Here’s Why You’re Addicted to Ultra-Processed Food: Chris van Tulleken (Transcript)

I want you to think about what the food is, if you’re answering yes. Think about the brand. Do you ever feel like you’re not in control when you’re eating them? Do you ever have cravings for those foods, and do you ever feel guilt?

Now, if this was a questionnaire about alcohol, I would be possibly diagnosed with a severe addiction to alcohol if I answered yes to all six of these questions. But there are two big problems with food addiction. The first thing is that food doesn’t seem to contain any addictive molecules. Some people think that sugar is addictive, but most of us can sit with a bowl of sugar on the table, and we don’t find ourselves compulsively eating it with a spoon. No one does that.

The Problem with Labeling Food as Addictive

Okay, my three-year-old does do that. She does it for the same reason that she does everything, which is to frustrate me. Broadly, sugar is not addictive, but there’s another much bigger problem with food addiction, which is that baked into the concept of addiction is the idea of abstinence, and none of us can be abstinent from food. So calling food addictive is really, really problematic. In 2009, a group of scientists in Brazil solved this problem almost by accident.

They were noticing this terrible epidemic of diet-related disease that was sweeping through South and Central America. There were lots of different products that the data showed were causing this. They were being aggressively marketed. This is the door-to-door sales force from Nestle, and they were selling frozen foods, breads, pizzas, candies, chips, noodles. There’s a great variety of products, but they all had one thing in common.

They were all industrially processed. So, the Brazilian team, led by Carlos Monteiro, created this definition. They called it ultra-processed food. Arguably, it might be the longest definition in science. It’s housed on the United Nations Food and Agriculture website.

Ultra-Processed Food and Its Impact

I may be one of a tiny number of people who’s read all 11 paragraphs. But if you’re wondering if a product that you’re eating is ultra-processed, it all boils down to this. They’re products with at least one ingredient you wouldn’t usually find in your kitchen at home. So, things like this sandwich, for example. It’s ultra-processed because it contains mono and diacetyl tartaric acid esters of mono and diglycerides of fatty acids, one of the most common emulsifiers in our bread.

It’s got xanthan gum, twice, and something extraordinarily called smoked water. Now, these products have overtaken our diet. They make up more than 60% of the calories that we consume in the United Kingdom. 80% is common for many, many children. And at the same time as they’ve started overtaking our diet, we’ve seen a global pandemic of diet-related disease that means that poor diet has now overtaken tobacco as the leading cause of early death.

And at the same time, we’ve done a lot of research on these foods, and that’s been driven because we’re living in an emergency in the UK and the US. Our children aren’t just some of the heaviest in any equivalent country, they’re also short. Children at the age of five in this country are that much shorter, the age of five, than their peers in Northern Europe, Eastern Europe, and Scandinavia, where they eat less of this kind of food.

The Addictive Nature of Ultra-Processed Foods

So, the research is pretty clear that a diet high in ultra-processed food is the problem. And just like tobacco, it seems to affect all of our body’s systems. It’s been linked to anxiety and depression, dementia, eating disorders, cancers of all kinds, liver disease, inflammatory bowel disease, metabolic disease, cardiovascular disease, early death from all causes, and most importantly, this is the thing we have the most data for, weight gain and obesity. We can’t seem to stop eating it.

And this is where that definition solves that problem. Because at least in theory, we could be abstinent from ultra-processed food. It’s only been in our diet for a few decades. But is it really addictive? You may have seen headlines like this comparing ice cream to heroin. And like me, you may have thought, well, come on, that’s a bit excessive. But I want you to reflect on this.

Of people who try cocaine or alcohol, between 10% and 20% of them develop an addiction. Not by any means all of them. We think, according to the best data at the moment, that around 14% of adults live with an addicted relationship to ultra-processed food products. And terrifyingly, we think it’s about 12% in children. We also know the risk factors for that kind of addiction, they’re the same, whether we’re talking about cocaine, alcohol, tobacco, or ultra-processed food.

Personal Experiment with Ultra-Processed Food

Stress, poverty, trauma. And when we put people in scanners, the same parts of the brain light up. So, there is a lot of commonality. Now, to find out more, I put myself on a diet a couple of years ago. It wasn’t a usual diet. It was a diet where I was the first participant in a big research study that I’m now running with my colleagues at University College in London.

The idea was I’d eat a very high ultra-processed food diet, 80% of my calories, a normal diet for a British teenager. And we’d see what happened to me, and that would guide us how to run the rest of the study. We’d get pilot data from me. So, I was very excited about this. Because of course, if you’re a doctor whose research is nutrition, and broadcasts about nutrition, you don’t usually get to eat stuff like this for breakfast.

It didn’t start feeling appropriate. So, I brought this whole bag of food home, and my daughter, Lyra, latched onto this. She called it the Mickey Mouse cereal. She’s never seen Cocoa Monkey before. And I was a bit uneasy about feeding it to her, but you look at the box. It’s not just safe for children. It’s positively designed for them. There’s a monkey on the box. There are lots of health claims.

The Impact of Ultra-Processed Foods on Consumption Habits

There is something weird, though, which is that the nutritional information, if you look on your boxes of cereal, and this isn’t just Cocoa Pops, all applies to an adult portion, a 30 gram portion. Now, has anyone here ever weighed out their breakfast cereal? Not even in this audience. Did one hand go up? So, I have here an adult portion of Cocoa Pops. There it is. It’s not much, is it? But if you stick to that amount, you’ll be fine.

Well, I sat down the first morning with Lyra, and we ate. She ate three and a half adult portions, and she didn’t pause for breath. She ate almost in a trance, looking at the box, communing with Cocoa Monkey. It was an incredible experience, and she did it in moments. This is food that has been designed to bypass our body’s ability to say, “I’m full. I’ve had enough calories.” And that speed of consumption is important.

In general, ultra-processed food, it’s very soft, it’s energy dense, it’s often full of salt and fat and sugar, and it doesn’t have much water in it, so you eat it quickly. The speed of consumption seems to be important for lots and lots of different addictive products. The delivery of the reward molecules, in this case, fat and sugar, is important if you do it quickly. Compare nicotine gum and cigarettes. Same addictive drug, same dose, but the cigarettes are essentially the most addictive drug we have.

Food Additives and Their Impact

Well, the nicotine gum isn’t addictive at all. In fact, we can use it to treat cigarette addiction. And there are lots of other examples. So, speed of consumption and energy density seem to be very, very common between ultra-processed foods and other addictive substances. But there’s another aspect to the food that we worry about, which is the additives. And there’s lots of additive anxiety, most of them are pretty safe, but there are a lot of them.

In the UK, we’ve got more than 2,000. In the US, no one has a list. Might be 5,000. By some estimates, it’s more than 15,000 chemicals added to food. And part of it is to save money. Strawberries are expensive. If you can put in a bit of ethyl, methyl, phenol, glycolate, you’ll save a lot of money, and you may be able to drive excess consumption.

The Impact of Food Additives on Health

We have emerging evidence that these cocktails of additives seem to be driving changes in our microbiome, our friendly bugs. They seem to be driving excess consumption, weight gain, and inflammation. The additives may well be one of the big problems with the food, and they may be contributing to addiction. Essentially, you are all participants in experiments that you didn’t volunteer for.

You take all the risk in this experiment. New molecules, new combinations of molecules are added to your food and trialed on you, and the benefits are all kept by a very small number of people who own a relatively small number of companies. But how did our food get to be this way? Well, I want to show you.

I spoke to hundreds of people in the food industry in the course of my research. I have good friends who work in the food industry, and I’ve got a good picture of how we develop products. It’s called A-B testing. I’ve got two slightly different formulations here of the same breakfast cereal.

The Food Industry’s Strategies for Increasing Consumption

One has a slightly different emulsifier. The way I test them is I give them to people like you. The main thing I’m interested in measuring is how quickly you eat them and how much you eat. If you eat box A quicker and more of it than box B, that’s the one that goes on the shelf.

Next month, I try box A against box C and then box D. Every single aspect of every product is optimized to drive excess consumption, and the reason is that the food is all made by a small number of companies. These companies have obligations mainly to institutional investors, such as pension funds and hedge funds, who are the owners of the company. Their obligations are to deliver them equity value and dividends, and so we have to sell as much food as possible.

Now, some people say that in doing all this, the food industry is behaving a bit like the tobacco industry, and that’s actually not quite accurate. Because what you have to remember is that for a very long time, the tobacco industry was the food industry. In the 1980s, R.J. Reynolds bought Nabisco, and Philip Morris bought General Foods and Kraft, creating the biggest food company in the world.

Tackling the Food Industry’s Influence

They used all the flavor technology and the marketing technology they’d been using to sell addictive cigarettes, and applied all that to selling addictive foods. So, Philip Morris had this program, it was a loyalty scheme. If you smoked more of their products, then you would get miles, and you could use the miles to buy cowboy swag. They developed the same thing for kids with the Kool-Aid Man, a loyalty program where the more Kool-Aid you bought, the more points you got, and kids would get swag.

The companies know their food is addictive. We’ve got cereals called Crave, we’ve got whole campaigns based around the notion of addiction. If you think about the advertisements of our childhoods, the behavior of the mascots, they all have a very addicted relationship with the products they are representing. We have to use the tobacco industry template to regulate the food industry. We learned how to control them, just as they are using the playbook that they developed to sell us cigarettes to now sell us food.

And the first thing that we have to do, that was successful with tobacco control, is interrupt the flow of money. The money has to be seen as shameful. This is our biggest nutrition charity in the UK, this is a list of the companies that give them money. We have to stop doctors, scientists, policymakers from having a financial relationship with food companies.

We need to get the tiger off the box and put warning labels on. This is a box from Mexico, and kids in Mexico and Chile, where there are these warning labels, and there aren’t tigers on the boxes, are now asking their parents to stop buying this food. Just as I asked my parents to stop smoking. But what should you do? You know, this will take decades, it will be more than the work of my lifetime. Well, I got an answer.

Changing Our Relationship with Food

If you’re struggling with this, midway through my diet, I called Fernanda Rauber, a colleague in Brazil. She said this line to me, just as an aside, “Ultra-processed food is not food, it’s an industrially produced edible substance.” We hung up the phone, and I sat down to eat my favorite meal, and I found I couldn’t eat it. She had flicked a switch in my brain. She turned it from addictive into disgusting.

We have some evidence that if you stop forbidding yourself an addictive product, and you engage with it meaningfully, you can make that transition from addiction to disgust. So, my invitation to you is to keep eating ultra-processed food. You’re soaked in it. We have to keep eating it. It’s all the food that’s available to many of us, particularly people living in disadvantage.

So keep eating it, inspect it, read your ingredients list, get it out on a plate, look at it, touch it with your hands, and ask yourself this question, “If food should be prepared with love for the purpose of nourishing us, is it food? Or is it an industrial substance designed to turn my health into other people’s money?” And if you’re struggling, and this is a conversation that is separating with shame and blame for so many people, I would ask you just to remember that all of these products are so carefully designed to make you keep eating them. And just remember, it really isn’t you, it is not your fault. It is the food.

Thank you all for listening, and thanks to my collaborators.

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