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I was asked to write an editorial commenting on a study published a couple of weeks ago that looked at changes in weight among people participating in a comparison of ultra-processed vs. minimally processed diets.

The study: Ultraprocessed or minimally processed diets following healthy dietary guidelines on weight and cardiometabolic health: a randomized, crossover trial. Nat Med (2025). https://doi.org/10.1038/s41591-025-03842-0.

The study has a long list of authors: Samuel J. Dicken, Friedrich C. Jassil, Adrian Brown, Monika Kalis, Chloe Stanley, Chaniqua Ranson, Tapiwa Ruwona, Sulmaaz Qamar, Caroline Buck, Ritwika Mallik, Nausheen Hamid, Jonathan M. Bird, Alanna Brown, Benjamin Norton, Claudia A. M. Gandini Wheeler-Kingshott, Mark Hamer, Chris van Tulleken, Kevin D. Hall, Abigail Fisher, Janine Makaronidis & Rachel L. Batterham .

It must have been a huge amount of work to conduct this trial.  I can’t even imagine.

The lead author, Sam Dicken, explained the trial and its results on X.

My editorial has just been published in Nature Medicine:  Ultra-processed diets promote excess calorie consumption (I have no idea why the editorial was not published at the same time as the study, but it is now out).

I fthought several things about the study to be especially interesting.

• Participants, all overweight or obese, lived at their homes while under study.
• They were fed ultra-processed meals for 8 weeks followed by minimally processed meals for 8 weeks, or vice versa.
• Both sets of meals were designed to meet British guidelines for healthy foods; the ultra-processed foods were all healthy.
• They were give about 4,000 calories a day and could eat as much as they wanted from that.
• Participants lost weight no matter which diet they were on.
• They lost twice as much weight on the minimally processed diet.
• They ate more calories on the ultra-processed diet in comparison to what they were eating on the minimally processed diet.

Here’s the summary from my editorial.

One of the co-authors on the study is Kevin Hall, who did a rigorously controlled clinical trial of ultra-processed v. minimally processed diets and reported participants to be unwittingly consuming 500 calories a day more on the ultra-processed.

His study has been criticized for being too short in duration: two weeks on each diet.

This study kept participants on one or the other diet for eight weeks, and got a smaller but similar result.

Dicken et al also addressed a frequent criticism of the concept of ultra-processed foods: that the category excludes healthy foods like whole wheat commercial bread, commercial yogurts, power bars, and the like.  That’s what these participants were fed when they were on the healthy ultra-processed diet.

Here’s how I concluded my editorial:

Overeating, overweight, and increased risks for chronic disease are rapidly increasing public health problems for global societies.  Dietary guidelines in the UK and the United States have had little effect on improving overall dietary intake. None of these guidelines considers the degree of processing; the findings from Dicken et al. suggest that they should.

Brazil’s dietary guidelines, issued in 2015, say “avoid ultra-processed foods.” Researchers in the United States have called for guidelines and regulatory approaches to reduce intake of ultra-processed foods.

Despite ongoing debates about their definition, classification, and effects on health, in the context of maintaining or losing weight the evidence points to a clear message: minimize intake of ultra-processed foods.

If nothing else, the study provided further evidence for this sensible dietary advice.

Dicken et al: press coverage

• New York Times
• The Guardian
• CNN  I’m quoted in this one

Sugar has long been thought to increase risks for type 2 diabetes, but whether it really does has not been easy to prove and is still a matter of debate.

A new study suggests one reason why.  It distinguishes between the effects of sugar in beverages (increased risk) and foods (no increased risk).

The study: Dietary Sugar Intake and Incident Type 2 Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.

Method: The study analyed prospective cohort studies reporting relative measures of incident T2D [type 2 diabetes] risk by categories of dietary sugar (total, free, added, fructose, sucrose) or 2 beverage sources (non-diet sugar-sweetened beverages [SSBs], fruit juice) in healthy adults.

Results: 

• Each additional serving of SSB and fruit juice was associated with a higher risk of T2D.
• In contrast, 20 g/d intakes of total sugar and sucrose were inversely associated with T2D.
• No associations were found for added sugar…or fructose.

The figure shows the effect of 20 g/d sugar intake on T2D risk, in comparison to typical doses of SSB and fruit juice.

A) shows the bar plot illustrating the summary effect of a 20 g/d intake for different sugar types on risk of T2D.

B) compares these doses to typical servings sizes per day of SSBs (39 g/d) and fruit juice (23.3 g/d).

Conclusion: These findings suggest that dietary sugar consumed as a beverage (SSB and fruit juice) is associated with incident T2D risk. The results do not support the common assumption that dietary sugar (i.e., total sugar and sucrose), irrespective of type and amount, is consistently associated with increased T2D risk.

Comment: Sugar is still nutritionally empty, causes tooth decay(especially if water is unfluoridated), and is best consumed in small amounts.  But if this finding holds up, the moral is clear:  Don’t drink your calories.

Michael Jacobson, founder of CSPI and now working on developing a National Food Museum in Washington, DC has issued press release and a graph-filled report analyzing changes in the U.S. diet since 1975.

He calls the report, “Opening the 1975 Food Time Capsule – Diet, Health, & Food Industry.”

From the press release:

And the food industry has gotten a lot more concentrated:

• In 1975, the top 20 grocers sold 40 percent of retail food. Now, just four companies (Walmart, Costco, Kroger, Ahold Delhaize) control 65 percent of the market.
• The market shares of the top four beef, pork, and poultry processors roughly doubled over the last 50 years.

Meanwhile, food prices (adjusted for inflation) have gone up, down, or sideways. For instance, milk costs half as much as 50 years ago, while ground beef has stayed the same. Overall, consumers are spending just 11 percent of their disposable income on food now compared to 13 percent in 1975.

From the report:

Lots of fun information here!

I particularly like it because I cover these changes and lots of others in my forthcoming book What to Eat Now.  to be published on November 11 this year.

Thanks to Matthew Kadey for this one.

The USDA’s Food Surveys Research Group recently released its most recent Dietary Data Briefs based on What We Eat in America (WWEIA) data from NHANES 2020.

• Mexican Food Consumption by Adults
• Mexican Food Consumption by Children
• Pizza Consumption of the U.S. population

I went right to pizza.

Women over the age of 60 report getting nearly a third of their daily calories from pizza?

Even little kids get a fifth?

And that was before the pandemic….

I love pizza, but dietary variety anyone?

Halloween is about candy, no?  Here are four thoughts on the topic.

I.  From CagleWorld.com

II.  From The CandyStore.com.

III.  From Consumer Reports: What 100 calories of Halloween candy looks like. 

IV.  From my son Charles, who forwarded this, I know not from where:

Enjoy the occasion!

Everything in moderation!

Not being a particular fan of Dunkin’ Donuts, I somehow missed this astonishing drink.

But the esteemed journalist Eric Schlosser, sent me a link to this video tweet (oops, X).

This is INSANE. pic.twitter.com/2TwuSaOofF

— David Belle (@davidbelle_) September 13, 2023

I did not believe it, but excellent journalist that he is, Eric sent me the DUNKIN’ NUTRITION evidence.  Go to page 6 and check out the highlighted item: 930 calories and 167 grams of added sugars (but see NOTE below)

No, you could not make this up.

930 calories, by the way, is about half of what many people need in a day.

Advice: share this with friends—plural.

NOTE: a sharp eyed reader points out that it’s not a pumpkin latte; it’s a large pumpkin swirl frozen coffee with whole milk.  Whatever.

I can hardly believe this, and had to laugh when I read all the articles last week about how worried the food industry is about the new obesity drugs.

Imagine: if the drugs really do reduce appetite and interest in food—horror of horrors—people might eat less.

Eating less, as I have pointed out repeatedly, is very bad for the food business.

In Food Politics, I explained how the fundamental purpose of  food companies is to get you to eat more food, not less.

Beginning in the early 1980s, food companies did a better job of creating an “eat more” food environment.

People responded to this environment by eating more calories—lots more—and way more than enough to account for the rising prevalence of overweight and obesity.  Evidence?   See my book with Mal Nesheim, Why Calories Count: From Science to Politics.

When I am at my most cynical, I ask this question: What industry might benefit if people ate more healthfully?

I am hard pressed to think of any—certainly not the food, diet, or diet-drug industries (Novo Nordisk, maker of the semaglutide drug, Wegovy, now makes more than the gross domestic product of Denmark).

The only exception I can think of is not-for-profit HMO’s like Kaiser Permanente, which do better if their patients are healthier (and have no excuse for not paying their workers better).

Anything that helps people eat less and more healthfully is bad news for the food industry, and especially for companies making ultra-processed junk food.

No wonder companies are worried.

Here’s my collection from last week (with thanks to Lisa Young and Michele Simon for making sure I saw these articles):

• Wall Street Journal: America’s Food Giants Confront the Ozempic Era
• Yahoo Finance: Ozempic Is Making People Buy Less Food, Walmart Says
• Bloomberg News: If Ozempic Leads People to Eat Less, Maker of Cheez-It Will Be Ready
• Yahoo Finance: Snack-maker Conagra may tweak portions as weight-loss drugs alter appetites
• Washington Post:  Food, clothing, airlines: Ozempic is coming for these industries and more
• Yahoo Finance: Surge in obesity drugs like Ozempic has pummeled big food stocks. Is it time to eat them up?
• Food Fix:  Why Ozempic makes Wall Street woozy
• PepsiCo: PepsiCo monitoring impact of weight loss drugs, but says early impact on sales is ‘negligible’