions. And at the moment, they're in a very poor environment to make good decisions. Perhaps the most important question of all what can be done. So, I'm speaking to you at a kind of funny moment because I've been feeling that a lot of my research and advocacy, broadcasting... you know, I've made documentaries, podcasts, I've written a book, I've published these papers. I've been in most of the major newspapers and during the time I've been doing this, you know, a little under 10 years I've been really focused on food. Much less time than you. Everything has got worse. Everything I've done has really failed totally. And I think this is a discussion about power, about unregulated corporate power. And the one glimmer of hope is this complaint that's been filed in Pennsylvania by a big US law firm. It's a very detailed complaint and some lawyers on behalf of a young person called Bryce Martinez are suing the food industry for causing kidney problems and type two diabetes. And I think that in the end is what's going to be needed. Strategic litigation. That's the only thing that worked with tobacco. All of the science, it eventually was useful, but the science on its own and the advocacy and the campaigning and all of it did no good until the lawyers said we would like billions and billions of dollars in compensation please. You know, this is an exciting moment, but there were a great many failed lawsuits for tobacco before the master settlement agreement in the '90s really sort of changed the game. You know, I agree with you. Are you, are you optimistic? I mean, what do you think? I am, and for exactly the same reason you are. You know, the poor people that worked on public health and tobacco labored for decades without anything happening long, long after the health consequences of cigarette smoking were well known. And we've done the same thing. I mean, those us who have been working in the field for all these years have seen precious little in the ways of policy advances. Now tobacco has undergone a complete transformation with high taxes on cigarettes, and marketing restrictions, and non-smoking in public places, laws, and things like that, that really have completely driven down the consumption of cigarettes, which has been a great public health victory. But what made those policies possible was the litigation that occurred by the state attorneys general, less so the private litigating attorneys. But the state attorneys general in the US that had discovery documents released. People began to understand more fully the duplicity of the tobacco companies. That gave cover for the politicians to start passing the policies that ultimately made the big difference. I think that same history is playing out here. The state attorneys general, as we both know, are starting to get interested in this. I say hurray to that. There is the private lawsuit that you mentioned, and there's some others in the mix as well. I think those things will bring a lot of propel the release of internal documents that will show people what the industry has been doing and how much of this they've known all along. And then all of a sudden some of these policy things like taxes, for example, on sugared beverages, might come in and really make a difference. That's my hope. But it makes me optimistic. Well, I'm really pleased to hear that because I think in your position it would be possible. You know, I'm still, two decades behind where I might be in my pessimism. One of the kind of engines of this problem to me is these conflicts of interest where people who say, I'm a physician, I'm a scientist, I believe all this. And they're quietly paid by the food industry. This was the major way the tobacco industry had a kind of social license. They were respectable. And I do hope the lawsuits, one of their functions is it becomes a little bit embarrassing to say my research institute is funded [by a company that keeps making headlines every day because more documents are coming out in court, and they're being sued by more and more people. So, I hope that this will diminish the conflict, particularly between scientists and physicians in the food industry. Because that to me, those are my biggest opponents. The food industry is really nice. They throw money at me. But it's the conflicted scientists that are really hard to argue with because they appear so respectable. Bio Dr. Chris van Tulleken is a physician and a professor of Infection and Global Health at University College London. He trained at Oxford and earned his PhD in molecular virology from University College London. His research focuses on how corporations affect human health especially in the context of child nutrition and he works with UNICEF and The World Health Organization on this area. He is the author of a book entitled Ultraprocessed People: Why We Can't Stop Eating Food That Isn't Food. As one of the BBC's leading broadcasters for children and adults his work has won two BAFTAs. He lives in London with his wife and two children.

Professors—and ultraprocessed food experts—Ashley Gearhardt and Kelly Brownell join Mark and Kate to talk about why the robust new science about food and addiction is going to be hard to ignore, how junk food could take the path of cigarettes and opioids with regards to litigation (and how tobacco paved the way), and why marketing these foods to kids is so successful (and the many reasons why kids are so important to focus on).Subscribe to Food with Mark Bittman on Apple Podcasts, Spotify, or wherever you like to listen, and please help us grow by leaving us a 5 star review on Apple Podcasts.Follow Mark on Twitter at @bittman, and on Facebook and Instagram at @markbittman. Want more food content? Subscribe to The Bittman Project at www.bittmanproject.com. Hosted on Acast. See acast.com/privacy for more information.

There are dangers lurking in our food that affect your health and the health of our entire society, and you should know about them. In this episode, get the highlights from two recent Congressional events featuring expert testimony about the regulation of our food supply, as well as testimony from the man who is soon likely to be the most powerful person in our national health care system. Please Support Congressional Dish – Quick Links Contribute monthly or a lump sum via Support Congressional Dish via (donations per episode) Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: Please make checks payable to Congressional Dish Thank you for supporting truly independent media! Background Sources Joe Rogan Episodes The Joe Rogan Experience. The Joe Rogan Experience. The Joe Rogan Experience. The Joe Rogan Experience. Ron Johnson Scott Bauer. January 3, 2023. AP News. Robert F. Kennedy, Jr. Daniel Cusick. October 28, 2024. Politico. Rachel Treisman. August 5, 2024. NPR. Susanne Craig. May 8, 2024. The New York Times. Department of Health and Human Services U.S. Department of Health and Human Services. FDA “Generally Recognized as Safe” Approach Paulette M. Gaynor et al. April 2006. U.S. Food and Drug Administration. Paulette Gaynor and Sebastian Cianci. December 2005/January 2006. U.S. Food and Drug Administration. Glyphosate September 20, 2023. Phys.org. Lobbying and Conflicts of Interest OpenSecrets. OpenSecrets. OpenSecrets. LinkedIn. Shift from Democrats to Republicans Will Stone and Allison Aubrey. November 15, 2024. NPR. Helena Bottemiller Evich and Darren Samuelsohn. March 17, 2016. Politico. Audio Sources September 25, 2024 Roundtable discussion held by Senator Ron Johnson Participants: , Author, Good Energy; Tech entrepreneur, Levels , Co-founder, Truemed; Advocate, End Chronic Disease , aka the Food Babe, food activist Jillian Michaels, fitness expert, nutritionist, businesswoman, media personality, and author Dr. Chris Palmer, Founder and Director, Metabolic and Mental Health Program and Director, Department of Postgraduate and Continuing Education, McLean Hospital; Assistant Professor of Psychiatry, Harvard Medical School Brigham Buhler, Founder & CEO, Ways2Well Courtney Swan, nutritionist, real food activist, and founder of the popular platform "Realfoodology" , Founder and CEO, HumanCo; co-founder, Hu Kitchen Dr. Marty Makary, Chief of Islet Transplant Surgery, Professor of Surgery, and Public Policy Researcher, Johns Hopkins University Clips Robert F. Kennedy, Jr: When discussing improvements to US healthcare policy, politicians from both parties often say we have the best healthcare system in the world. That is a lie. Robert F. Kennedy, Jr: Every major pillar of the US healthcare system, as a statement of economic fact, makes money when Americans get sick. By far the most valuable asset in this country today is a sick child. The pharma industry, hospital industry, and medical school industry make more money when there are more interventions to perform on Americans, and by requiring insurance companies to take no more than 15% of premiums, Obamacare actually incentivized insurance companies to raise premiums to get 15% of a larger pie. This is why premiums have increased 100% since the passage of Obamacare, making health care the largest driver of inflation, while American life expectancy plummets. We spend four times per capita on health care than the Italians, but Italians live 7.5 years longer than us on average. And incidentally, Americans had the highest life expectancies in the world when I was growing up. Today, we've fallen an average of six years behind our European neighbors. Are we lazier and more suicidal than Italians? Or is there a problem with our system? Are there problems with our incentives? Are there problems with our food? 46:15 Robert F. Kennedy, Jr: So what's causing all of this suffering? I'll name two culprits, first and worst is ultra processed foods. 47:20 Robert F. Kennedy, Jr: The second culprit is toxic chemicals in our food, our medicine and our environment. Robert F. Kennedy, Jr: The good news is that we can change all this, and we can change it very, very, very quickly, and it starts with taking a sledgehammer to corruption, the conflicts in our regulatory agencies and in this building. These conflicts have transformed our regulatory agencies into predators against the American people and particularly our children. 80% of NIH grants go to people who have conflicts of interest, and these scientists are allowed to collect royalties of $150,000 a year on the products that they develop at NIH and then farm out to the pharmaceutical industry. The FDA, the USDA and CDC are all controlled by giant for-profit corporations. Their function is no longer to improve and protect the health of Americans. Their function is to advance the mercantile and commercial interests of the pharmaceutical industry that has transformed them and the food industry that has transformed them into sock puppets for the industry they're supposed to regulate. 75% of FDA funding does not come from taxpayers. It comes from pharma. And pharma executives and consultants and lobbyists cycle in and out of these agencies. Robert F. Kennedy, Jr: Money from the healthcare industry has compromised our regulatory agencies and this body as well. The reality is that many congressional healthcare staffers are worried about impressing their future bosses at pharmaceutical companies rather than doing the right thing for American children. Today, over 100 members of Congress support a bill to fund Ozempic with Medicare at $1,500 a month. Most of these members have taken money from the manufacturer of that product, a European company called Novo Nordisk. As everyone knows, once a drug is approved for Medicare, it goes to Medicaid, and there is a push to recommend Ozempic for Americans as young as six, over a condition, obesity, that is completely preventable and barely even existed 100 years ago. Since 74% of Americans are obese, the cost of all of them, if they take their Ozempic prescriptions, will be $3 trillion a year. This is a drug that has made Novo Nordisk the biggest company in Europe. It's a Danish company, but the Danish government does not recommend it. It recommends a change in diet to treat obesity and exercise. Virtually Novo Nordisk's entire value is based upon its projections of what Ozempic is going to sell to Americans. For half the price of Ozempic, we could purchase regeneratively raised organic agriculture, organic food for every American, three meals a day and a gym membership for every obese American. Why are members of Congress doing the bidding of this Danish company instead of standing up for American farmers and children? Robert F. Kennedy, Jr: For 19 years, solving the childhood chronic disease crisis has been the central goal of my life, and for 19 years, I have prayed to God every morning to put me in a position to end this calamity. I believe we have the opportunity for transformational, bipartisan change to transform American health, to hyper-charge our human capital, to improve our budget, and I believe, to save our spirits and our country. 1:23:10 Sen. Ron Johnson (R-WI): Our next presenter, Dr. Marty Makary also bears a few scars from telling the truth during COVID. Dr. Makary is a surgeon and public policy researcher at Johns Hopkins University. He writes for The Washington Post and The Wall Street Journal, and is the author of two New York Times best selling books, Unaccountable and The Price We Pay. He's been an outspoken opponent of broad vaccine mandates and some COVID restrictions at schools. Dr. Makary holds degrees from Bucknell University, Thomas Jefferson University and Harvard University. Dr. Marty Makary: I'm trained in gastrointestinal surgery. My group at Johns Hopkins does more pancreatic cancer surgery than any hospital in the United States. But at no point in the last 20 years has anyone stopped to ask, why has pancreatic cancer doubled over those 20 years? Who's working on that? Who's looking into it? We are so busy in our health care system, billing and coding and paying each other, and every stakeholder has their gigantic lobby in Washington, DC, and everybody's making a lot of money, except for one stakeholder, the American citizen. They are financing this giant, expensive health care system through their paycheck deduction for health insurance and the Medicare excise tax as we go down this path, billing and coding and medicating. And can we be real for a second? We have poisoned our food supply, engineered highly addictive chemicals that we put into our food, we spray it with pesticides that kill pests. What do you think they do to our gut lining and our microbiome? And then they come in sick. The GI tract is reacting. It's not an acute inflammatory storm, it's a low grade chronic inflammation, and it makes people feel sick, and that inflammation permeates and drives so many of our chronic diseases that we didn't see half a century ago. Who's working on who's looking into this, who's talking about it? Our health care system is playing whack a mole on the back end, and we are not talking about the root causes of our chronic disease epidemic. We can't see the forest from the trees. Sometimes we're so busy in these short visits, billing and coding. We've done a terrible thing to doctors. We've told them, put your head down. Focus on billing and coding. We're going to measure you by your throughput and good job. You did a nice job. We have all these numbers to show for it. Well, the country is getting sicker. We cannot keep going down this path. We have the most over-medicated, sickest population in the world, and no one is talking about the root causes. Dr. Marty Makary: Somebody has got to speak up. Maybe we need to talk about school lunch programs, not just putting every kid on obesity drugs like Ozempic. Maybe we need to talk about treating diabetes with cooking classes, not just throwing insulin at everybody. Maybe we need to talk about environmental exposures that cause cancer, not just the chemo to treat it. We've got to talk about food as medicine. Sen. Ron Johnson (R-WI): So, Dr Makary, I've got a couple questions. First of all, how many years have you been practicing medicine? Dr. Marty Makary: 22 years. Sen. Ron Johnson (R-WI): So we've noticed a shift from decades ago when 80% of doctors are independent to now 80% are working for some hospital association. First of all, what has that meant in terms of doctors' independence and who they are really accountable too? Dr. Marty Makary: The move towards corporate medicine and mass consolidation that we've witnessed in our lifetime has meant more and more doctors are told to put their heads down, do your job: billing and coding short visits. We've not given doctors the time, research, or resources to deal with these chronic diseases. 1:32:45 Sen. Ron Johnson (R-WI): Dr. Casey Means is a medical doctor, New York Times Best Selling Author, tech entrepreneur at Levels, an aspiring regenerative gardener and an outdoor enthusiast. While training as a surgeon, she saw how broken and exploitative the health care system is, and led to focus on how to keep people out of the operating room. And again, I would highly recommend everybody read Good Energy. It's a personal story, and you'll be glad you did. Dr. Casey Means: Over the last 50 years in the United States, we have seen rapidly rising rates of chronic illnesses throughout the entire body. The body and the brain, infertility, obesity, type 2 diabetes and pre-diabetes, Alzheimer's, dementia, cancer, heart disease, stroke, autoimmune disease, migraines, mental illness, chronic pain, fatigue, congenital abnormalities, chronic liver disease, autism, and infant and maternal mortality all going up. Americans live eight fewer years compared to people in Japan or Switzerland, and life expectancy is going down. I took an oath to do no harm, but listen to these stats. We're not only doing harm, we're flagrantly allowing harm. While it sounds grim, there is very good news. We know why all of these diseases are going up, and we know how to fix it. Every disease I mentioned is caused by or worsened by metabolic dysfunction, a word that it is thrilling to hear being used around this table. Metabolic dysfunction is a fundamental distortion of our cellular biology. It stops our cells from making energy appropriately. According to the American College of Cardiology, metabolic dysfunction now affects 93.2% of American adults. This is quite literally the cellular draining of our life force. This process is the result of three processes happening inside our cells, mitochondrial dysfunction, a process called oxidative stress, which is like a wildfire inside our cells, and chronic inflammation throughout the body and the gut, as we've heard about. Metabolic dysfunction is largely not a genetic issue. It's caused by toxic American ultra processed industrial food, toxic American chemicals, toxic American medications, and our toxic sedentary, indoor lifestyles. You would think that the American healthcare system and our government agencies would be clamoring to fix metabolic health and reduce American suffering and costs, but they're not. They are deafeningly silent about metabolic dysfunction and its known causes. It's not an overstatement to say that I learned virtually nothing at Stanford Medical School about the tens of thousands of scientific papers that elucidate these root causes of why American health is plummeting and how environmental factors are causing it. For instance, in medical school, I did not learn that for each additional serving of ultra processed food we eat, early mortality increases by 18%. This now makes up 67% of the foods our kids are eating. I took zero nutrition courses in medical school. I didn't learn that 82% of independently funded studies show harm from processed food, while 93% of industry sponsored studies reflect no harm. In medical school, I didn't learn that 95% of the people who created the recent USDA Food guidelines for America had significant conflicts of interest with the food industry. I did not learn that 1 billion pounds of synthetic pesticides are being sprayed on our food every single year. 99.99% of the farmland in the United States is sprayed with synthetic pesticides, many from China and Germany. And these invisible, tasteless chemicals are strongly linked to autism, ADHD, sex hormone disruption, thyroid disease, sperm dysfunction, Alzheimer's, dementia, birth defects, cancer, obesity, liver dysfunction, female infertility and more, all by hurting our metabolic health. I did not learn that the 8 billion tons of plastic that have been produced just in the last 100 years, plastic was only invented about 100 years ago, are being broken down into micro plastics that are now filling our food, our water, and we are now even inhaling them in our air. And that very recent research from just the past couple of months tells us that now about 0.5% of our brains by weight are now plastic. I didn't learn that there are more than 80,000 toxins that have entered our food, water, air and homes by industry, many of which are banned in Europe, and they are known to alter our gene expression, alter our microbiome composition and the lining of our gut, and disrupt our hormones. I didn't learn that heavy metals like aluminum and lead are present in our food, our baby formula, personal care products, our soil and many of the mandated medications, like vaccines and that these metals are neurotoxic and inflammatory. I didn't learn that the average American walks a paltry 3500 steps per day, even though we know based on science and top journals that walking, simply walking 7000 steps a day, slashes by 40-60% our risk of Alzheimer's, dementia, type two diabetes, cancer and obesity. I certainly did not learn that medical error and medications are the third leading cause of death in the United States. I didn't learn that just five nights of sleep deprivation can induce full blown pre-diabetes. I learned nothing about sleep, and we're getting about 20% less sleep on average than we were 100 years ago. I didn't learn that American children are getting less time outdoors now than a maximum security prisoner. And on average, adults spend 93% of their time indoors, even though we know from the science that separation from sunlight destroys our circadian biology, and circadian biology dictates our cellular biology. I didn't learn that professional organizations that we get our practice guidelines from, like the American Diabetes Association and American Academy of Pediatrics, have taken 10s of millions of dollars from Coke, Cadbury, processed food companies, and vaccine manufacturers like Moderna. I didn't learn that if we address these root causes that all lead to metabolic dysfunction and help patients change their food and lifestyle patterns with a united strong voice, we could reverse the chronic disease crisis in America, save millions of lives, and trillions of dollars in health care costs per year. Instead, doctors are learning that the body is 100 separate parts, and we learn how to drug, we learn how to cut and we learn how to bill. I'll close by saying that what we are dealing with here is so much more than a physical health crisis. This is a spiritual crisis we are choosing death over life. We are we are choosing death over life. We are choosing darkness over light for people and the planet, which are inextricably linked. We are choosing to erroneously believe that we are separate from nature and that we can continue to poison nature and then outsmart it. Our path out will be a renewed respect for the miracle of life and a renewed respect for nature. We can restore health to Americans rapidly with smart policy and courageous leadership. We need a return to courage. We need a return to common sense and intuition. We need a return to awe for the sheer miraculousness of our lives. We need all hands on deck. Thank you. Sen. Ron Johnson (R-WI): I'm not letting you off that easy. I've got a couple questions. So you outlined some basic facts that doctors should know that truthfully, you could cover in one hour of an introductory class in medical school, yes. So why aren't we teaching doctors these things? Dr. Casey Means: The easy thing to say would be, you know, follow the money. That sounds sort of trite, but frankly, I think that is the truth, but not in the way you might think that, like doctors are out to make money, or even medical schools. The money and the core incentive problem, which is that every institution that touches our health in America, from medical schools to pharmaceutical companies to health insurance companies to hospitals offices, they make more money when we are sick and less when we are healthy. That simple, one incentive problem corrodes every aspect of the way medicine is thought about. The way we think about the body, we talked about interconnectedness. It creates a system in which we silo the body into all these separate parts and create that illusion that we all buy into because it's profitable to send people to separate specialties. So it corrodes even the foundational conception of how we think about the body. So it is about incentives and money, but I would say that's the invisible hand. It's not necessarily affecting each doctor's clinical practice or the decision making. It's corroding every lever of the basics of how we even consider what the human body is and what life is. Sen. Ron Johnson (R-WI): In your book, you do a really good job of describing how, because of the specialization of medicine, you don't see the forest for the trees. The fact is, you do need specialized medicine. I mean, doctors can't know it all. So I think the question is, how do we get back to the reward for general practitioners that do focus on what you're writing about? Dr. Casey Means: I have huge respect for doctors, and I am incredibly grateful for the American health care system, which has produced miracles, and we absolutely need continue to have primary care doctors and specialists, and they should be rewarded highly. However, if we focused on what everyone here is talking about, I think we'd have 90% less throughput through our health care system. We would be able to have these doctors probably have a much better life to be honest. You know, because right now, doctors are working 100 hours a week seeing 50, 60, 70 patients, and could actually have more time with patients who develop these acute issues that need to be treated by a doctor. But so many of the things in the specialist office are chronic conditions that we know are fundamentally rooted in the cellular dysfunction I describe, which is metabolic dysfunction, which is created by our lifestyle. So I think that there's always going to be a place for specialists, but so so many, so much fewer. And I think if we had a different conception for the body is interconnected, they would also interact with each other in a very different way, a much more collaborative way. And then, of course, we need to incentivize doctors in the healthcare system towards outcomes, not throughput. 1:46:25 Sen. Ron Johnson (R-WI): Our next presenter is Dr. Chris Palmer. Dr. Palmer is a Harvard trained psychiatrist, researcher and author of Brain Energy, where he explores a groundbreaking connection between metabolic health and mental illness. He is a leader in innovative approaches to treating psychiatric conditions, advocating for the use of diet and metabolic interventions to improve mental health outcomes. Dr. Palmer's work is reshaping how the medical field views and treats mental health disorders. Dr. Chris Palmer: I want to build on what Dr. Means just shared that these chronic diseases we face today. Obesity, diabetes, fatty liver, all share something in common. They are, in fact, metabolic dysfunction. I'm going to go into a little bit of the science, just to make sure we're all on the same page. Although most people think of metabolism as burning calories, it is far more than that. Metabolism is a series of chemical reactions that convert food into energy and building blocks essential for cellular health. When we have metabolic dysfunction, it can drive numerous chronic diseases, which is a paradigm shift in the medical field. Now there is no doubt metabolism is complicated. It really is. It is influenced by biological, psychological, environmental and social factors, and the medical field says this complexity is the reason we can't solve the obesity epidemic because they're still trying to understand every molecular detail of biology. But in fact, we don't need to understand biology in order to understand the cause. The cause is coming from our environment, a toxic environment like poor diet and exposure to harmful chemicals, and these are actually quite easy to study, understand, and address. There is no doubt food plays a key role. It provides the substrate for energy and building blocks. Nutritious foods support metabolism, while ultra processed options can disrupt it. It is shocking that today, in 2024, the FDA allows food manufacturers to introduce brand new chemicals into our food supply without adequate testing. The manufacturer is allowed to determine for themselves whether this substance is safe for you and your family to eat or not. Metabolism's impact goes beyond physical health. I am a psychiatrist. Some of you are probably wondering, why are you here? It also affects mental health. Because guess what? The human brain is an organ too, and when brain metabolism is impaired, it can cause symptoms that we call mental illness. It is no coincidence that as the rates of obesity and diabetes are skyrocketing, so too are the rates of mental illness. In case you didn't know, we have a mental health crisis. We have all time prevalence highs for depression, anxiety, bipolar disorder, deaths of despair, drug overdoses, ADHD and autism. What does the mental health field have to say for this? Well, you know, mental illness is just chemical imbalances, or maybe trauma and stress that is wholly insufficient to explain the epidemic that we are seeing. And in fact, there is a better way to integrate the biopsychosocial factors known to play a role in mental illness. Mental Disorders at their core are often metabolic disorders impacting the brain. It's not surprising to most people that obesity and diabetes might play a role in depression or anxiety, but the rates of autism have quadrupled in just 20 years, and the rates of ADHD have tripled over that same period of time. These are neuro developmental disorders, and many people are struggling to understand, how on earth could they rise so rapidly? But it turns out that metabolism plays a profound role in neurodevelopment, and sure enough, parents with metabolic issues like obesity and diabetes are more likely to have children with autism and ADHD. This is not about fat shaming, because what I am arguing is that the same foods and chemicals and other drivers of obesity that are causing obesity in the parents are affecting the brain health of our children. There is compelling evidence that food plays a direct role in mental health. One study of nearly 300,000 people found that those who eat ultra processed foods daily are three times more likely to struggle with their mental health than people who never or rarely consume them. A systematic review found direct associations between ultra processed food exposure and 32 different health parameters, including mental mental health conditions. Now I'm not here to say that food is the only, or even primary driver of mental illness. Let's go back to something familiar. Trauma and stress do drive mental illness, but for those of you who don't know, trauma and stress are also associated with increased rates of obesity and diabetes. Trauma and stress change human metabolism. We need to put the science together. This brings me to a key point. We cannot separate physical and mental health from metabolic health. Addressing metabolic dysfunction has the potential to prevent and treat a wide range of chronic diseases. Dr. Chris Palmer: In my own work, I have seen firsthand how using metabolic therapies like the ketogenic diet and other dietary interventions can improve even severe mental illnesses like schizophrenia and bipolar disorder, sometimes putting them into lasting remission. These reports are published in peer reviewed, prestigious medical journals. However, there is a larger issue at play that many have talked about, medical education and public health recommendations are really captured by industry and politics, and at best, they often rely on weak epidemiological data, resulting in conflicting or even harmful advice. We heard a reference to this, but in case you didn't know, a long time ago, we demonized saturated fat. And what was the consequence of demonizing saturated fat? We replaced it with "healthy vegetable shortening." That was the phrase we used, "healthy vegetable shortening." Guess what was in that healthy vegetable shortening? It was filled with trans fats, which are now recognized to be so harmful that they've been banned in the United States. Let's not repeat mistakes like this. Dr. Chris Palmer: So what's the problem? Number one, nutrition and mental health research are severely underfunded, with each of them getting less than 5% of the NIH budget. This is no accident. This is the concerted effort of lobbying by industry, food manufacturers, the healthcare industry, they do not want root causes discovered. We need to get back to funding research on the root causes of mental and metabolic disorders, including the effects of foods, chemicals, medications, environmental toxins, on the human brain and metabolism. Dr. Chris Palmer: The issue of micro plastics and nano plastics in the human body is actually, sadly, in its infancy. We have two publications out in the last couple of months demonstrating that micro plastics are, in fact, found in the human brain. And as Dr. Means said, and you recited, 0.5% of the body weight, or the brain's weight, appears to be composed of micro plastics. We need more research to better understand whether these micro plastics are, in fact, associated with harmful conditions, because microplastics are now ubiquitous. So some will argue, well, they're everywhere, and everybody's got them, and it's just a benign thing. Some will argue that the most compelling evidence against that is a study published in the New England Journal of Medicine a few months ago now, in which they were doing routine carotid endarterectomies, taking plaque out of people's carotid arteries. Just routinely doing that for clinical care, and then they analyzed those plaques for micro plastics. 58% of the people had detectable micro plastics in the plaques. So they compared this 58% group who had micro plastics to the ones who didn't, followed them for three years, just three years, and the ones who had micro plastics had four times the mortality. There is strong reason to believe, based on animal data and based on cell biology data, that microplastics are in fact, toxic to the human body, to mitochondrial function, to hormone dysregulation and all sorts of things. There are lots of reasons to believe that, but the scientists will say, we need more research. We need to better understand whether these micro plastics really are associated with higher rates of disease. I think people are terrified of the answer. People are terrified of the answer. And if you think about everything that you consume, and how much of it is not wrapped in plastic, all of those industries are going to oppose research. They are going to oppose research funding to figure this out ASAP, because that will be a monumental change to not just the food industry but our entire economy. Imagining just cleaning up the oceans and trying to get this plastic and then, more importantly, trying to figure out, how are we going to detox humans? How are we going to de-plasticize human beings? How are we going to get these things out? It is an enormous problem, but the reality is, putting our heads in the sand is not going to help. And I am really hopeful that by raising issues and letting people know about this health crisis, that maybe we will get answers quickly. Dr. Chris Palmer: Your question is, why are our health agencies not exploring these questions? It's because the health agencies are largely influenced by the industries they are supposed to be regulating and looking out for. The medical education community is largely controlled by pharmaceutical companies. One and a half billion dollars every year goes to support physician education. That's from pharmaceutical companies. One and a half billion from pharmaceutical companies. So physicians are getting educated with some influence, large influence, I would argue, by them, the health organizations. It's a political issue. The NIH, it's politics. Politicians are selecting people to be on the committees or people to oversee these organizations. Politicians rely on donations from companies and supporters to get re-elected, and the reality is this is not going to be easy to tackle. The challenge is that you'll get ethical politicians who say, I'm not going to take any of that money, and I'm going to try to do the right thing and right now, the way the system is set up, there's a good chance those politicians won't get re-elected, and instead, their opponents, who were more than happy to take millions of dollars in campaign contributions, will get re-elected, and then they will return the favor to their noble campaign donors. We are at a crossroads. We have to decide who are the constituents of the American government. Is it industry, or is it the American people? 2:09:35 Sen. Ron Johnson (R-WI): Calley Means the co-founder of Truemed, a company that enables tax free spending on food and exercise. He recently started an advocacy coalition with leading health and wellness companies called End Chronic Disease. Early in his career, he was a consultant for food and pharma companies. He is now exposing practices they used to weaponize our institutions of trust, and he's doing a great job doing interviews with his sister, Casey. Calley Means: If you think about a medical miracle, it's almost certainly a solution that was invented before 1960 for an acute condition: emergency surgical procedures to ensure a complicated childbirth wasn't a death sentence, sanitation procedures, antibiotics that insured infection was an inconvenience, not deadly, eradicating polio, regular waste management procedures that helped control outbreaks like the bubonic plague, sewage systems that replaced the cesspools and opened drains, preventing human waste from contaminating the water. The US health system is a miracle in solving acute conditions that will kill us right away. But economically, acute conditions aren't great in our modern system, because the patient is quickly cured and is no longer a customer. Start in the 1960s the medical system took the trust engendered by these acute innovations like antibiotics, which were credited with winning World War Two, and they used that trust to ask patients not to question its authority on chronic diseases, which can last a lifetime and are more profitable. But the medicalization of chronic disease in the past 50 years has been an abject failure. Today, we're in a siloed system where there's a treatment for everything. And let's just look at the stats. Heart disease has gone up as more statins are prescribed. Type 2 diabetes has gone up as more Metformin is prescribed. ADHD has gone up as more Adderall is prescribed. Depression and suicide has gone up as more SSRIs are prescribed. Pain has gone up as more opioids are prescribed. Cancer has gone up as we've spent more on cancer. And now JP Morgan literally at the conference in San Francisco, recently, they put up a graph, and they showed us more Ozempic is projected to be prescribed over the next 10 years, obesity rates are going to go up as more is prescribed. Explain that to me. There was clapping. All the bankers were clapping like seals at this graphic. Our intervention based system is by design. In the early 1900s, John D. Rockefeller using that he could use byproducts from oil production to create pharmaceuticals, heavily funded medical schools throughout the United States to teach a curriculum based on the intervention-first model of Dr. William Stewart Halsted, the founding physician of Johns Hopkins, who created the residency-based model that viewed invasive surgical procedures and medication as the highest echelon of medicine. An employee of Rockefeller's was tasked to create the Flexner Report, which outlined a vision for medical education that prioritized interventions and stigmatized nutritional and holistic remedies. Congress affirmed the Flexner Report in 1910 to establish that any credentialed medical institution in the United States had to follow the Halsted-Rockefeller intervention based model that silos disease and downplay viewing the body as an interconnected system. It later came out that Dr. Halsted's cocaine and morphine addiction fueled his day long surgical residencies and most of the medical logic underlying the Flexner Report was wrong. But that hasn't prevented the report and the Halsted-Rockefeller engine based brand of medicine from being the foundational document that Congress uses to regulate medical education today. Calley Means: Our processed food industry was created by the cigarette industry. In the 1980s, after decades of inaction, the Surgeon General and the US government finally, finally said that smoking might be harmful, and smoking rates plummeted. We listened to doctors in this country. We listened to medical leadership, and as smoking rates plummeted, cigarette companies, with their big balance sheets, strategically bought up food companies, and by 1990 the two largest food companies in the world were Philip Morris and RJ Reynolds, two cigarette companies. These cigarette companies moved two departments over from the cigarette department to the food department. They moved the scientists. Cigarette companies were the highest payers of scientists, one of the biggest employers of scientists to make the cigarettes addictive. They moved these addiction specialists, world leading addiction specialists, to the food department by the thousands. And those scientists weaponized our ultra processed food. That is the problem with ultra processed food. You have the best scientists in the world creating this food to be palatable and to be addictive. They then moved their lobbyists over. They used the same playbook, and their lobbyists co-opted the USDA and created the food pyramid. The Food Pyramid was a document created by the cigarette industry through complete corporate capture, and was an ultra processed food marketing document saying that we needed a bunch of carbs and sugar. And we listened to medical experts in this country, the American people, American parents. Many parents who had kids in the 90s thought it was a good thing to do to give their kids a bunch of ultra processed foods and carb consumption went up 20% in the American diet in the next 10 years. The Devil's bargain comes in in that this ultra processed food consumption has been one of the most profitable dynamics in American history for the health care industry. As we've all just been decimated with chronic conditions, the medical industry hasn't. Not only have they been silent on this issue, they've actually been complicit, working for the food industry. I helped funnel money from Coca Cola to the American Diabetes Association. Yeah. 2:31:40 Sen. Ron Johnson (R-WI): Next presenter will be Brigham Buhler. Brigham is the Founder and CEO of Ways2Well, a healthcare company that provides personalized preventive care through telemedicine, with a strong background in the pharmaceutical industry. Brigham is focused on making healthcare more accessible by harnessing the power of technology, delivering effective and tailored treatments. His vision for improving health outcomes has positioned him as a leader in modern patient centered healthcare solutions. Brigham Buhler: We hear people reference President Eisenhower's speech all the time about the military industrial complex, but rarely do we hear the second half of that speech. He also warned us about the rise of the scientific industrial complex. He warned us, if we allow the elite to control the scientific research, it could have dire consequences. 2:36:30 Sen. Ron Johnson (R-WI): I'm going to call an audible here as moderator, I saw that hopefully the future chairman of the Senate Finance Committee, Senator Mike Crapo from Idaho, came into the room. I asked Mike to share his story. He used to wear larger suits, let's put it that way. But he went down the path of the ketogenic diet, I believe. But Mike, why don't you tell your story? And by the way, he's somebody you want to influence. Chairman of Senate Finance Committee makes an awful lot of decisions on Medicare, Medicaid, a lot of things we talked about with Ozempic, now the lobbying group try and make that available, and how harmful, I think, most people in this room think that might be so. Senator Crapo, if you could just kind of tell us your story in terms of your diet change and what results you had. Sen. Mike Crapo (R-ID): Well, first of all, let me thank you. I didn't come here to say anything. I came here to listen, but I appreciate the opportunity to just have a second to tell you my personal story. I'll say before I do that, thank you for Ron Johnson. Senator Johnson is also a member of the Finance Committee, and it is my hope that we can get that committee, which I think has the most powerful jurisdiction, particularly over these areas, of any in the United States Congress, and so I'm hopeful we can get a focus on addressing the government's part of the role in this to get us back on a better track. 2:54:35 Sen. Ron Johnson (R-WI): Vani Hari, known as the Food Babe -- they wrote that for me, that wasn't me, that's my not my nickname -- is a food activist, author and speaker committed to improving food quality and safety. She has built a powerful platform through her blog advocating for transparency in food labeling and the removal of harmful chemicals from processed food. Her activism has spurred significant change in the food industry, encouraging consumers to make healthier, more informed choices, while prompting companies to adopt cleaner practices. Vani Hari: Our government is letting US food companies get away with serving American citizens harmful ingredients that are banned or heavily regulated in other countries. Even worse, American food companies are selling the same exact products overseas without these chemicals, but choose to continue serving us the most toxic version here. It's un-American. One set of ingredients there, and one set of ingredients here. Let me give you some examples. This is McDonald's french fries. I would like to argue that probably nobody in this room has not had a McDonald's french fry, by the way, nobody raised their hand during the staff meeting earlier today. In the US, there's 11 ingredients. In the UK, there's three, and salt is optional. An ingredient called dimethyl polysiloxane is an ingredient preserved with formaldehyde, a neurotoxin, in the US version. This is used as a foaming agent, so they don't have to replace the oil that often, making McDonald's more money here in the United States, but they don't do that across the pond. Here we go, this is Skittles. Notice the long list of ingredient differences, 10 artificial dyes in the US version and titanium dioxide. This ingredient is banned in Europe because it can cause DNA damage. Artificial dyes are made from petroleum, and products containing these dyes require a warning label in Europe that states it may cause adverse effects on activity and attention in children, and they have been linked to cancer and disruptions in the immune system. This on the screen back here, is Gatorade. In the US, they use red 40 and caramel color. In Germany, they don't, they use carrot and sweet potatoes to color their Gatorade. This is Doritos. The US version has three different three different artificial dyes and MSG, the UK version does not and let's look at cereal. General Mills is definitely playing some tricks on us. They launched a new version of Trix just recently in Australia. It has no dyes, they even advertise that, when the US version still does. This is why I became a food activist. My name is Vani Hari, and I only want one thing. I want Americans to be treated the same way as citizens in other countries by our own American companies. Vani Hari: We use over 10,000 food additives here in the United States and in Europe, there's only 400 approved. In 2013, I discovered that Kraft was producing their famous mac and cheese in other countries without artificial dyes. They used Yellow 5 and Yellow 6 here. I was so outraged by this unethical practice that I decided to do something about it. I launched a petition asking Kraft to remove artificial dyes from their products here in the United States, and after 400,000 signatures and a trip to their headquarters, Kraft finally announced they would make the change. I also discovered Subway was selling sandwiches with a chemical called azodicarbonamide in their bread in other countries. This is the same chemical they use in yoga mats and shoe rubber. You know, when you turn a yoga mat sideways and you see the evenly dispersed air bubbles? Well, they wanted to do the same thing in bread, so it would be the same exact product every time you went to a Subway. When the chemical is heated, studies show that it turns into a carcinogen. Not only is this ingredient banned in Europe and Australia, you get fined $450,000 if you get caught using it in Singapore. What's really interesting is when this chemical is heated, studies show that it turns into a carcinogen. Not only is this ingredient banned, but we were able to get Subway to remove azodicarbonamide from their bread in the United States after another successful petition. And as a bonus, there was a ripple effect in almost every bread manufacturer in America followed suit. For years, Starbucks didn't publish their ingredients for their coffee drinks. It was a mystery until I convinced a barista to show me the ingredients on the back of the bottles they were using to make menu items like their famous pumpkin spice lattes. I found out here in the United States, Starbucks was coloring their PSLs with caramel coloring level four, an ingredient made from ammonia and linked to cancer, but using beta carotene from carrots to color their drinks in the UK. After publishing an investigation and widespread media attention, Starbucks removed caramel coloring from all of their drinks in America and started publishing the ingredients for their entire menu. I want to make an important point here. Ordinary people who rallied for safer food shared this information and signed petitions. Were able to make these changes. We did this on our own. But isn't this something that the people in Washington, our elected politicians, should be doing? Vani Hari: Asking companies to remove artificial food dye would make an immediate impact. They don't need to reinvent the wheel. They already have the formulations. As I've shown you, consumption of artificial food dyes has increased by 500% in the last 50 years, and children are the biggest consumers. Yes, those children. Perfect timing. 43% of products marketed towards children in the grocery store contain artificial dyes. Food companies have found in focus groups, children will eat more of their product with an artificial dye because it's more attractive and appealing. And the worst part, American food companies know the harms of these additives because they were forced to remove them overseas due to stricter regulations and to avoid warning labels that would hurt sales. This is one of the most hypocritical policies of food companies, and somebody needs to hold them accountable. Vani Hari: When Michael Taylor was the Deputy Commissioner of the of the FDA, he said, he admitted on NPR, we don't have the resources, we don't have the capabilities to actually regulate food chemicals, because we don't have the staff. There's no one there. We are under this assumption, and I think a lot of Americans are under this assumption, that every single food additive ingredient that you buy at the grocery store has been approved by some regulatory body. It hasn't. It's been approved by the food companies themselves. There's 1000s of chemicals where the food company creates it, submits the safety data, and then the FDA rubber stamps it, because they don't have any other option. 3:09:15 Sen. Ron Johnson (R-WI): So our next presenter is Jason Karp. Jason is the founder and CEO of HumanCo, a mission driven company that invests in and builds brands focused on healthier living and sustainability. In addition to HumanCo, Jason is the co-founder of Hu Kitchen, known for creating the number one premium organic chocolate in the US. My wife will appreciate that. Prior to HumanCo, Jason spent over 21 years in the hedge fund industry, where he was the founder and CEO of an investment fund that managed over $4 billion. Jason graduated summa cum laude from the Wharton School of the University of Pennsylvania. 3:11:10 Jason Karp: I've been a professional investor for 26 years, dealing with big food companies, seeing what happens in their boardrooms, and why we now have so much ultra processed food. Jason Karp: Having studied the evolution of corporations, I believe the root cause of how we got here is an unintended consequence of the unchecked and misguided industrialization of agriculture and food. I believe there are two key drivers behind how we got here. First, America has much looser regulatory approach to approving new ingredients and chemicals than comparable developed countries. Europe, for example, uses a guilty until proven innocent standard for the approval of new chemicals, which mandates that if an ingredient might pose a potential health risk, it should be restricted or banned for up to 10 years until it is proven safe. In complete contrast, our FDA uses an innocent until proven guilty approach for new chemicals or ingredients that's known as GRAS, or Generally Recognized as Safe. This recklessly allows new chemicals into our food system until they are proven harmful. Shockingly, US food companies can use their own independent experts to bring forth a new chemical without the approval of the FDA. It is a travesty that the majority of Americans don't even know they are constantly exposed to 1000s of untested ingredients that are actually banned or regulated in other countries. To put it bluntly, for the last 50 years, we have been running the largest uncontrolled science experiment ever done on humanity without their consent. Jason Karp: And the proof is in the pudding. Our health differences compared to those countries who use stricter standards are overwhelmingly conclusive. When looking at millions of people over decades, on average, Europeans live around five years longer, have less than half our obesity rates, have significantly lower chronic disease, have markedly better mental health, and they spend as little as 1/3 on health care per person as we do in this country. While lobbyists and big food companies may say we cannot trust the standards of these other countries because it over regulates, it stifles innovation, and it bans new chemicals prematurely, I would like to point out that we trust many of these other countries enough to have nuclear weapons. These other countries have demonstrated it is indeed possible to not only have thriving companies, but also prioritize the health of its citizens with a clear do no harm approach towards anything that humans put in or on our bodies. Jason Karp: The second driver, how we got here, is all about incentives. US industrial food companies have been myopically incentivized to reward profit growth, yet bear none of the social costs of poisoning our people and our land. Since the 1960s, America has seen the greatest technology and innovation boom in history. As big food created some of the largest companies in the world, so too did their desire for scaled efficiency. Companies had noble goals of making the food safer, more shelf stable, cheaper and more accessible. However, they also figured out how to encourage more consumption by making food more artificially appealing with brighter colors and engineered taste and texture. This is the genesis of ultra processed food. Because of these misguided regulatory standards, American companies have been highly skilled at maximizing profits without bearing the societal costs. They have replaced natural ingredients with chemicals. They have commodified animals into industrial widgets, and they treat our God given planet as an inexhaustible, abusable resource. Sick Americans are learning the hard way that food and agriculture should not be scaled in the same ways as iPhones. 3:16:50 Jason Karp: They use more chemicals in the US version, because it is more profitable and because we allow them to do so. Jason Karp: Artificial food dyes are cheaper and they are brighter. And the reason that I chose to use artificial food dyes in my public activist letter is because there's basically no counter argument. Many of the things discussed today, I think there is a nuanced debate, but with artificial food dyes, they have shown all over the world that they can use colorants that come from fruit. This is the Canadian version. This is the brightness of the Canadian version, just for visibility, and this is the brightness of artificial food dyes. So of course, Kellogg and other food companies will argue children prefer this over this, just as they would prefer cocaine over sugar. That doesn't make it okay. Calley Means: Senator, can I just say one thing? As Jason and Vani were talking, it brought me back to working for the food industry. We used to pay conservative lobbyists to go to every office and say that it was the "nanny state" to regulate food. And I think that's, as a conservative myself, something that's resonated. I just cannot stress enough that, as we're hopefully learned today, the food industry has rigged our systems beyond recognition. And addressing a rigged market is not an attack on the free market. Is a necessity for a free market to take this corruption out. So I just want to say that. 3:21:00 Sen. Ron Johnson (R-WI): Our next presenter is Jillian Michaels. Ms. Michaels is a globally recognized fitness expert, entrepreneur, and best selling author. With her no nonsense approach to health, she's inspired millions through her fitness programs, books and digital platforms, best known for her role on The Biggest Loser, Michaels promotes a balanced approach to fitness and nutrition and emphasizing long term health and self improvement. Jillian Michaels: The default human condition in the 21st century is obese by design. Specific, traceable forms of what's referred to as structural violence are created by the catastrophic quartet of big farming, big food, Big Pharma, and big insurance. They systematically corrupt every institution of trust, which has led to the global spread of obesity and disease. Dysfunctional and destructive agricultural legislation like the Farm Bill, which favors high yield, genetically engineered crops like corn and soy, leading to the proliferation of empty calories, saturated with all of these toxins that we've been talking about today for three hours, it seems like we can never say enough about it, and then this glut of cheap calories provides a boon to the food industry giants. They just turn it into a bounty of ultra processed, factory-assembled foods and beverages strategically engineered to undermine your society and foster your dependence, like nicotine and cocaine, so we literally cannot eat just one. And to ensure that you don't, added measures are taken to inundate our physical surroundings. We're literally flooded with food, and we are brainwashed by ubiquitous cues to eat, whether it's the Taco Bell advertisement on the side of a bus as you drive to work with a vending machine at your kids school, there is no place we spend time that's left untouched. They're omnipresent. They commandeer the narrative, with 30 billion worth of advertising dollars, commercials marketed to kids, with mega celebrities eating McDonald's and loving it, sponsored dietitians paid to promote junk food on social media, utilizing anti-diet body positivity messaging like, "derail the shame" in relation to fast food consumption, Time Magazine brazenly issuing a defense of ultra processed foods on their cover with the title, "What if altra processed foods aren't as bad as you think?" And when people like us try to sound the alarm, they ensure that we are swiftly labeled as anti-science, fat shamers, and even racists. They launch aggressive lobbying efforts to influence you. Our politicians to shape policy, secure federal grants, tax credits, subsidy dollars, which proliferates their product and heavily pads their bottom line. They have created a perfect storm in which pharmaceuticals that cost hundreds, if not 1000s per month, like Ozempic, that are linked to stomach paralysis, pancreatitis and thyroid cancer, can actually surge. This reinforces a growing dependence on medical interventions to manage weight in a society where systemic change in food production and consumption is desperately needed and also very possible. These monster corporations have mastered the art of distorting the research, influencing the policy, buying the narrative, engineering the environment, and manipulating consumer behavior. Jillian Michaels: While I have been fortunate enough to pull many back from the edge over the course of my 30 year career, I have lost just as many, if not more, than I have saved. I have watched them slip through my fingers, mothers that orphan their children, husbands that widow their wives. I have even watched parents forced to suffer the unthinkable loss of their adult children. There are not words to express the sadness I have felt and the fury knowing that they were literally sacrificed at the altar of unchecked corporate greed. Most Americans are simply too financially strained, psychologically drained and physically addicted to break free without a systemic intervention. Attempting to combat the status quo and the powers that be is beyond swimming upstream. It is like trying to push a rampaging river that's infested with piranhas. After years of trying to turn the tide, I submit that the powers that be are simply too powerful for us to take on alone. I implore the people here that shape the policy to take a stand. The buck must stop with you, while the American people tend to the business of raising children and participating in the workforce to ensure that the wheels of our country go around. They tapped you to stand watch. They tapped you to stand guard. We must hold these bad actors accountable. And I presume the testimonials you heard today moved you. Digest them, discuss them, and act upon them, because if this current trend is allowed to persist, the stakes will be untenable. We are in the middle of an extinction level event. The American people need help. They need heroes. And people of Washington, your constituents chose you to be their champion. Please be the change. Thank you. Sen. Ron Johnson (R-WI): There was one particular piece of legislation or one thing that we could do here in Washington, what would it be? Jillian Michaels: Get rid of Citizens United and get the money out of politics. Sen. Ron Johnson (R-WI): Okay. 3:37:00 Calley Means: To the healthcare staffers slithering behind your bosses, working to impress your future bosses at the pharmaceutical companies, the hospitals, the insurance companies, many of them are in this building, and we are coming for you. 3:37:25 Sen. Ron Johnson (R-WI): Next up is Ms. Courtney Swan. Ms. Swan is a nutritionist, real food activist, and founder of the popular platform, Realfoodology. She advocates for transparency in the food industry, promoting the importance of whole foods and clean eating. Courtney is passionate about educating the public on the benefits of a nutrient dense diet, and she encourages sustainable, chemical-free farming practices to ensure better health for people and the planet. Courtney Swan: Our current agriculture system's origin story involves large chemical companies -- not farmers, chemists. 85% of the food that you are consuming started from a patented seed sold by a chemical corporation that was responsible for creating agent orange in the Vietnam War. Why are chemical companies feeding America? Corn, soy and wheat are not only the most common allergens, but are among the most heavily pesticide sprayed crops today. In 1974 the US started spraying our crops with an herbicide called glyphosate, and in the early 1990s we began to see the release of genetically modified foods into our food supply. It all seems to begin with a chemical company by the name IG Farben, the later parent company of Bayer Farben, provided the chemicals used in Nazi nerve agents and gas chambers. Years later, a second chemical company, Monsanto, joined the war industry with a production of Agent Orange, a toxin used during the Vietnam War. When the wars ended, these companies needed a market for their chemicals, so they pivoted to killing bugs and pests on American farmlands. Monsanto began marketing glyphosate with a catchy name, Roundup. They claimed that these chemicals were harmless and that they safeguarded our crops from pests. So farmers started spraying these supposedly safe chemicals on our farmland. They solved the bug problem, but they also killed the crops. Monsanto offered a solution with the creation of genetically modified, otherwise known as GMO, crops that resisted the glyphosate in the roundup that they were spraying. These Roundup Ready crops allow farmers to spray entire fields of glyphosate to kill off pests without harming the plants, but our food is left covered in toxic chemical residue that doesn't wash, dry, or cook off. Not only is it sprayed to kill pests, but in the final stages of harvest, it is sprayed on the wheat to dry it out. Grains that go into bread and cereals that are in grocery stores and homes of Americans are heavily sprayed with these toxins. It's also being sprayed on oats, chickpeas, almonds, potatoes and more. You can assume that if it's not organic, it is likely contaminated with glyphosate. In America, organic food, by law, cannot contain GMOs and glyphosate, and they are more expensive compared to conventionally grown options, Americans are being forced to pay more for food that isn't poisoned. The Environmental Working Group reported a test of popular wheat-based products and found glyphosate contamination in 80 to 90% of the products on grocery store shelves. Popular foods like Cheerios, Goldfish, chickpea pasta, like Banza, Nature Valley bars, were found have concerning levels of glyphosate. If that is not alarming enough, glyphosate is produced by and distributed from China. In 2018, Bayer bought Monsanto. They currently have patented soybeans, corn, canola and sugar beets, and they are the largest distributor of GMO corn and soybean seeds. Americans deserve a straight answer. Why does an agrochemical company own where our food comes from? Currently, 85 to 100% of corn and soy crops in the US are genetically modified. 80% of GMOs are engineered to withstand glyphosate, and a staggering 280 million pounds of glyphosate are sprayed on American crops annually. We are eating this roundup ready corn, but unlike GMO crops, humans are not Roundup Ready. We are not resistant to these toxins, and it's causing neurological damage, endocrine disruption, it's harming our reproductive health and it's affecting fetal development. Glyphosate is classified as a carcinogen by the World Health Organization's International Agency for Research on Cancer. It is also suspected to contribute towards the rise in celiac disease and gluten sensitivities. They're finding glyphosate in human breast milk, placentas, our organs, and even sperm. It's also being found in our rain and our drinking water. Until January of 2022, many companies made efforts to obscure the presence of GMOs and pesticides in food products from American consumers. It was only then that legislation came into effect mandating that these companies disclose such ingredients with a straightforward label stating, made with bio engineered ingredients, but it's very small on the package. Meanwhile, glyphosate still isn't labeled on our food. Parents in America are unknowingly feeding their children these toxic foods. Dr. Don Huber, a glyphosate researcher, warns that glyphosate will make the outlawed 1970s insecticide DDT look harmless in comparison to glyphosate. Why is the US government subsidizing the most pesticide sprayed crops using taxpayer dollars? These are the exact foods that are driving the epidemic of chronic disease. These crops, heavily sprayed with glyphosate, are then processed into high fructose corn syrup and refined vegetable oils, which are key ingredients for the ultra processed foods that line our supermarket shelves and fill our children's lunches in schools across the nation. Children across America are consuming foods such as Goldfish and Cheerios that are loaded with glyphosate. These crops also feed our livestock, which then produce the eggs, dairy and meat products that we consume. They are in everything. Pick up almost any ultra processed food package on the shelf, and you will see the words, contains corn, wheat and soy on the ingredients panel. Meanwhile, Bayer is doing everything it can to keep consumers in the dark, while our government protects these corporate giants. They fund educational programs at major agricultural universities, they lobby in Washington, and they collaborate with lawmakers to protect their profits over public health. Two congressmen are working with Bayer right now on the Farm Bill to protect Bayer from any liability, despite already having to pay out billions to sick Americans who got cancer from their product. They know that their product is harming people. Sen. Ron Johnson (R-WI): Couple questions. So you really have two issues raised here. Any concern about just GMO seeds and GMO crops, and then you have the contamination, Glycosate, originally is a pre-emergent, but now it's sprayed on the actual crops and getting in the food. Can you differentiate those two problems? I mean, what concerns are the GMO seeds? Maybe other doctors on t

Dr. Ashley Gearhardt, Ph.D., is an esteemed psychologist and Associate Professor of Psychology at the University of Michigan. She is renowned for her pioneering research on the intersection of addiction, eating behavior, and obesity. Dr. Gearhardt earned her Ph.D. in Clinical Psychology from Yale University, where she co-created the Yale Food Addiction Scale, a widely used tool to assess food addiction and its parallels with substance dependence. Her research focuses on understanding how highly processed foods may contribute to addictive-like eating behaviors and the broader implications for public health. Dr. Gearhardt's work has been extensively published in top-tier scientific journals, and she frequently presents her findings at international conferences. Her research has significantly influenced how the scientific community and the public understand the role of food in the obesity epidemic. Dr. Gearhardt is also actively involved in community outreach and policy discussions, aiming to translate her research into actionable strategies to improve public health. In addition to her academic work, Dr. Gearhardt has appeared in various media outlets, contributing expert commentary on topics related to food addiction, obesity, and public health policies. Her contributions have been instrumental in advancing the conversation around the addictive properties of certain foods and their impact on behavior and health. Episode Overview: In this insightful episode of the Food Junkies Podcast, co-hosts Dr. Vera Tarman and Molly Painschab sit down with the esteemed Dr. Ashley Gearhardt, a leading expert in the field of food addiction and psychology. Dr. Gearhardt is known for her groundbreaking work in developing the Yale Food Addiction Scale, which has become a pivotal tool in understanding the addictive properties of highly processed foods. Key Discussion Points: Introduction to Dr. Ashley Gearhardt: Learn about Dr. Gearhardt's background, her journey into the field of psychology, and what inspired her to focus on food addiction. Understanding Food Addiction: Dr. Gearhardt explains the parallels between substance addiction and food addiction, particularly how certain foods can trigger addictive-like behaviors in the brain. The Yale Food Addiction Scale: Discover how it was developed, its impact on the field, and how it is used to assess food addiction in individuals. The Role of Highly Processed Foods: The conversation delves into the role of highly processed foods in contributing to obesity and addictive eating patterns, highlighting the challenges faced by individuals struggling with food addiction. Public Health Implications: Dr. Gearhardt discusses the broader implications of her research on public health, including potential strategies to combat the rise of food addiction and obesity. Future Research and Initiatives: Hear about Dr. Gearhardt's ongoing research and what she sees as the future directions for studying and addressing food addiction. Find Dr. Gearhardt: Website: https://ihpi.umich.edu/our-experts/agearhar Yale Food Addiction Scale: https://sites.lsa.umich.edu/fastlab/yale-food-addiction-scale/ Book: https://www.amazon.com/Food-Addiction-2nd-Brownell/dp/019067105X The content of our show is educational only. It does not supplement or supersede your healthcare provider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.  

Our food is delicious, plentiful… and addictive and possibly killing us! We've got Dr. Ashley Gearhardt here to walk us through the process of ultra-processed food. And then get ready to exercise your moral authority - it's the return of the Paula Poundstone Ethicspalooza! GUEST Dr. Ashley Gearhardt @um_psychology HOUSE BAND Chris Ketcham Campbell @chrisketcham SPONSORS Get 15% off OneSkin with the code PAULA at https://www.oneskin.co/ #oneskinpod. Go to Quince.com/nobody to get free shipping and 365-day returns on your next order! Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, we dive deep into the science behind food addiction and explore why certain foods can be as addictive as drugs like nicotine or alcohol. Our guest, Ashley Gearhardt, is an expert in the field and shares fascinating insights into how the food industry has engineered products to hijack our brains' reward systems, leaving many people struggling with cravings and compulsive eating. We also discuss the parallels between Big Tobacco and the modern food environment, and how recognizing food addiction could be a crucial step in addressing the obesity epidemic. Expect to Learn: ✦ Why identifying a single addictive substance in food is not the whole story ✦ How the food industry has optimized products to be hyper-palatable and addictive ✦ The role of dopamine in driving compulsive eating behavior ✦ The striking similarities between Big Tobacco's tactics and the modern food industry ✦ Why acknowledging food addiction could be a game-changer for public health policy

GET MY FREE INSTANT POT COOKBOOK: https://www.chefaj.com/instant-pot-download ------------------------------------------------------------------------------------ MY LATEST BESTSELLING BOOK: https://www.amazon.com/dp/1570674086?tag=onamzchefajsh-20&linkCode=ssc&creativeASIN=1570674086&asc_item-id=amzn1.ideas.1GNPDCAG4A86S ----------------------------------------------------------------------------------- Disclaimer: This podcast does not provide medical advice. The content of this podcast is provided for informational or educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health issue without consulting your doctor. Always seek medical advice before making any lifestyle changes. to see Dr Gearhardt's talk on The Science of Food Addiction: https://www.youtube.com/watch?v=yJ1EhYrYpDQ&t=11s Dr. Ashley Gearhardt is a Professor of Psychology in the Clinical Science area at the University of Michigan. She received her Ph.D. in clinical psychology at Yale University with training on the underpinnings of both excess food and alcohol consumption. Dr. Gearhardt currently investigates the contribution of reward dysfunction (e.g., craving, liking) to eating-related problems across the lifespan. She uses a multi-method approach to explore the neurobiological, psychological, and behavioral factors that contribute to problematic eating behavior. Dr. Gearhardt also investigates the role of addictive processes in compulsive overeating and is the Director of the Food Addiction Science and Treatment Laboratory. She created the Yale Food Addiction Scale, which has been cited over 1000 times and has been translated into over 10 languages. Her research has received funding from the National Institute of Health and the American Heart Association. She has published over 150 peer-reviewed articles and her research has been featured on media outlets including the New York Times, ABC News, the Today Show, and Time Magazine. Website: https://sites.lsa.umich.edu/fastlab/

Could your genes have you wired to be addicted to food? Or is it the food itself that makes it so easy to overeat?   "The Weight Loss Champion" Chuck Carroll, who went to extreme lengths to lose 280 pounds and break a severe food addiction, is joined by Dr. Ashley Gearhardt on The Exam Room to explore the mind's relationship with food.   Topics Discussed   - Which foods are most addictive? - How quickly can you become addicted to food? - Withdrawal symptoms while dieting - Rethinking "cheat days" to not derail weight loss - What are ultraprocessed foods? - Are food addictions more severe than drug and alcohol dependence? - And more! — — — Dr. Ashley Gearhardt https://sites.lsa.umich.edu/fastlab — — — Chuck Carroll Instagram: https://www.instagram.com/ChuckCarrollWLC Twitter: https://www.twitter.com/ChuckCarrollWLC Facebook: http://wghtloss.cc/ChuckFacebook — — — Physicians Committee Instagram: https://www.instagram.com/physicianscommittee Facebook: https://www.facebook.com/PCRM.org Twitter: https://www.twitter.com/pcrm — — — Barnard Medical Center https://www.barnardmedical.org — — — Subscribe to the Podcast Apple: https://apple.co/2JXBkpy​​ Spotify: https://spoti.fi/2pMLoY3 — — — Share the Show Please subscribe and give the show a 5-star rating on Apple Podcasts, Spotify, or many other podcast providers. Don't forget to share it with a friend for inspiration!

Can some foods be addictive? What's happening in our bodies when we consume ultra processed foods with addictive properties? And how can we be more conscious and aware about the impact of food addiction on our bodies and lives? Ashley Gearhardt, Associate Professor of Psychology in the Clinical Science area at the University of Michigan. She also earned her B.A. in psychology from The University of Michigan as an undergraduate. While working on her doctorate in clinical psychology at Yale University, Dr. Gearhardt became interested in the possibility that certain foods may be capable of triggering an addictive process. To explore this further, she developed the Yale Food Addiction Scale (YFAS) to operationalize addictive eating behaviors, which has been linked with more frequent binge eating episodes, an increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Looking for more in-depth learning experiences on Anatomy & Physiology or other topics? Sign up for Pearson+ today to explore content from experts like Joan Salge Blake. Learn more about your ad choices. Visit podcastchoices.com/adchoices

As of 2022, the World Health Organisation estimated that More than 1 billion people worldwide are obese – 650 million adults, 340 million adolescents and 39 million children. Given that there are approximately 8 billion people on the planet that is equivalent to 12 and a half percent of the global population. This situation is made all the worse by the seeming impossibility in many developed countries of avoiding cheap, processed which is high in calories, salt and sugar, while also being incredibly low in nutrition. At the same time, evidence linking obesity and substance use disorders continues to grow, which has led to increased interest in the role of an addictive process in problematic eating behavior. To find out more about the challenges of food addiction we were delighted to be joined by Professor Ashley Gearhardt of the University of Michigan. Ashley Gearhardt is an Associate Professor of Psychology in the Clinical Science area at the University of Michigan. While working on her doctorate in clinical psychology at Yale University, Dr. Gearhardt became interested in the possibility that certain foods may be capable of triggering an addictive process. To explore this further, she developed the Yale Food Addiction Scale (YFAS) to operationalize addictive eating behaviors, which has been linked with more frequent binge eating episodes, an increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. It has been cited over 800 times and translated into over ten foreign languages. Her areas of research also include investigating how food advertising activates reward systems to drive eating behavior and the development of food preferences and eating patterns in infants. She has published over 100 academic publications and her research has been featured on media outlets, such as ABC News, Good Morning America, the Today Show, the Wall Street Journal, and NPR. Further information on Ashley's research and the work of the Food and Addiction Science and Treatment Lab is available on their website: https://sites.lsa.umich.edu/fastlab/

For more details on this podcast visit: https://www.journeybeyondweightloss.com/blog/99 Get ready to dive deeper into your cravings as we explore the addictiveness of processed foods with Dr. Ashley Gearhardt! This renowned researcher is leading us on a journey through sweeteners, marketing tactics, potential risks, and much more - so buckle up for an eye-opening chat that will leave you enlightened yet hungry (for knowledge)!   Episode Highlights: (4:18) One of the ways that we knew nicotine was addictive was we would have animals in the research lab choose between nicotine or cocaine. And cocaine was a much stronger reinforcer than nicotine. The animals would choose cocaine about 80% of the time, but they would still choose nicotine 20% of the time, and they would work to get nicotine. Sugar versus cocaine, 80% of the time they'll choose sugar over cocaine. (09:47) Big tobacco has now gotten into the food game. I just recently learned how much Philip Morris and RJ Reynolds have played a huge role in shaping processed food and the way we eat it. And the way it's engineered and designed and marketed because when they started coming under heat for their addictiveness of the tobacco products, they diversified by buying companies like Craft and General Mills. And so if we wouldn't trust them around tobacco, why would we trust them with the food that we eat? (10:56) Self-compassion is one of the things I preach … It is like your biology wants this stuff because it's worried it's gonna starve, and there's a trillion-dollar industry that is using their know-how that they honed on things like cigarettes, and that has been applied to our food environment.

For more details on this podcast visit: https://www.journeybeyondweightloss.com/blog/98 Marchelle and I have an absolute treat for you today! We've got the amazing Dr. Ashley Gearhardt joining us to share her expertise on Processed Food Addiction - a topic she is one of the leading lights in worldwide.  During her grad school years at Yale, Dr. Gearhardt noticed that when people battling with obesity discussed food, it sounded very similar to the way people struggling with addiction talked about drugs like nicotine or alcohol. So, Dr. Gearhardt developed The Yale Food Addiction Scale, and wouldn't you know it … Her research showed people did experience the same cravings and loss of control as other substances- fascinating stuff! Dr. Gearhardt now has the evidence to prove that munching tasty treats like pizza or chips is pretty darn close to puffing away at cigarettes in terms of addiction! This one had us thinking big… You are going to love our conversation today, Dr. Gearhardt just blew us away with her knowledge and there are a lot of aha's from this interview.  This interview comes in 2 parts - here is Part 1; Enjoy!   Episode Highlights:  (19:55) You typically protect children and teens against marketing and accessibility (to addictive substances) and all these sorts of things. But for kids and teens, these foods with this addictive potential is the main source of calories that they're getting, and they're the huge marketing target for the industry. (24:23) These foods are really engineered and designed to be appealing, to grab us, to challenge us. And they really use our most inherent evolutionary biology against us. Dying of famine was one of our biggest threats. And our reward systems are shaped by really calorically dense foods to really wake up the dopamine system and make us want it, and make us desire it. (31:16) Reminding yourself all the reasons why it's not going to be as fulfilling as you thought, or how you're gonna feel five minutes afterwards, or reminding yourself what your values are. You're trying to have different healthy eating goals. All of those things can help, we know that cravings come and they peak and they go down on their own.  (34:07) We've generally had this perspective that self-control is a muscle and that it wears out and there's some evidence for that. But there's also evidence that people will do better if instead they kind of think of self control is the more you use it, the more it works.

In this episode of Addiction Audio, Rob Talks to Dr Ashley Gearhardt from the University of Michigan about whether highly processed foods can be considered to be addictive substances.Dr Gearhardt starts by defining highly processed foods before covering the issues that arise from having an addictive substance (such as food) that you can't ‘opt out' of. Ashley makes comparisons with other addictive substances noting that highly processed foods can induce cravings and lead to a loss of control. She then talks about which foods have a bigger impact on addictive behaviours highlighting foods that contain refined sugars and added fats such as pizzas and donuts.Rob and Ashley then discuss the limits to research whereby there is little agreement on how to define an addictive substance. This is in stark contrast with a growing consensus on how to identify addictive behaviours. There are, for example, agreed diagnostic criteria for addiction, but there is less agreement on how to define whether a substance is addictive.They also talk about how a substance that isn't intoxicating can be addictive.“It isn't necessarily the amount of pleasure or liking you get at the moment you consume them [highly processed foods], but the ability that they have to sensitise motivation systems to want more and more and more”“We argue that we need to treat these highly processed foods, not so much as foods per se but as highly refined substances that have been engineered to be incredibly rewarding.”Original article: Highly processed foods can be considered addictive substances based on established scientific criteria by Ashley Gearhardt and Alexandra DiFeliceantonio. Published in Addiction (2022) Hosted on Acast. See acast.com/privacy for more information.

Videos: Society is going to COLLAPSE -Neil Oliver ( 5:24) Fear Psychosis and the Cult of Safety – Why are People so Afraid?  – Academy of Ideas (13:25) The Great Reset and Transhumanism | Beyond the Cover (17:50) We can be Brainwashed if allowed (Macdonald) MEP Clare Daly calls out EU on wanting to supply arms to Ukraine but not Palestine or Yemen Antioxidants may reduce oxidative stress in men with prostate cancer Universities of Connecticut, Louisiana State, North Carolina, South Carolina, and California , November 3, 2022 This latest paper – which looked at men with prostate cancer from the North Carolina-Louisiana Prostate Cancer Project – came in light of a growing body of evidence suggesting oxidative stress plays a role in the development and progression of prostate cancer. The researchers looked at biomarkers of oxidative stress in the blood, urine and prostate tissue.  They found a greater antioxidant intake was associated with lower urinary 8-isoprostane concentrations.  A 10% increase in antioxidant intake saw an unadjusted 1.1% decrease in urinary 8-isoprostane levels.  8-Isoprostane has been described as a “reliable marker”  and recognised  “gold standard” for lipid peroxidation – the oxidative degradation of lipids.  “This study demonstrated that intake of antioxidants was associated with less oxidative stress among men with incident prostate cancer,” the researchers concluded in the British Journal of Nutrition.    “The results of this study and others warrant additional research in humans on the mechanisms underlying the relationship between dietary antioxidants and prostate tissue redox status and carcinogenesis, as well as determining whether this relationship may influence disease severity, progression and recurrence.”  High-intensity exercise changes how muscle cells manage calcium  Karolinska Institute (Sweden) November 2, 2022 Researchers at Karolinska Institutet in Sweden have discovered a cellular mechanism behind the surprising benefits of short, high-intensity interval exercise. Their findings, which are published in the scientific journal PNAS, also provide clues to why antioxidants undermine the effect of endurance training.  A few minutes of high-intensity interval exercise is enough to produce an effect at least equivalent to that achieved with traditional much more time-consuming endurance training. High-intensity exercise has become popular with sportspeople and recreational joggers alike, as well as with patients with impaired muscle function. However, one question has so far remained unanswered: how can a few minutes' high-intensity exercise be so effective? To investigate what happens in muscle cells during high-intensity exercise, the researchers asked male recreational exercisers to do 30 seconds of maximum exertion cycling followed by four minutes of rest, and to repeat the procedure six times. They then took muscle tissue samples from their thighs. “Our study shows that three minutes of high-intensity exercise breaks down calcium channels in the muscle cells,” says Professor Håkan Westerblad, principal investigator at Karolinska Institutet's Department of Physiology and Pharmacology. “This causes a lasting change in how the cells handle calcium, and is an excellent signal for adaptation, such as the formation of new mitochondria.” Mitochondria are like the cell's power plants, and changes that stimulate the formation of new mitochondria increase muscle endurance. What the researchers found was that the breakdown of calcium channels that was triggered by the high-intensity exercise was caused by an increase in free radicals, which are very reactive and oxidise cellular proteins. The cells therefore have antioxidative systems for trapping and neutralising the radicals. Antioxidants, like vitamins E and C, are also present in food and are common ingredients in dietary supplements. In the present study, the researchers examined what happens when isolated mouse muscles are treated with an antioxidant before and after simulated high-intensity interval exercise. “Our study shows that antioxidants remove the effect on the calcium channels, which might explain why they can weaken muscular response to endurance training,” says Professor Westerblad. “Our results also show that the calcium channels aren't affected by the three minutes of high-intensity interval exercise in elite endurance athletes, who have built up more effective antioxidative systems.”  8 Weeks Of Mindfulness Training Can Lower Blood Pressure For Months Brown University, November 8, 2022 A custom mindfulness program which teaches people how to have healthy relationships with their diet, physical activity, alcohol use, and stress can help lower blood pressure for at least six months, a new study finds. A team with the American Heart Association found that eight weeks of mindfulness training significantly lowers systolic blood pressure readings — the top number in a blood pressure measurement. The training focused on attention control, meditation, self-awareness, and emotion regulation, using weekly group sessions and daily mindfulness exercises. “Mindfulness is non-judgmental, present-moment awareness of physical sensations, emotions and thoughts,” says lead study author Eric Loucks, Ph.D., an associate professor of epidemiology and director of the Mindfulness Center at Brown University, in a media release. “It is almost like a scientist curiously and objectively observing the information coming in through the sense organs and the mind, and then responding skillfully to that information. Mindfulness also involves the concept of remembering, or in other words, remembering to bring one's wisdom (wherever it was gained, such as from health care professionals or public health messages) into the present moment. Wisdom in the context of elevated blood pressure levels may include knowledge that evidence-based practices, such as physical activity, diet, limited alcohol consumption and antihypertensive medication adherence, can improve well-being.”The participant group included over 200 adults from the Providence, Rhode Island area who all had high blood pressure, meaning their readings were higher than 120 mm Hg systolic or 80 mm Hg diastolic blood pressure (the bottom number). Nearly six in 10 were women (59%) and had an average age of 59. Results show the Mindfulness-Based Blood Pressure Reduction group saw their systolic blood pressure drop by an average of 5.9 mm Hg. Those using enhanced usual care only saw their blood pressure drop by 1.4 mm Hg. While systolic blood pressure changed, neither group saw their diastolic blood pressure drop. In addition to improving their blood pressure, the mindfulness group also engaged in far fewer sedentary activities over the six months. Those in mindfulness training reduced their sedentary sitting by an average of 351 minutes each week. Those doing mindfulness training were also more likely to eat a heart-healthy diet and experienced less stress during the course of the study. Grapefruit Juice Supports Healthy Arteries  French National Institute for Agricultural Research, November 2022 Want to hydrate your way toward a healthier heart? Then you may want to consider adding grapefruit juice into your diet. Because a recent study found that grapefruit juice enriched with the flavonoid naringenin actually improved a marker associated with arterial function. The results of the study were published in the American Journal of Clinical Nutrition. Previous research shows citrus bioflavonoids support blood vessel function. They strengthen blood vessel walls, decrease bruising, prevent bleeding, and heal hemorrhoids (hemorrhoids are swollen veins). Of the group of citrus bioflavonoids, naringenin stands out. For the current study, 48 healthy post-menopausal women were recruited and assigned to drink grapefruit juice or a drink without flavonoids for 6 months. The grapefruit juice contained 210 mg of naringenin glycosides. According to the results of the study, the women drinking the grapefruit juice showed a lower carotid femoral pulse wave velocity, indicating a reduction in arterial stiffening. Naringenin is also found in oranges and tomatoes. It's also available as a dietary supplement and is usually found in citrus bioflavonoid formulas. Low levels of air pollution deadlier than previously thought McGill University, November 7, 2022 The World Health Organization's most recent estimates (2016) are that over 4.2 million people die prematurely each year due to long-term exposure to fine particulate outdoor air pollution (often referred to as PM2.5). A recent study involving McGill researchers now suggests that the annual global death toll from outdoor PM2.5 may be significantly higher than previously thought. That's because the researchers found that mortality risk was increased even at very low levels of outdoor PM2.5, ones which had not previously been recognized as being potentially deadly. These microscopic toxins cause a range of cardiovascular and respiratory diseases and cancers. “We found that outdoor PM2.5 may be responsible for as many as 1.5 million additional deaths around the globe each year because of effects at very-low concentrations that were not previously appreciated,” said Scott Weichenthal, an Associate Professor at McGill University and the lead author on the recent paper in Science Advances. The researchers arrived at this conclusion by combining health and mortality data for seven million Canadians gathered over a twenty-five-year period with information about the levels of outdoor PM2.5 concentrations across the country. The WHO recently set out ambitious new guidelines for annual average outdoor fine particulate air pollution, cutting its earlier recommendations in half, from concentrations of 10 to concentrations of 5 micrograms (ug) per cubic meter. The current United States Environmental Protection Agency standard of 12 (ug) per cubic meter is now more than double the value recommended by the WHO. Highly processed foods can be considered addictive like tobacco products, study claims University of Michigan & Virginia Tech University, November 9, 2022 Can highly processed foods be addictive? A new University of Michigan and Virginia Tech analysis took the criteria used in a 1988 U.S. Surgeon General's report that established that tobacco was addictive and applied it to food.  Based on the criteria set for tobacco, the findings indicate that highly processed foods can be addictive, said lead author Ashley Gearhardt, U-M associate professor of psychology, and Alexandra DiFeliceantonio, assistant professor at Fralin Biomedical Research Institute at Virginia Tech.  In fact, the addictive potential for food such as potato chips, cookies, ice cream and French fries may be a key factor contributing to the high public health costs associated with a food environment dominated by cheap, accessible and heavily marketed highly processed foods, the researchers said.  The research, published in the current issue of Addiction, offers evidence that highly processed foods meet the same criteria used to identify cigarettes as an addictive substance:  They trigger compulsive use where people are unable to quit or cut down (even in the face of life-threatening diseases like diabetes and heart disease) They can change the way we feel and cause changes in the brain that are of a similar magnitude as the nicotine in tobacco products They are highly reinforcing They trigger intense urges and cravings  DiFeliceantonio said the ability of highly processed foods to rapidly deliver unnaturally high doses of refined carbohydrates and fat appear key to their addictive potential. Highly processed foods contain complex substances that cannot be simplified to a single chemical agent acting through a specific central mechanism. The same can be said for industrial tobacco products, which contain thousands of chemicals including nicotine, Gearhardt said. Poor diets dominated by highly processed foods now contribute to preventable deaths on par with cigarettes. Similar to tobacco products, the food industry designs their highly processed foods to be intensely rewarding and hard to resist, the researchers said. 

We live in a nation awash with cheap, easy-to-get calories, mostly from highly processed convenience foods. Now, some researchers argue that these foods may actually be addictive – just like cigarettes or alcohol. Ashley Gearhardt, PhD, of the University of Michigan, talks about why highly processed foods may trigger addiction, the difference between addiction and simply liking to indulge in treats, who is most at risk for food addiction, and more. Links Ashley Gearhardt, PhD Speaking of Psychology Home Page

Is it possible to be addicted to food? According to the experts who are studying the mind and body's response to food, the answer is a resounding yes. Ashley Gearhardt, PhD, Associate Professor of Psychology at the University of Michigan, joins me to weigh in on the insidious nature of food addiction. She'll also share with us how she created the Yale Food Addiction Scale, an internationally recognized tool to identify those who are most likely to experience an addictive response to food, and what we can do to combat food addiction.

In this episode, Dr. Susan Peirce Thompson speaks compassionately and frankly about what she has experienced and what she knows about food addiction from working with thousands of people.   Ad-free episode: https://plantscription.substack.com/subscribe   Affiliate links:  Get 10% off your OFUURE order: https://www.ofuure.com/DRYAMI  Use code ‘DRYAMI' at checkout!   Save 15% off your Hamama.com order for a limited time  Use code ‘HAMAMA15'   Disclaimer: The information on this blog, website and podcast is for informational purposes only. It is not meant to replace careful evaluation and treatment. If you have concerns about your or your child's eating, nutrition or growth, consult a doctor.   DR. SUSAN PEIRCE THOMPSON https://brightlineeating.com/     Mentions: Food Freedom Quiz mentioned by Dr. Susan Peirce Thompson: https://foodfreedomquiz.com/   Bright Line Eating website: https://brightlineeating.com/   Dr. Susan's new book, Rezoom: https://www.amazon.com/Rezoom-Powerful-Crash-Burn-Addiction-ebook/dp/B0921GBR81/   Previous food addiction episodes on VDR: 158: Food Addiction, Emotional Eating and The Complexities of the Human Brain with Dr. Ashley Gearhardt: https://apple.co/3lP2qCc   150: Exploring Food Addiction, Shame and Transformation with Chuck Carroll: https://apple.co/3lNfLeB   Resources for listener question: Lacemed is a great resource to look up medications: https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm   Addiction and substance use: https://www.infantrisk.com/content/addiction-and-substance-abuse   Alcohol & breastfeeding: https://www.infantrisk.com/content/alcohol-and-breastfeeding   Tobacco & breastfeeding: https://www.infantrisk.com/content/tobacco-use   Marijuana: https://www.infantrisk.com/forum/forum/medications-and-breastfeeding-mothers/analgesics/1510-bf-and-marijuana   Opiates: https://www.infantrisk.com/review-codeine-safety-and-regulations-breastfeeding-mother   Send me an email to yami@doctoryami.com with questions and topics   Sign up for my newsletter doctoryami.com/signup   MORE LISTENING OPTIONS Apple Podcasts: http://bit.ly/vdritunes Spotify: http://bit.ly/vdrspotify     NEWSLETTER SIGN UP https://doctoryami.com/signup     FIND ME AT Doctoryami.com Instagram.com/thedoctoryami Facebook.com/thedoctoryami Veggiefitkids.com   * * * * MORE FROM ME Read - http://veggiefitkids.com/blog Listen: http://bit.ly/vdrpodcast Watch - http://bit.ly/vfkvideos TEDx Talk - http://bit.ly/DOCTORYAMITEDX   * * * *   Questions? Email me: Yami@doctoryami.com

Much has been written and said about ultra-processed foods, first in scientific circles and now more broadly in the media. This concept is relatively new, but what is even newer in this discussion is how such foods figure into the issue of food and addiction. Our guest, Dr. Ashley Gearhardt is doing pioneering work on this. So, we eat a lot of these foods. A paper published several months ago, found that as much as 80% of all calories consumed in the US and in Canada come from such foods. Such diets are high in added sugar, in fat and saturated fat and low in fiber and key vitamins and minerals. We've recorded earlier podcasts on ultra-processed foods, most notably with Dr. Carlos Monteiro, who created the term. But now let's talk addiction. Ashley Gearhardt is Associate Professor in the department of psychology at the University of Michigan and as a leading expert on the issue of food and addiction. Interview Summary So, let's start by you telling us what is ultra-processed food?   Well, I'll start with the scientific definition which is foods composed of mostly cheap industrial sources of dietary energy and nutrients plus additives. But in layman's term, I think the easiest way to have a feel for what ultra-processed foods are, they're the sorts of baked goods and sugary treats and salty snacks that are on our shelves. That when you look at the ingredient list, you kind of can't pronounce or understand many of the ingredients in that food substance. That's a big way for me that I tell that something's ultra-processed.   You've made very interesting parallels between these ultra-processed foods and cigarettes. Can you explain that?   Yes, absolutely. So, with cigarettes, one of the things that's really surprised me is that we know nicotine is the addictive agent in cigarettes. But I think something that surprised me recently is we're all probably consuming nicotine every single week. Nicotine is in things like tomatoes and eggplants. But of course, we're not getting hooked on eggplants and tomatoes and consuming them to excess. It was really when Big Tobacco got involved and they were able to take the tobacco leaf which has high levels of nicotine and process and optimize it so that it gave us naturally extreme levels of nicotine that were absorbed really rapidly into the system. And they did that through manipulating the nicotine leaf, but also putting additives in there. Things like bronchodilators that let the smoke to get into the lung more rapidly and to hit the brain. And they added all these different flavors and tastes with sugar and cocoa being the most popular. So, really industry got in and ultra-processed the tobacco leaf that led it to be the perfect delivery device for nicotine in a way that made it addictive.   And I think about the same thing with our foods. When I think of naturally occurring foods that have sugars and fats that we enjoy, we find reinforcing, like berries and nuts, people just don't seem to develop a compulsive relationship with those foods. It's really when industrial processes get involved and it amps up the level of that reinforcing ingredients of the sugar sugars and the fats, but then it also ultra-processes it into these packages that just delivers it so rapidly into our body and into our brain, and adds all these unique flavorants and additives that further amplify the rewarding nature of things like sugar and fat. So, the way the companies are manufacturing the foods then makes them maximally palatable, but then they interact with the brain in interesting ways too.   So, how would you know if these ultra-processed foods are addictive?   I think one of the things that's a misunderstanding at times about addiction is that there's some sort of magical brain signature that if the brain just does this, we know something's addictive. And that is not the case. Scientifically, we haven't figured out what that would be. What we've done to figure out whether something's addictive or not is really to look mostly at the behaviors of the people who are consuming it. And so again, going back to cigarettes. What really led people to consider these substances as not just a bad habit, but truly addictive, was how compulsively people were consuming them. You know, that people wanted to quit desperately and they couldn't, even in the face of some really stark negative consequences like a lung cancer or emphysema. People come out of the hospital wanting to stop smoking and then start smoking right away. And we know as well that these substances impact our mood and our pleasure experiences. They'll often help us feel a little less stressed, help us feel more pleasure. And we'll work hard to get them and we enjoy them. If we know that doing a certain behavior will get us something like an addictive drug, we're willing to do it over and over again.   And that was really, when we looked at cigarettes, the three core criteria that we used to decide that cigarettes were addictive in the Surgeon General's report. They trigger compulsive behavior, they were really pleasurable and reduced negative feelings and they were reinforcing. Meaning they left us coming back for more.   And when I look at these ultra-processed foods, it's clear to me that they meet all of those behavioral signatures. That people want to cut down and they can't. Even in the face of something like having bariatric surgery and having your stomach fully rewired, about 30% of people are regaining the weight within a couple years. And they report that the cravings for these sorts of foods is one of the biggest obstacles. It's these ultra-processed foods. They are impactful in giving us a hit of pleasure and helping us feel a little less bored and a little less stressed. Those are some of our major motivations for using them. And they're very reinforcing. When we look at animal models, ultra-processed foods and the ingredients in those foods are arguably as reinforcing - meaning animals will work for them as much as they would for something like cocaine and definitely more than nicotine.   So, all of those factors together really strike me as fitting the bill for something that is addictive. And then when we bring the brain into it, we're starting to understand from looking at the dopamine system which is kind of the core system that gets activated by addictive drugs, the degree to which fats and sugars - which are elevated in these ultra-processed foods - can cause the dopamine system to release. It's actually a pretty similar magnitude to what alcohol and nicotine can do. So, all of these factors combined really lead us to see some really strong parallels, which to me, makes the case that these unique, novel, highly-processed substances should be considered addictive.   What you're saying is very persuasive and another issue that's come up in the context of drug addiction is tolerance. That people might need more of the drug over time in order to get the same reward. Is there any evidence of that in the context of food?   You know, it's been really hard to study in humans, because unlike other drugs of abuse, we're getting exposed to these sorts of foods from the time we're one or two years old. So, if I try and look at even a teenager, I don't have like that baseline to say, oh, this is how they used to respond to it and now they respond to it differently 18 years later. So, we've really kind of had to look at our animal models to help us get some information about tolerance. And in the animal models, we do see that exposure to the ultra-processed foods and the ingredients that are so heightened in these foods like sugar and fats cause changes in the reward system of the brain that is consistent with tolerance. I mean, look at those animals, they start binging on more and more and more of those foods over time, which also suggests they're becoming tolerant to the effects. To me, I see some parallels in what we see in our society. Just looking at the fact that our portion sizes are getting bigger and bigger and bigger, and the amount of sugar is going up and up and up and salt is going up and up and up, suggests that the same amount of food or the same amount of sugar, just isn't quite doing it for us. So, then we're amping it up and taking something a little sweeter or eating more of it to get the fix that we would've had previously.   Well, it would be interesting, wouldn't it, to take those animal intake curves that show increasing consumption of the rewarding foods and project from that what human weight trends would look like over time and then see how closely those lines parallel each other. I bet they'd be pretty close.   I bet they would as well.   And you know industry says, in defense of things like large portion sizes, that 'we're just giving consumers what they want.' And other critics say, ‘heck no, you're driving that consumers are eating so much by increasing portion sizes.' It's quite possible both are true and both could be being driven by this common effect on the brain of these highly reinforcing foods.   Absolutely. You know, we have a sense that the ultra-processed foods, in addition to being really tempting and rewarding and really activating your drive for wanting more and the industry will say that, they're trying to create foods that have maximum craveability that inspire more-ishness, that you want more and more and more. I mean, these are all code words for addiction without saying it, but then they also seem to not be as effective at triggering our satiety signals. So, the food itself and the way that they're engineered, leads us to want more and more and more and to not have those signals that it's time to stop because we're feeling full.   So, how do these foods make trusting our intuitions about what we're eating more challenging?   The intuitive eating movement, I think has a lot of really wonderful things about it, of kind of connecting with yourself more. However, my one concern about it is that if you're trying to intuitively eat ultra-processed foods, it's not an even playing field. They trick your brain into wanting more. They're not signaling hunger and satiety signals in the way that normal, minimally processed foods do. And we see in my lab that it's really, really hard to distinguish when you're hungry, because you need calories, and when you're hungry, because you're tempted by reward. I have this simulated fast food restaurant lab and we'll bring people in, we'll kind of randomize people. And say, half of them will go into this kind of normal blank lab space and we'll ask them how hungry are you and ‘meh, not that hungry.' And we'll randomize these other group of people to come into our fast food restaurant lab where it smells like French fries and there's all the cues of the restaurant and everything is kind of setting you up. And they'll say, ‘oh, I'm really, really hungry.' And the only thing that changed is that that one group is in that acute environment. So, their reward systems are kind of perked up and it's hard to distinguish that fact that you're now desiring food from I'm actually calorically deprived and I need calories. So, I think we have a hard time as humans, knowing when we're truly hungry and when we're being tempted by ultra-processed foods.   Over the course of human evolution, body weights have been pretty healthy for populations, for the most part. And that's been true for century after century. Then all of a sudden in a very short period of time, body weight in basically all other countries has really skyrocketed. And it's pretty hard to argue that people have changed in some fundamental way or that biology has changed in fundamental ways. What really seems to have changed are the food and physical activity environment, and you're narrowing down exactly how those changes have been made and how ordinary biology that works well under normal circumstances, fails under abnormal circumstances and that's how we're living today.   Absolutely correct. And I think one thing that people sometimes don't understand is that drugs of abuse, addictive drugs, they are hijacking the system that was designed so we would be seeking out food and calories and making sure we were eating enough. And those drugs of abuse are so novel and potent that they can get in and take that system and start to shift the drive towards those drugs rather than things like food and sustenance and things we need for survival. Now, these ultra-processed foods that are novel, chemical substances that really just popped up since the 70s and 80s, really, they are working on that same reward sustenance system and they're on overdrive. So, they don't even have to hijack this system. They just have to amp it up higher than it typically is by normal foods to start to trigger this loss of control, this compulsive seeking, this hard time stopping yourself even when you know it's not good for you.   And what's really interesting to me about the timeline, if we kind of say, it's 70s, 80s, 90s, this is this time where we really feel like the food environment changed so drastically, that's also when big tobacco really got into food. Philip Morris and R.J Reynolds were the biggest producers of the sort of processed foods that we're talking about today, in the 80s. And they really used the same playbook, the same scientific strategies. Their know about how to develop and market and create these addictive substances like cigarettes to make them so optimized and apply that to the development of their food portfolios.    So, when we talk about ultra-processed foods, I think of them in my mind, much more as a similar substance to something like a cigarette, than an apple, or a salmon filet, because the process that creates them and the consequences for our brain and our psyche and our biology is much more similar to that cigarette than it is for those other sorts of foods, even though they all give us calories.   So, what do we know about how these ultra-processed foods affect children and adolescents?   To me, that's one of the most concerning spots about this. And I would say that research is really just beginning. We know that that is the dominant source of calories for adolescents and children, when we are looking at the United States, that ultra-processed foods is where they're getting most of their caloric intake. And our lab, we assess this addictive profile, the like classic signs of addiction with eating and we do that with these ultra-processed foods, and we do that in adults. And the current estimates is that about, anywhere between 15% to 20% of adults in the United States would meet this kind of diagnostic level of addiction to these ultra-processed foods.   What's concerning is that we see about 15% of children and adolescents are showing that same addictive profile. Our research finds that this is a profile that's associated with a harder time maintaining a healthy body weight, failure to respond to typical treatments, to help reduce obesity that it's associated with mental health concerns like depression and difficulties with inhibitory control. Seeing this in kids and teens, in many ways is not surprising, because you're not exposed to things like alcohol and cigarettes from the time you're one to two years old. Whereas in contrast with children, by the time a kid is two years old, a major part of their diet are ultra-processed foods. And we really don't know. We're in the middle of the experiment to understand how does that impact a developing brain that would be more vulnerable to addictive substances and how does that set them up for a lifetime of struggling to maintain a healthy relationship with food?   Again, the animal models are very concerning. The animal models suggest that young, early exposure to those sorts of ingredients in ultra-processed foods and ultra-processed foods is particularly likely to change the brain and adolescent and young rats in a way that makes them vulnerable, not only to show an addictive profile with a those foods, but also to be more sensitized to the addictive properties of things like stimulants and alcohol. So, it is not an issue that might just be in the realm of food, but might also be setting people up to be vulnerable for other addictive substances as they get more exposure to them in adolescence and early adulthood.   Now, what you're talking about is really concerning, especially in light of how much marketing of these ultra-processed foods goes on that's directed at children and adolescents, and almost all of it is for the least healthy foods in the company's portfolios. So, you think about kids getting bombarded by these inducements to eat these things, they're engineered to taste really good and their biology starts getting hijacked at an earlier age such that tolerance may develop and they need more of the foods over time, it's really pretty bad.   Yes. And you know, we've even done some work around withdrawal where I think people often think of withdrawal as really physical, with people like shaking or vomiting or sweating. That actually isn't often how withdrawal from addictive drugs presents. It's often, if you think of cigarettes more psychological. It is irritability and depression and kind of agitation. So, we've been looking at that in adults, what happens when people are trying to get off these foods and eat a healthier diet and people are reporting those same clusters of symptoms that we see with withdrawal from other addictive substances and it follows kind of the same time course, that it often starts in about 24 hours, it peaks in that first week where it's really severe and hard and then slowly starts to taper off. And the more withdrawal people are experiencing, the more likely they are to fail at their weight loss attempt.   Now, when we started to do this work, we thought, well, wait, this wouldn't just be happening with adults, we would expect this with children too if this is playing a role. So, we asked parents who had tried to cut their kids junk food down in the past year and asked them about the signs of withdrawal and they reported that, yes, their children had that experience, it followed the same time course as typical withdrawal syndromes and that children whose parents had addictive eating themselves were more likely to experience withdrawal. So, I just think for parents how challenging that is if you're trying to help your child and maybe help yourself simultaneously move away from these ultra-processed foods, that if it's triggering this aversive withdrawal syndrome that makes your child far harder to parent and while you're also feeling that way, it really sets people up to fail.   So, let me ask you one final question. How do we reduce the harm that's associated with these ultra-processed foods?   You know, I think if there's one lesson we've learned from addiction over and over again, is that while we need to have good treatments and we need to provide people with psychoeducation, if we don't address the environment, our treatments aren't powerful enough to overcome that. So, again, cigarettes is our best example. We knew so much and we were developing nicotine gum and we had treatments out there that were available, but what really helped us turn back the tide was by addressing the environment around cigarettes through policy, by things like restricting marketing and taxation and restricting vending machines that children could so easily access. So, I fundamentally believe that for this same change to take place in the context of the harms of these foods, it's going to have to take policy initiatives that focus on giving us an environment that allows us to have a fighting chance. And it's even more relevant in the context of food because you don't get to opt out of eating. So, you have to go into the grocery store that's dominated by ultra-processed foods. My students here in college, they have to go into the dining hall that's dominated by ultra-processed foods and that environment that's so dominated by that, I think really works with our biology in ways that really mimics what we see with addictive substances that makes it hard for us to eat in a healthy, nourishing way.   Bio   Ashley Gearhardt, Ph.D., is an Associate Professor of Psychology in the Clinical Science area at the University of Michigan. She also earned her B.A. in psychology from The University of Michigan as an undergraduate. While working on her doctorate in clinical psychology at Yale University, Dr. Gearhardt became interested in the possibility that certain foods may be capable of triggering an addictive process. To explore this further, she developed the Yale Food Addiction Scale (YFAS) to operationalize addictive eating behaviors, which has been linked with more frequent binge eating episodes, an increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. It has been cited over 800 times and translated into over ten foreign languages. Her areas of research also include investigating how food advertising activates reward systems to drive eating behavior and the development of food preferences and eating patterns in infants. She has published over 100 academic publications and her research has been featured on media outlets, such as ABC News, Good Morning America, the Today Show, the Wall Street Journal, and NPR.

In this episode of Veggie Doctor Radio, I interview Dr. Ashley Gearhardt about food addiction and the many complexities of the human brain.    About featured guest: Dr. Ashley Gearhardt is an Associate Professor of Psychology in the Clinical Science area at the University of Michigan. She received her Ph.D. in clinical psychology at Yale University with training on the underpinnings of both excess food and alcohol consumption. Dr. Gearhardt currently investigates the contribution of reward dysfunction (e.g., craving, liking) to eating-related problems across the lifespan. She uses a multi-method approach to explore the neurobiological, psychological, and behavioral factors that contribute to problematic eating behavior. Dr. Gearhardt also investigates the role of addictive processes in compulsive overeating and is the Director of the Food Addiction Science and Treatment Laboratory. Her research has received funding from the National Institute of Health and the American Heart Association. She has published over 100 peer-reviewed articles and her research has been featured on media outlets including the New York Times, ABC News, the Today Show, and Time Magazine.   DR. ASHLEY GEARHARDT https://sites.lsa.umich.edu/fastlab/             Disclaimer: The information on this blog, website and podcast is for informational purposes only. It is not meant to replace careful evaluation and treatment. If you have concerns about your or your child’s eating, nutrition or growth, consult a doctor.     I have an affiliate partnership with Splendid Spoon where you can get $25 off your first order if you want to give it a try! Splendid spoon offers pre-made smoothies, juice shots and delicious bowls that require no preparation besides heating up!  https://splendidspoon.z724.net/c/2360827/774963/9621    Shop my favorite things doctoryami.com/shop   Please support my work, become a Patreon https://patreon.com/thedoctoryami   Mentions: The Crime of the Century (Sackler family opioid addiction documentary): https://www.hbo.com/documentaries/the-crime-of-the-century   Hooked: Food, Free Will, and How the Food Giants Exploit Our Addictions: https://www.amazon.com/Hooked-Food-Giants-Exploit-Addictions/dp/0812997298/ref=asc_df_0812997298/?tag=hyprod-20&linkCode=df0&hvadid=509234950067&hvpos=&hvnetw=g&hvrand=5760060263430439221&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9031928&hvtargid=pla-1195039867404&psc=1     Study mentioned: Ultra-processed diets cause excess calorie intake and weight gain: An inpatient randomized controlled trial of ad libitum food intake by Kevin D. Hall, Ph.D., et al.: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946062/pdf/nihms-1528772.pdf     A Parent’s Guide to Intuitive Eating: How to Raise Kids Who Love to Eat Healthy by Dr. Yami   Leave an 'Amazon Review'   MORE LISTENING OPTIONS Apple Podcasts: http://bit.ly/vdritunes Spotify: http://bit.ly/vdrspotify   NEWSLETTER SIGN UP https://doctoryami.com/signup OR Text 'FIBER' to 668-66     FIND ME AT Doctoryami.com Instagram.com/thedoctoryami Facebook.com/thedoctoryami Veggiefitkids.com         * * * * MORE FROM ME Read - http://veggiefitkids.com/blog Listen: http://bit.ly/vdrpodcast Watch - http://bit.ly/vfkvideos TEDx Talk - http://bit.ly/DOCTORYAMITEDX   * * * *   Questions? Email me: Yami@doctoryami.com

When the food industry promises to police itself and pledges to improve nutrition in public health, can it be trusted to make meaningful change or must government mandate those changes? Our two guests today have done groundbreaking work to help address this very question. Dr. Jessica Fanzo, Professor of Global Food and Agricultural Policy and Ethics at Johns Hopkins University, and Dr. Jennifer Harris is Senior Research Advisor for Marketing Initiatives at the Rudd Center for Food Policy and Obesity at the University of Connecticut. Interview Summary So Jess, let's begin with you. You coauthored what I thought was a very important and novel report released by the Global Alliance for Improved Nutrition on product reformulation by the food industry. Would you might explain what's meant by reformulation? When we think about reformulation, it's really defined as the process of all-terrain a food or a beverage product. You can alter that by improving the products' health profile or reducing the content of harmful nutrients or ingredients. So it's a process of either removing those negative ingredients or nutrients or adding back positive ones into foods. Why is that done? Because people consume a lot of processed foods. Almost every food that we consume has gone through some form of processing, but there's a whole range of that processing from very minimal to very highly processed, what's often called ultra-processed or junk food that doesn't have a lot of nutritional value. In the report, we were looking at what are the challenges with reformulating food? What are some of the opportunities to reformulate food? And in the realm of reformulation, has it had a positive impact on public health? So we were looking at those aspects of the reformulation of processed foods. So I'm assuming there could be enormous advances to public health if reformulation were done on a broad scale and or if it were done in a meaningful way. So what were your main findings then? Have there been examples of industry being successful with voluntary reformulation? Somewhat. And absolutely it could have potentially really important positive impacts for public health, but it's also not a panacea for improving diets and nutrition. And while there are some examples where voluntary reformulation has had some impact, the UK with salt and some other examples, overall we found that it's important for governments to mandate reformulation through different tools, whether it's labeling, taxes, et cetera. For foods that are not reformulated, we felt that it was really important for governments to mandate with clear, transparent and direct targets, particularly removing the unhealthy ingredients like added sugars, salts, unhealthy fats like trans fats. The food industry should be involved in implementing reformulation policies but not in their design. And governments need to really step in and step up. But that said, that doesn't mean that reformulation is going to solve all the problems. Governments also need to invest in many other tools to protect consumers and to invest in other ways to improve diets for nutrition. So reformulation shouldn't be the only answer. So I'm assuming the reason that food industry won't go far enough on their own is that these things that make the food less healthy also tend to make them pretty palatable, or give them long shelf life or properties that make people enjoy them a lot. And that why in the world would they do something that would make their products less desirable? Does that pretty much the case or do you see other reasons why? That's definitely true. I mean, these highly processed foods are cheap in their ingredients to make, they are very palatable, there's a high demand for them. We're seeing this shift now into low-income countries like with tobacco when consumers catch on that these foods are not so healthy, they go to populations where there's a bit of a lag in that knowledge. But also reformulating foods from the industry's perspective is not so easy. It's quite expensive to do it. It's difficult to reduce salt and sugar, which are vital not only for the taste of foods, but for their composition and shelf-life and texture. So it has a lot of ramifications to remove those ingredients. So meeting government mandates around reformulation can be really challenging and sometimes impossible for companies. So they often will deal with getting a warning label, for the example in Chile, they'll just take the warning label because they can't reformulate some foods. But there's a change in consumer demand and tastes. Consumers like their brands, but the more and more consumers are caring about clean labels, environmental sustainability, their health, people are concerned about the amount of sugar in foods so they're going to have to answer to that, that changing demand as consumers demand better foods whether it's from a health or sustainability or transparency perspective. Let me ask one more question related to this. Is it also the case that it's pretty difficult for some company to be the first out of the gate if they were inclined to do this voluntarily because then their products would become less desirable and their competitors would be kinda stuck in the old ways? So isn't that another argument for government intervening that everybody is on the same playing field? Absolutely, yes. I mean, why not hold every player accountable and to the same standards and mandates? It pushes them all to take action. So when we were interviewing some of the industry players, they really struggle because when they did try to reformulate some of the foods, consumers no longer bought them because they're very wedded to their brands, they're wedded to certain tastes, it's a real challenge for them to keep their consumer base. But at the same time, try to adhere to government mandate. And some companies care more about health and sustainability than others. We definitely learn that some companies have no interest in that, because they know they'll always be a big consumer base for these quote less healthy foods. So there's a real issue from company to company of who's willing to take more action to reformulate and who doesn't really care to reformulate at all and they're willing to live with warning stickers and taxes. So Jennifer, let's turn to you. So you've done really pioneering work on the impact of food marketing on children that began when we were colleagues together at the Rudd Center when it was at Yale University. And there I was witness to the fact that you created a very impressive methodology for studying what's a pretty complicated issue. And you paid a lot of attention to industry promises for self-policing of children's food marketing. Do you mind giving us a quick sense of what's being marketed to who and how, and how much marketing children are exposed to? Annually, companies spend over $13 billion in advertising food to all consumers. And just to put that number in perspective, the whole chronic disease prevention budget at the CDC is 1 billion. So the companies are really controlling the messages about what people should eat. And most of that money is spent to advertise very unhealthy products. The products that are contributing to poor diet and disease in this country. The biggest ones are fast food, sugary drinks, sweet and salty snacks and candy. Those categories represent about 80% of all foods that are advertised. Healthier categories of foods, if you look at all of juice, water, fruits, and vegetables and nuts combined, it's less than 3% of the total. So they're really pushing these very high fat, high sugar, high salt products extensively. Companies spend most of their advertising dollars on television ads. On an annual basis, kids see about 4,000 of those ads per year. So almost 4,000 ads, that's over 10 a day for unhealthy food. Kids of color, so black kids see twice as many of those ads. A lot of the worst products, their advertising is targeted to Black and Hispanic communities and especially adolescents. But TV isn't the only way companies advertise. And in the last few years, the ways that companies market just increased exponentially. Now with smartphones and tablets, they can reach kids any place and any time through things like ads on YouTube videos, social media, smartphone apps, with games and ordering programs, even educational websites teachers are using in grade school have ads on them. This kind of marketing is personalized. So what you see depends on what you do online. They know who you are and they can reach you. And unfortunately, this kind of marketing also is the kind of thing that parents can't monitor as easily as what your child is watching on TV. So the companies basically try to be wherever the consumer is to reach them with their advertising. Well those are really stunning numbers. I know one of the arguments the industry has made for years, and one of the things that you've addressed directly in your research is their claim that this food advertising doesn't really make kids or adults eat an unhealthy diet, it just shifts their preference from brand to brand. So if Coke is advertising a lot, they might say, "Well we just wanna take market share from Pepsi, "but we're not encouraging sugar beverage consumption." What would you say to that? That is something they've argued for a long time. And one thing that we showed is that just watching a television program with food advertising makes kids and adults eat a lot more both while they're watching and afterwards. And another of our colleagues, Ashley Gearhardt has done some really interesting research showing how the food advertising actually activates the reward regions of the brain and leads to increased consumption. So that's one way that food marketing affects more than brand preferences. There's also been a lot of research showing that if you advertise Coke, it increases consumption and purchases of all sugary drinks. They also affect sales of the categories, not just the specific brands. So with you and others doing so much work showing how much of the marketing there is and how disastrous the impact is, you can imagine the industry feels vulnerable to the possibility of outside regulation or perhaps even litigation. And so one of the things the industry has done and this links back to what Jessica was talking about in the context of reformulation, is to say that they can police themselves. So can you explain how they've gone about doing that? Well in the US there's a program called the Children's Food and Beverage Advertising Initiative, which is the food industry self-regulatory program to address food advertising to kids. And there are similar programs in countries around the world. But basically what the industry has promised is that they will only advertise products that meet nutrition standards in child directed media. That sounds really great. They implemented the program in 2007, but you said Kelly, we've done a lot of research showing how many limitations and loopholes there are in this program. One is that they only define children as 11 years and younger. So they only have promised to reduce unhealthy advertising to young children. And more and more of the research is showing that adolescents are just as affected and maybe even more effected by the advertising. Since their program was implemented, they've increased their advertising to the slightly older group that isn't covered by the CFBAI. Another limitation is their definition of what is child directed is advertising in media where children are the primary audience. So on television that would basically be children's TV. So Nickelodeon, Cartoon Network, those kinds of programs. But children watch a lot more television than just children's television. And so they can still advertise anything they want on programs that are also watched by adults and older children. And then the third major limitation is that they've set their own nutrition standards. So they have defined what is healthy. And maybe not surprisingly, a lot of the products that they say are healthier choices that can be advertised to kids are things like sugary cereals, fruit drinks that maybe have less sugar but they also have artificial sweeteners in them. Things like goldfish crackers, fast-food kids' meals, all of those can still be advertised to children under their nutrition standards. What we found is since the program was implemented in 2007, food advertising on children's television has gone down quite a bit, 45%. But at the same time, advertising on other types of television that children watch has gone up about 30%. So now kids see almost as much food advertising as they used to, but most of it is not on children's television, it's on the other kinds of television that they're watching. And a lot of the harder things to monitor, things like apps and social media and websites do not qualify as child directed media under this program. Now the reason I asked both of you to be on this podcast at the same time as I figured there would be interesting similarities, even though you're working on somewhat different topics, and boy does it turn out to be they're real themes weave through this. So let's talk next about what might be done then. So Jessica, with your work on industry reformulation, what have you concluded can be done voluntarily? Kelly, I think government needs to be much more involved than they are. The challenges that we see with voluntary regulation, whether it's in reformulation or marketing of unhealthy foods to children, we know that voluntary reformulation, industry sets its own agenda, they set their own targets, they have no accountability to meet those targets, they may pledge to reduce harmful ingredients but if the product has a very high level of these unhealthy ingredients, the reformulation may not make much of a difference from a public health point of view. So I think we need much more regulation. Governments need to hold industry accountable and ensure that they are meeting national standards for public health. I think government has been too laissez-faire about industry and the power that they hold. And I think now we're seeing the consequences of that not only in the United States, but everywhere in the world with rising levels of obesity and NCDs and unhealthy diets being a big risk factor with these processed foods playing a huge role in that. So we really need to see government step up in a much more profound way and hold industry having public health goals. It's a little bit of enough is enough. So Jess, just out of curiosity, let's say you were the government official in charge of taking such action and you have the authority to do it, where would you start? Would you start with particular nutrients across the food chain or would you start with certain categories of food and would you worry first about sugar, salt, fat? That's a good question. In the paper we outline four types of processed foods. To me I would probably look across the entire food supply chain at those highly, highly processed foods. And it would be good to start with at least the three categories of sugars, salt, and trans fats to even start with and setting key targets for those and marking those ultra-processed foods that go beyond that target. Chile had the great food law that's been enacted that's put warning labels on the front of packages and has regulated I think some of the advertising of those foods. Jennifer you probably know about this. And I think that's been an important case study for the rest of the world to look at of how Chile has done that because sales of those foods that have the warning label have gone down somewhere in the ballpark of I think between 23 and 28%, depending on the population. But I think there's lessons to be learned of how Chile has done that that other governments could learn from. Now I'm happy that you pointed out the advances in Chile because there have been some very impressive impacts reported from the studies that have been done so far. So I agree that that is really a model to look to. So Jennifer, let's just get your opinion on this. Where do you come down on this issue of voluntary versus mandated? So we've given the industry 12 years now to show that they can market healthier products to kids. And basically what they've done is they're marketing slightly healthier products to kids but the products they're marketing are not nutritious products that children should be consuming a lot of like sugared cereals. So it's pretty clear that they can't do it on their own and that regulation is required. In the US, we have a little bit of an issue that not all countries have because of the First Amendment. And advertising is protected speech according to the Supreme Court. So we can't just say companies cannot advertise anything. So we have to be more strategic about the kinds of regulations that we can implement here. If we could do anything we wanted, Chile is a great example. In the next year, they won't be able to advertise any products that are high in fat, sugar and salt before 9:00 p.m. So it's not just children's programming, they won't be able to advertise it. They had to take all their characters off their packages. And so Tony the Tiger can't be on the package of frosted flakes anymore because it's high in sugar. They've done a lot of great things in Chile and sure we can adapt some of what they've done. In other countries also, for example the UK has very strong laws about marketing foods in digital media. So that would be another thing that we could import from other countries.   Bios   Jessica Fanzo, Ph.D., is the Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Berman Institute of Bioethics, the Bloomberg School of Public Health, and the Nitze School of Advanced International Studies (SAIS) at the Johns Hopkins University in the USA. She also serves as the Director of Hopkins' Global Food Policy and Ethics Program, and as Director of Food & Nutrition Security at the JHU Alliance for a Healthier World.  From 2017 to 2019, Jessica served as the Co-Chair of the Global Nutrition Report and the UN High Level Panel of Experts on Food Systems and Nutrition. Before coming to Hopkins, she has also held positions at Columbia University, the Earth Institute, Food and Agriculture Organization of the United Nations, the World Food Programme, Bioversity International, and the Millennium Development Goal Centre at the World Agroforestry Center in Kenya. She was the first laureate of the Carasso Foundation's Sustainable Diets Prize in 2012 for her research on sustainable food and diets for long-term human health. Jennifer Harris, Ph.D., is a Senior Research Advisor, Marketing Initiatives at the Rudd Center. Previously, Dr. Harris worked as Director of Marketing Initiatives and was an Associate Professor in Allied Health Sciences at the University of Connecticut. Harris received her B.A. from Northwestern University and M.B.A. in Marketing from The Wharton School. Before returning to graduate school, she was a marketing executive for eighteen years, including at American Express as a Vice President in consumer marketing and as principal in a marketing strategy consulting firm. Harris completed her PhD in Social Psychology at Yale University with John Bargh and Kelly Brownell.

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Ashley Gearhardt describes significant differences between natural food and the modern food environment and how the human brain could be affected. Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Show ID: 36381]

Can some foods have addictive properties? We all have cravings for some things--chocolate, let's say? But can food really hijack the brain much as happens with classic substances of abuse? And are foods engineered by the food industry in ways that trigger addictive like reactions in the brain? Such are the questions being asked by Dr. Ashley Gearhardt. She is an associate professor of psychology and the clinical science area at the University of Michigan and a leading researcher in the field of food and the brain, food, and addiction in particular. About Ashley Gearhardt Ashley Gearhardt received her Ph.D. In clinical psychology at Yale University with training on the underpinnings of both excess food and alcohol consumption. Her work explores eating-related problems across the lifespan and particularly the role of food craving and liking in eating dysfunction. She also investigates the role of addictive processes and compulsive overeating and is director of the Food Addiction Science and Treatment Laboratory at the University of Michigan. Interview Summary What interested you in these topics and how you got going on this area? Yeah, absolutely. For me, it was really a perfect storm of scientific experiences and exposures that lead me to really pursue this line of research. And at the time I was in grad school, I was initially studying traditional addictive substances like alcohol and how we responded to that. But at that time, not only was there this major global obesity epidemic, but there was all this research coming out from the neuroimaging world. They were finding that the way that the brain responded to really highly processed, highly rewarding foods really seemed to engage the circuitry in the brain that goes awry in addiction. And then Nicola Vena Bart Hobos group at Princeton, they were publishing this beautiful research in animal models showing that really being exposed to a lot of sugar and then having it removed from the diet could trigger all the classic signs that we think of when we think of addiction. The rats would binge, they would go out and pursue trying to get sugar even if they were getting electrified and shocked. And they would go through withdrawal when sugar was taken away from their diet, even if they had other foods and chow available. So this really got me inspired to think about where does the boundary lie here? What does it mean if these highly processed junk foods that have become so common in our world truly are addictive? Where's the boundary? What do we know and how do we figure it? Individuals who are listening to this are probably wondering what it means to have food having this impact on one's brain. And let's begin by talking about the Yale Food Addiction Scale, which you developed and has now been translated into many languages used by researchers around the world. What sort of questions does it ask people? That'll give our listeners a sense of how the addictive impact of food might actually be experienced by individuals. Absolutely. So what we have seen--when I first started doing this work I realized that wasn't really any sort of measure or tool out there to try and identify who might be actually showing signs of addiction to these foods. And so I used the diagnostic criteria, the way we diagnose alcohol use disorder, cigarette use disorder, and I applied those to the consumption of these highly rewarding foods. And some of the behaviors that we see that people report is that they really struggle to maintain their control once they start eating some of these foods. So they'll think, okay, I'm just going to have one cookie and the next thing they know that the whole pack is gone. There are really intense cravings. I mean, we all experience cravings, but it's almost that the craving is so strong that you can't think of anything else. That person will have a strong desire and really be trying hard to cut down, but they just keep repeatedly failing. There's a tendency that even if you have some pretty significant negative consequences, health consequences, emotional consequences--you keep returning to that same dietary pattern. And so these sorts of behaviors seem to be key. And we also see that people are reporting things like withdrawal. That when they cut down on these highly processed foods try and eat healthier then they experienced a really big uptick in cravings. They experienced irritability, headaches, fatigue, and just really a struggle to maintain this healthier dietary pattern. Because the foods themselves seem to have kind of taken an oversized view in their world. They really start kind driving their eating behavior and sometimes driving their entire life. You're talking about the kind of extreme cases where somebody might set out to eat one cookie but eats the whole package. Are there lower levels of this that may not be as clinically significant but might be important from a public health point of view? Somebody who is having two cookies rather than one or not, or having one soda rather than zero--are these same processes in effect at those levels? Absolutely. I'm so glad you brought that up because people sometimes think of addiction as this black and white thing. You kind of either have it, or you don't. But really that's not what we see with any addiction. You know, there is this kind of the extreme tail end of people who are kind of full-blown, clinically addicted. If we think of alcohol, about 10% of people who use alcohol will get clinically addicted. In that case, we might really think about treatment and pharmacological approaches to helping them get better. But when you look at alcohol, it's one of the top leading causes of preventable death in the United States. And that's driven mostly by people who don't have a full-blown addiction to alcohol. But alcohol has enough of an addictive pull that for some people they're using it just enough that it's starting to impact their health or lead them to make unwise decisions like getting behind the wheel of a car when they really shouldn't. And I think this is going to be even more important in the context of these highly processed foods. We see in our work that on average, the average person is experiencing at least one to two symptoms of addiction when it comes to their relationship with these highly rewarding foods. And if we think about this with food--we all have to eat. It's so in our face--these highly processed foods are always there, and it really doesn't take that much of extra consumption or an extra pull from these foods to start consuming enough extra calories that maybe you're starting to deal with health issues or gaining weight in a way that's problematic. So when I really think about this, we do need to be thoughtful about providing clinical treatment and helping people. But from a public health perspective, the biggest concern is if these foods have enough of an addictive pull, they trigger enough of a response that you really struggle to eat in moderation. That says, on a broad scale, people are struggling with their relationship with these foods in a way that increases health-related problems. You were mentioning as you were describing the Yale food addiction scale, things that people might experience like craving and withdrawal. And I think most people are familiar with what those concepts mean. The concept of tolerance also comes up in addiction a lot. Can you explain what tolerance is and those that apply to this area? Absolutely. My pleasure. So tolerance is when you start using an addictive substance, and your body is trying to adapt to it. You know, our bodies really want to kind of be in an even-keeled state. And so if you're taking something like alcohol and it has this big impact on your bodily systems, it kind of slows everything down. And so when you start drinking alcohol, your body tries to adapt to it by kind of speeding up before you have the alcohol. And how this impacts you over time is that initially it might've had one glass of wine and felt pretty tipsy and intoxicated. But over time, as you drink more and more, your body's adjusting more successfully. And so then you need to drink maybe the whole bottle of wine to get the same effects that you used to in the past from a much lower amount. So this tolerance can kind of drive people to consume larger and larger quantities of food or larger and larger quantities of alcohol. And we're seeing that similar processes may be playing a role in the reward system when it comes to these highly rewarding foods. That initially, consuming a little bit of, let's say a sugar-sweetened beverage, really hits the level of reward that you're hoping for. But over time, as your body adapts, it gets used to it. It starts to prepare for it more successfully. You might need to consume rather than just a can of coke maybe you're starting to get closer and closer to a Big Gulp to get that level of reward and satisfaction that you want. And one of those things that is a little more challenging to study in the context of food is that unlike something like alcohol--that maybe people have their first drink when they're 14 or 15--with these highly processed foods were being exposed to them from the very first years of life. So this tolerance effect may actually start to emerge in infants and young children. And it's going to be really important to try and understand on a global level as well when you're seeing these major diet shifts where all of a sudden we're going from traditional diets to a western food diet. Western diets are really very saturated with highly processed foods that are impacting the reward system in a way such that people start to expect more intensely rewarding foods and it takes larger quantities of those foods to start to get the same reward experience that they used to in the past. These foods carry calories with them, and you can see that increasing need or desire for these foods over time creates an increased risk for obesity and diabetes. Let me ask the question about particular types of foods. Are there certain foods or constituents of foods that are most likely to trigger these effects? Yes. So we see pretty strong evidence in this in our lab that it's really these foods that seem to have high levels of refined carbohydrates like sugar or flour or starches and high levels of fat. And from an evolutionary view, this makes a lot of sense. Our brain--the reward system of our brain--evolved at a time where food was scarce. It evolved to be sensitive to calories and to motivate us to find the foods in our environment that had the most calories. And if we think about that from early human history, that would be foods that were higher in fat like perhaps animal meats or nuts, or foods that had a high amount of naturally occurring sugar like a berry. And so our brain says, man, if it tastes something sweet or fatty, it remembers that it gives us a bigger reward response. But what's happened is that our brain systems have stayed in this kind of "preparation for food scarcity stage" where it says: really pay attention to those foods and respond to them. But our food environment has changed so drastically. And so the food industry has become so skilled and adept at making these foods that are really dense and the amount of fat and refined carbohydrates they have. They just kind of blow out of the water the level of reward that our brain really evolved to handle. And so it is those foods that have just like a lot of sweet, a lot of fat, a lot of calories that really activate those reward systems in the brain in a way that really seems to mimic what we see with the drugs of abuse. Think of some of the top foods--things like chocolate and pizza and French fries and really sugary things like sugar-sweetened beverages where people start to show these addictive behaviors. It's not really those naturally occurring foods like fruits and vegetables and lean meats and legumes. You know, people just don't seem to show an addiction to things like kale. How much is known about the impacts of these foods on children? That is something that we're really diving into deeply in our lab, particularly infancy. We see that by the time a child is two, they're more likely to have a sugar-sweetened food or beverage on any given day than they are a fruit or vegetable. And when we think about this, you know, we know from other addictions that the earlier you're exposed to an addictive substance, the more vulnerable you are. And the more likely you are to develop problems with that addictive substance potentially. As I mentioned earlier, when you think of something like cigarettes or alcohol or cannabis, most people are being exposed to this in early adolescence or early adulthood. Whereas with these potentially addictive foods. The early exposure is maybe in the first year of life. And so we're just starting to really understand how that might impact the brain. We suspect that if you're getting a lot of exposure to these potentially addictive foods, that may be impacting the reward and motivation circuitry in the brain and setting it up. So the threshold of food reward you're anticipating is more at these addictive levels, and that things like fruits that generally typically would have been rewarding, maybe just aren't sufficiently activating for these kids and really it's starting to drive a lifelong dietary preference towards these highly processed foods. We see in our research that, you know, even kids as young as eight years old are showing kind of a one or two symptoms of addiction-like eating based on the Yale food addiction scale, and this seems to predict a greater tendency towards being overweight. To consuming more junk food in the lab, and to be more prone to lose control of their eating behavior. Are there lessons from other areas of addiction then that can be applied to the food area for either prevention treatment? Yeah, absolutely. And I think what we've learned from the addiction world is that it's important to have good, solid empirically supported treatments. Cognitive behavioral therapy is a good one. There's really good pharmacology out there that can be considered for addiction with things like Methylnaltrexone. Even if you have excellent treatments, if this is occurring in a really toxic environment where the addictive drug is cheap and easily accessible and heavily marketed, and really societally normative, even the best treatments kind of can't compete with an environment that's putting so much pressure on the individual to be exposed to these addictive substances. And so when we look at what has been helpful on a kind of population public health level, with, for example, tobacco, things like taxation, things like reducing accessibility through vending machines, things like restricting advertising have really been successful in having an environment where it's encouraging less use of the addictive substance. And when you have that kind of environment, it really then gives the treatment a better chance of being successful. And so I think when I think about food, you know, man, the environment! And changing the environment through policy is going to give our treatments the best chance of being successful. And we have to think about that and not just focus solely on the individual. But think about the environment that they're operating in. As this field looks forward, what do you see as interesting and important questions? So one of the things I'm really interested in is that infancy period. What happens the very first time you have a cookie or a cake? If you're a child who's getting--in those first years of your life--a diet that's really rich and these highly processed foods, how does that set you up potentially for a lifetime of struggles? Are there things that we can tell parents that can help them set up their child with a better diet and those early, early days, um, to help them be successful? And are there ways that we can pass policy that could potentially protect children and adolescents from our kind of current toxic food environment? One of the things I'm working on in my lab is actually spending a lot of time investigating teenagers and how they might be at risk. We see that teenagers are neurobiologically very vulnerable. Their reward systems have adapted and developed more rapidly than that system of the brain that helps put the brakes on. And I think anybody who interacts with a teenager can kind of feel that sometimes--that it's all about reward and what's happening right now and not necessarily thinking about the long term consequences of it. And the food industry is really taking advantage of this by targeting adolescents really intensely for marketing of potentially addictive foods. And some of the work that we're doing in our lab is finding out how those advertisements that teens are being exposed to for these potentially addictive foods. It's really getting in under the skin. It's really activating reward systems in the brain in a way that they may not be consciously aware of, and that is setting them up not only to eat more of these highly processed, potentially addictive foods but to be at higher risk for weight gain over time. And, when I think about this, because it seems to be a situation where it's happening unconsciously, it's happening on this biological level, just using intervention and just trying to help kids try and protect themselves from these advertisements, it isn't going to be sufficient. It's really going to be more effective to reduce the amount of these advertisements that teens are exposed to. You were talking about the importance of early exposure to this food. What about the mother's diet during pregnancy or other the mother's or father's diets even before conception occurs? Is there any evidence on those issues? Yes, there is this really interesting line of emerging research that suggests a role for prenatal exposure-when the mom is pregnant and is eating a diet that's rich in these highly processed foods. Based on what we've seen in animal models, there seems to be a pretty clearly impact on what kinds of foods the babies prefer and how the reward systems of the brain are set up even before the baby is born (in these animal models). If the mom has consumed a lot of these highly processed junk foods, when the baby's born, the dopamine system of the brain that's really associated with addiction and reward and motivation, it seems to be changed and altered in a way that drives these babies to have a really strong preference for junk foods themselves. And it might set these babies up not only to be more vulnerable for a preference for these junk foods but that they might also be prone later in life to be more likely to develop a preference for addictive drugs like alcohol or amphetamines. So, we think about for this kid, you know, what is the first thing they eat? But also in those early in utero periods, and what the mom's eating even before she gets pregnant may actually start to program preferences for these foods. So we just really can't start early enough trying to shape their preferences away from these potentially addictive foods.  

Ashley Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 31671]

Ashley Gearhardt developed the Yale Food Addiction Scale (YFAS) to operationalize addictive-like eating behaviors, which has recently been linked with more frequent binge eating episodes in clinical populations, increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 31671]

Ashley Gearhardt, Yale and Rudd Center for Policy and Obesity, explores what makes certain foods capable of triggering an addictive process. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 21692]

Ashley Gearhardt, Yale and Rudd Center for Policy and Obesity, explores what makes certain foods capable of triggering an addictive process. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 21692]