Ashlee Williams, MD (Host): Ultraprocessed foods. We've all heard the term, seen the headlines, and probably consumed more of these foods than we'd like to admit. But what exactly are ultraprocessed foods? And more importantly, how do we identify them and find healthier alternatives? Welcome to the Healthier You podcast. I'm Dr. Ashlee Williams. And today I'm talking with Dr. Lakshmi Latimer, a Board Certified Gastroenterologist at Kaiser Permanente, about how ultra processed foods affect our health and how we can make smarter food choices without sacrificing flavor or fun. Thank you so much, Dr. Latimer for joining me today.

Lakshmi Lattimer, MD: I'm very excited to be here talking about this important health topic.

Host: It's such a great topic. Okay, let's just start with the basics. What exactly are ultra processed foods? What's the difference between ultra processed versus processed foods, minimally processed foods, or whole foods?

Lakshmi Lattimer, MD: So ultra processed foods are products made with ingredients that are not typically found in foods that you would consume in nature. So unlike minimally processed foods or unprocessed whole foods, such as eggs for example, which pretty much, come to your table from the farm looking very similar; ultra processed foods have been radically altered by manufacturers, so by the time they hit the grocery store shelf, and then later on your kitchen table, they are very different than the foods that they started out as.

So they often have been heated, pressed, and have chemicals added, that make them last longer, often taste better, but can really be detrimental to our health. As far as minimally processed foods, minimally processed foods are foods that may undergo some processing, but don't have as many chemicals and other compounds added to the food. So, it may be heated, it may have salt added, but, a lot of the additional chemicals are not added to the food. So that's the difference between an unprocessed whole food, a minimally processed food, and an ultra processed food.

Host: Got it. So how do we identify which foods are ultra processed?

Lakshmi Lattimer, MD: Yeah, and that's a good question because, you know, it's estimated that over 60 percent of the standard American diet is composed of ultra processed foods. So they really are everywhere. It does take some thought on how we can reduce the amount of ultra processed foods that we're eating.

 Ultra processed foods are a lot of the things that people will eat. Think about breakfast cereals. Think about protein shakes, protein bars, any of the sugary snacks, cookies, candies that are packaged, any of the kind of packaged snacks. All of these are ultra processed.

So, literally, they are everywhere. Fast food, they're easy to ship and they're very convenient. And so, in order to reduce our processed food intake, we have to be more intentional about looking at the foods that we're consuming. The best way to do that is actually to turn the package around and look at the ingredients label.

And what you'll find as you're looking at the ingredients label is that ultra processed foods often have a long list of ingredients that sound more like chemicals than actual food or flavoring. So for example, some of these could be sodium nitrate, hydrogenated oils, malto dextram, monosodium glutamate.

So these all sound like chemicals. They don't sound like things that you would actually cook at home with. And so that's going to be a tip off that it's an ultra processed food and something that you're going to want to try to avoid when possible.

The rule of thumb is that if it contains ingredients that you don't have in your home kitchen, then you can assume that it is ultra processed. And really, what ultraprocessing does is it takes food that is healthy in its natural state and it modifies it and often adds chemicals and then removes healthy things like fiber and micronutrients.

And the more it's modified, often the unhealthier it is and the less nutritional value it has, so that by the end, what you're left with is not, no longer a healthy whole food, but what I like to consider more of a edible processed food like substance.

Host: Wow. It sounds like ultra processed foods are the easier grab and go foods. I love the tip about if you can't find it in your pantry, it's probably something that is ultra processed. Can you talk a little bit about why ultra processed foods are bad for your health?

Lakshmi Lattimer, MD: Absolutely. So, there are numerous studies out there that have examined the health effects of ultraprocessed foods and diets that contain a high amount of ultraprocessed foods. So, researchers have actually found that a diet high in ultra processed foods increase your risks for numerous diseases, which are, include things like high blood pressure, type 2 diabetes, depression, obesity, anxiety, and even dementia.

There was a recent study I was reading about that actually linked consumption of ultra processed foods to an increased risk of cognitive decline and stroke risk. And then there are several other evidence to suggest that ultra processed foods can actually increase your risk for early death and increase your risk of cancer. So for every 10 percent increase in a person's consumption of ultra processed food over a lifetime, this will result in a 10 percent increased risk of cancer and a greater than 10 percent increased risk of early death. As you can see, there are a lot of problems with ultraprocessed foods, and it's a combination of the chemicals that are being added to the foods and also the healthy things that are often stripped away in the processing.

So for example, foods that are often ultraprocessed are highly refined and have the fiber removed from the foods. The thing that we know about fiber is that it's really good for your health. There are numerous types of fibers that we can get from plant based foods. And these healthy fibers, when we consume them, they actually increase the balance of anti inflammatory chemicals within our GI tract and reduce the pro inflammatory chemicals within our GI tract.

So when you are consuming ultraprocessed foods, you're tipping that balance more to pro inflammatory. Not only is this going to cause issues inside your GI tract, but that inflammation then spreads to your entire body. It will increase your risk of GI symptoms such as bloating, diarrhea, constipation, but also increases your risk for other diseases such as GI tract diseases like colon cancer and then cardiovascular diseases as well.

Host: Wow. I'm thinking about what's in my pantry and what I've been feeding my family. You've presented a lot of information that really has me thinking a lot. Are there any processed foods that are okay to eat?

Lakshmi Lattimer, MD: Yeah, most things that are going to be found in cans or packaging, they have been processed some, but there are minimally processed foods that can be convenient and can be things that we can include in our diet. So for example, canned tuna, right? If you look at the ingredients list on the canned tuna, it typically will say something like tuna, some salt, maybe water and oil.

 That's going to be an example of a minimally processed food. The important thing is that not to rely on what's on the front of a package, but really to look at the ingredients list and, manufacturers have become particularly savvy at trying to capture our attention with labels that make the food sound really healthy.

So sometimes they'll write things like organic, all natural, low fat, and even plant based foods can be ultra processed. So it's not just enough to look at the front of the package, but really to read the ingredients label, and the more you do it, the better you will be at spotting these ultra processed foods and looking for alternatives to consuming them.

Host: Oh, great. That's a segue into my next question. So we've talked a lot about ultra processed foods. Can you give us some examples of healthier alternatives to ultra processed foods and what we should be eating instead of processed foods?

Lakshmi Lattimer, MD: Yeah, absolutely. So, I think there are a few ways to tackle this problem. If it's something that you're interested in doing, just understand that it's not an all or nothing, right? So, if we understand that the average American consumes 60 percent of their calories from ultra processed foods, it's going to take a while to really change your eating habits.

And so the important thing is to start where you are and find ways that you can improve, and select more high quality foods. The first thing I would say is when you go to the grocery store, you want to shop the periphery of the grocery store. Think of the produce section, for example.

Love the produce section. It's gonna have, healthy things, fruits and vegetables. They're not going to have chemicals added. The nice thing about fresh fruits and vegetables, not only are they going to be high in fiber and have a diversity of fiber, but they're also going to have a lot of micronutrients and phytochemicals, which are really good for our health.

So I would say start with the produce section and make sure you're loading up on those healthy fruits and vegetables. The other thing is on the periphery of the grocery store, you're going to find things like, the meat section, the seafood section. So those are going to be things that are kind of coming to you, they might be cut, but usually are less processed, don't have a lot of chemicals added.

So if you're interested in eating, you know, animal based products, you're going to want to stick to the meats that are fresh meats rather than things that are processed meats or canned meats, for example. The next thing I would say is, cooking at home, it's a great way to save money, but also to reduce the amount of ultra processed foods that you're consuming.

Because, unfortunately, a lot of the fast food places out there, the majority of their menu are going to be ultra processed. I recommend, you know, if you cook dinner, if you plan ahead and you have a healthy dinner that's minimally processed, what I always do before I clean up my own kitchen is I take some leftovers and I pack it into an individual container so that I can take it with me to work the next day.

And that way it eliminates the temptation of first thing in the morning and I'm running out the door and I'm not prepared. Or, I get to work and I realize I don't have anything to eat, and then I'm kind of forced to kind of eat whatever's quickly available. So, cooking at home is great tip.

 Planning ahead is going to be very important so that you have options. And then, things like snacks. There are a lot of healthy snacks that you can have. You know, the workday's on, people are on the go, they're shuttling their kids to sports practices and other places. So the more that you can, you know, have healthy options available that are within reach, the less likely you'll be tempted to hit the vending machine, for example.

So, I'll take an apple. I'll plan ahead and take, you know, pumpkin seeds. There are things that can be convenient just because it's convenient doesn't necessarily mean that it's unhealthy, but it does require a little bit of thought in advance in order to have those options available.

Host: So true. Yeah planning ahead is definitely key and I think one thing that you touched on which is really great is making enough food so that you can package it individually so that you don't have to like divide it up during the week. Cause that also takes time.

Lakshmi Lattimer, MD: Yeah, exactly. I mean, it's, and you have to clean up the kitchen anyway, right? So it saves you time to just put it in a Tupperware and leave it in there. And it just reduces your stress in the morning and just helps to like the flow of your day. And then, you know, in the middle of the day, you'll probably find that as you are eating your healthier food options, you may actually have more energy and just generally feel better when you're, you know, feeding your body with healthy foods that are overall just better for your health.

Host: Right, so you mentioned fiber. Why is it better to get fiber from whole foods versus like pre packaged granola?

Lakshmi Lattimer, MD: Fiber is not only one thing. There are thousands of different types of fiber that we get from the plants that we, when we eat whole plants, essentially. And so that can be things like fruits and vegetables, whole grains, beans. They have different types of fiber.

So fiber is not all the same. Eating different, a diversity of foods is very important to kind of feed those healthy microbiome. That's the microorganisms that live inside our GI tract. Different, populations kind of feed on different types of fiber. So in order to have a robust, microbiome with healthy anti inflammatory bacteria, you have to feed all the different populations the things that they are going to be able to metabolize and break down, and the way to do that is really to get a diversity of fiber within your diet. So rather than trying to consume it in a fiber bar, it's much better to think about how you can diversify your diet with plant based foods, because not only will you be getting fiber, but as you consume these naturally occurring types of fiber, you're also going to get added benefits, micronutrients such as vitamins, antioxidants, and phytochemicals, which overall, are converted by the microorganisms inside your GI tract into short chain fatty acids, and these are chemicals, which we consider postbiotics, which have numerous health benefits.

So, it's basically, you get more high quality fiber, you get a diversity of fiber, and you get other really important nutrients by consuming fiber in whole plant form, rather than a processed fiber supplement.

Host: Thanks for this great information, Dr. Lattimer. We learned a lot about how ultra processed foods can impact our health. For recap, 1. Researchers have linked eating more ultra processed foods to health risk, including increases in obesity, high blood pressure, type 2 diabetes, dementia, and depression.

The more we learn about ultraprocessed foods, the more we realize how bad it is for our health. 2. Look at the list of ingredients to tell if a food is ultraprocessed. If a food is ultraprocessed, it will contain a long list of ingredients, many of which may sound more like chemicals than real food. 3. To avoid ultra processed foods, choose foods that contain ingredients you recognize.

Healthier options include whole grain pastas or shredded wheat cereal instead of regular refined grain pasta or sugary cereals. Four, shop the perimeter of the grocery store for fresh produce, lean proteins, nuts, whole grains, and legumes. These foods are less processed, provide more nutrients, and are better for your health overall.

And five, one of the best ways to cut back on ultra processed foods is to cook from home. If you're not used to cooking at home, no worries. It takes time to develop this habit. Start small, like eating a whole food meal at home every Sunday. You can prepare lots of meals over the weekend and eat them during the week.

Sometimes pre packaging does help. For more healthy tips from our experts and other health advice, visit kp.org/doctor and listen to more episodes of Healthier You wherever you get your podcast. If you enjoyed this episode, be sure to share it with others who may find it helpful. Thank you from all of us at Kaiser Permanente.

Be well.