Following my review of obesity last week, this week I want to provide an overview of a review carried out by Mushinsky (2017) who sought to discover whether there was a link between ultra-processed foods (UPF) and obesity.

So firstly, what is obesity, and why is it such a big deal?

Simply put, obesity is defined as having a Body Mass Index (BMI) above 30. The incidences of obesity have doubled in 73 countries between 1980 and 2015. Obesity is a risk factor for many diseases, including: -

Type 2 Diabetes
Cancer
Hypertension
Stroke
Cardiovascular Disease
Sleep Apnea
Osteoarthritis
Chronic Kidney Disease
Gallstone disease

Furthermore, obesity has become a crisis not just of health, but also of economics. In 2014, McKinsey & Co estimated the global economic cost associated with obesity to be roughly $2,000,000,000,000 (which equates roughly to the costs associated with terror, war and armed violence combined).

So what the hell are UPF's?

Well, processed foods are modified whole foods and can still be recognised as foods. Examples include: -

Canned Fish
Fruits in syrup
Salted or sugared nuts
Cured or smoked meats
Fresh bread

Ultra-processed foods (UPFs) on the other hand, are not modified whole foods, but are mostly or completely made from substances extracted from whole foods together with special additives which enhance their seductiveness and durability. A multitude of sequences of processes is used to combine the usually many ingredients and to create the final product. The overall purpose of ultra-processing is to create branded, convenient (durable, ready to consume), attractive (hyper palatable) and high profitable (low cost ingredients) food products designed to displace all other food groups.

Examples include: -

Soft drinks
Sweet or savoury packaged snacks
Reconstituted meat products and pre-prepared frozen dishes
Margarines and spreads
Mass produced packaged breads

Are UPFs Responsible for the Recent Sharp Increase In Obesity?

According to the World Obesity Federation's Position Stand, the prime environmental factor that has caused the rise in obesity over the past few decades is excess energy from highly seductive (tasty), energy dense, ready-to-eat (or heat) industrial foods. Compounding their problem is their increased availability, accessibility, and affordability. UPF's were not in existence 50 years ago, before this great surge in obesity in the industrialised world.

UPFs can be considered 'obesogenic' due to their high energy density & the ease at which people can over-consume these foods. They provide little satiety, meaning they are 'super tasty and non-filling'.

Therefore, focusing on a sustainable diet that can be adhered to is of primary importance. This diet must focus on keeping the dieter satiated, so that hunger is avoided wherever possible. This is best done with a diet that: -

Is moderate to high in protein (1.6-2.5g/kg BW/Day)
Is largely made up of whole foods - avoiding UPFs wherever possible
Is high in dietary fibre

If 80% or more of someone's diet can be comprised of the first group of foods outlined by Mushinsky (2017) - 'unprocessed or minimally processed foods' - then it is my contention that long-term weight loss will be much easier to achieve. The following factors will help with any weight loss diet: -

Focus on consuming foods that are unprocessed - aim for at least 80% of your food to be unprocessed/minimally processed
Ensure you consume a moderate to high amount of protein - this is extremely important for satiety
Ensure you include a lot of fresh vegetables and fruit. Not only do these provide a wide range of vitamins, minerals and phytonutrients, but they are very low calorie and also high in fibre, which again is very important both for gut health and satiety
If weight loss is plateauing do a 'food audit' - start to count your calories and assess all the foods and drinks you are consuming. Are you consuming 'hidden calories'? Are you underestimating portion sizes? Do you need to reduce calories further to induce weight loss?
If dieting for an extended period of time, include diet breaks to allow your body to recovery from being in a constant energy deficit.
Minimise consumption of UPFs