(logo booming) (logo chiming) (audience applauding) - Well, thank you all
very much for coming. I'm impossibly honoured
to be here at the Ri. I've attended many
wonderful lectures here. I wanna talk about food and
about stuff that isn't food. But before we do that, I wanna discuss a little bit about the language we
use for this discussion. Because I'm gonna talk
about the wide effects of this category of ultra-processed food on human health and on planetary health, but the thing that a lot of
people want to understand and the thing that a lot of the research is focused on is weight and obesity. And we don't really have the language to talk about this in a sensitive way. The language is still evolving. And if we're not really, really careful, a war on obesity very quickly
becomes a war on people, because more than anything else, we use the word obesity
in its adjectival form. People are obese. So obesity and identity are conflated. And so when we tackle obesity, if we say that food is the problem, the people who eat it can
quickly become the problem, as we see in this headline
from the "Daily Express." So what I want to do is
use the framing of this, that people can live with obesity, and many of us live with lots of problems and obesity needn't be an identity. It's an identity that people can put up and they can pick it up and they can put it down
in different contexts. And the reason I say that and the reason I frame it so carefully is because we absolutely do
have to have this discussion, because in the last decade, poor diet has overtaken tobacco as the leading cause of
early death for human beings and for animals on Planet Earth. It's the leading cause of early death for, of course, the animals we eat. It's also the leading cause of early death for all the animals that we don't eat, because ultra-processed food and the food system that supplies it is the leading cause of
loss of biodiversity. So this is a really, really
important discussion to have. And while the solutions to this problem are gonna be really complicated, and I'm gonna explain why
they're so complicated, they're gonna need to be local and nuanced and driven by grassroots activism, and they're gonna need to
deeply understand all of us and what we want and what we need and they're gonna involve politics and economics and culture. The cause of this pandemic of diet-related disease is pretty simple. I want to make the case
to all of you today and to anyone watching that the primary cause of
pandemic diet-related disease, including obesity and malnutrition, the primary cause is the rise of a diet of industrially produced edible substances known formally as ultra-processed foods. I wanna make the case that
obesity and diet-related disease is therefore commerciogenic. It's driven by profit incentives. And more and more my research focuses on working with economists
and with agriculturalists to understand how financial
incentives drive this pandemic. But unless we frame the problem
as commercial in origin, we will never solve it. And so I draw the parallel with tobacco because I think we have to start thinking about treating the
companies that make our food a little bit in the way that
we treat other companies that interact with our health, the oil industry and particularly
the tobacco industry. You are all part of an experiment that you didn't volunteer for. We're all being trialled constantly
using brand new molecules which have never been in our diet before, and new formulations of ancient molecules that have never been
tried in a formulation. And you have an internal
evolved system to deal with food that isn't very good at
dealing with these foods. So in my book, I explicitly link, I try and write it using the techniques developed in this bestselling book called "The Easy Way to Quit Smoking." Has anyone here ever read this book or used it to quit smoking? Yeah, it's very popular, and it's unique in the self-help genre because it's the only book recommended by the World Health Organisation as a well evidenced way
of quitting smoking. And I put up a few research studies there. This book actually seems
to be, in some studies, as effective as nicotine
patches or therapy or lots of the other methods we use. And part of the trick in this book is that you're advised to keep smoking while you read the book. And so at the heart of
my book is an invitation to participate in the experiment. You're already doing it, ultra-processed foods make up a huge proportion of what we eat, but to do it for yourself. So keep eating while you read. And if you don't wanna buy the book, lots of people can't afford my book, there are some amazing resources online. There's Bee Wilson's
resource in "The Guardian," the long read on ultra-processed food, which had huge influence on me. So you can read about ultra-processed food and I would encourage
you to engage with it, 'cause that was the experiment that I did when I was writing the book, is I went on a month-long
diet of ultra-processed food. And I didn't do that casually. I didn't do it as a stunt
for a telly programme. I did it to gather pilot data for a much bigger study that
we're now running at UCL. So I did it with the help
of very expert colleagues, and I'll talk a little bit about what happened to me in that diet. So I've written the
book with that in mind. We're part of this experiment. A thing that's really important
to understand early on is that processed food is not the same as ultra-processed food. Processing is ancient. Humans are the only
obligate processivores. We must process our food. I've put up there some
guts of different animals of comparative size, some of them. Humans compared to other animals
of similar size and weight, we have tiny jaws, minuscule teeth, and very short digestive tracts. We have extended our
gastrointestinal system, our digestive system,
out into our kitchens. We use grinders and knives
to chop and cut our food instead of our teeth and our jaws, and we use cooking and processing
and mashing and extracting to make our food much more easy to digest. And so modern food was invented primarily by female scientists
over hundreds of millennia, and they worked in caves
and leaf shelters and huts and then modern kitchens
to invent the modern diet, and it involved a huge
amount of processing. For over a million years
we've been cooking food and for hundreds of thousands of years we've been grinding it and mashing it and extracting it and salting it and curing it and
fermenting it and smoking it and doing all of these wonderful things that make diets edible and delicious. And we're very sure that every traditional diet
that we've ever studied is associated with really good health. You can go to East Asia and
look at pescatarian diets or South Asia and look at vegan diets. You can go to the High
Arctic and look at diets that comprise mainly fats from sea mammals and are primarily carnivorous diets. All of them seem to be
associated with good health. Of course, there's the
Mediterranean diet as well. What we've never been able to do is to extract any molecule
from any of those diets and show that it has any
benefit in healthy people, and that's really, really important. So when we talk about food, I'm much less interested
in individual products or individual components of food than I am in a dietary pattern. The food we eat is, we
never eat individual food. So whenever we're talking about food, people always want to know, is broccoli healthier than burgers? Well, if you're on a desert island, you'd be much, much
better off eating burgers. You could live your
entire life on burgers. If the meat was rare, it
would have vitamin C in it. They're are good source
of all kinds of things. They've got loads of calories. You wouldn't live long on broccoli. Broccoli is deficient in
all kinds of essential fats. It's very low in protein. And yet broccoli forms a key part of a really healthy balanced diet in a way that an
ultra-processed burger wouldn't. Processing is ancient, therefore, and has shaped our genes, our physiology, but ultra processing is very different. So we have now entered
what in my book I describe as the third age of eating. In the first age of eating, creatures, microorganisms ate stuff that had never been alive. Bugs ate rocks. In the second age of
eating, people eat food. So organisms created a shortcut where we eat things that have been alive. And the second age of
eating continues today. You can go into any big supermarket and you can buy things
that used to be alive and you can assemble
them at home into a diet. But ultra-processed food
is where we eat things that have never been in our diet before, and I'm gonna explain what they are. Using photos in these talks, especially about weight and diet, can be really stigmatising. The only people I'm gonna
stigmatise are my own two kids. That's Sasha, she's now three, and she is very much a child of the ultra-processed food age. She's grown up eating lots of it. There she's eating ultra-processed food. It's ultra-processed cat food.
(audience laughs) She's a huge fan of it. And I have friends who work, I have lots of friends
in the food industry, I have friends who have worked
in the pet food divisions and moved over to the
human food divisions, and we use the same flavouring
technologies in both. So ways of getting pets to like food are great ways of getting
kids to like food, and Sasha was a huge
fan of this particular, it was a kibble for cats
with poor dentition. Anyway.
(audience chuckling) So there she is. And you may find, I've
got a lot of messages from people who, having
engaged with the book, have switched their perpetually
hungry domestic pets to whole food. And it's very expensive to do it, there are environmental
concerns about doing it, but they found a lot of their pets become much more satisfied
eating real foods. That's anecdote. So what is ultra-processed food? I'm happy to talk more about the controversy
about the definition. In fact, the definition in
terms of independent scientists is extremely widely agreed on. UNICEF, who I work with, the World Health Organisation who I'm on an expert advisory panel for, research groups at Harvard, Oxford, my group at University
College in London, Cambridge, all over the world, have agreed that this is
a great and useful way of defining a category of food. It came out of work in Brazil. Don't worry about trying
to read this, by the way. I'm putting it up there to make it clear that the definition is extremely long. If it's too long, didn't read, here's a really good working definition that some of you will know, of course. "Wrapped in plastic with
at least one ingredient you wouldn't normally find
in a standard home kitchen." It's almost certainly ultra-processed. The definition came out of
a research group in Brazil led by someone called Carlos Monteiro. And a lot of the best work on UPF has been done by research groups in South and Central America, because in lots of countries, Mexico, Brazil, Columbia, Chile, they found that in a
very short space of time, obesity and metabolic disease
like type two diabetes went from being essentially unheard of, they just didn't really exist, to in the space of around a decade being the dominant public health problem. And the only thing that had happened was the incursion of a Western
American industrialised diet where most of the calories were coming from a ultra-processed food. So it was a really, really
powerful natural experiment. Carlos Monteiro was a very senior nutritional professor in Brazil, he's a medical doctor as well, and he collected the data
and derived this definition from the data that he was seeing in the public health
research that he was doing. So the definition's very long. There is a bit of social
theory baked into this. I'll expand the definition a bit. But in paragraph nine, it makes it clear that part of the purpose
of the food is profit, that we make this food
so it is easily marketed and easy to sell. So, this was a huge
paradigm shift in nutrition, because everyone here
in this room I would bet has thought for most of your life about nutrition in terms
of about four things: salt, sugar and carbs,
fat, protein, and fibre. Those are the things that
our food is made up of and that's the way our food is labelled, and that's what nutrition is, it's about the nutritional components. Carlos Monteiro was proposing that food is more than the
sum of its component parts, that what we do to the
food actually matters. And this was revolutionary,
and we're gonna see why. So we're having a conversation
where we need sensitivity, kindness, nuance,
scientific sophistication, and to use lots of
different siloed knowledge. So I thought who better to turn
to for this kind of thought than the words of former and perhaps future president Donald Trump. (audience chuckling) Donald Trump was one of the early adopters of the idea that ultra processing had a significant effect on human health. So in 2012 he sent out a series of tweets. "I have," I won't do an impression. (audience laughing) Now I really want to. "I have never seen a thin
person drinking Diet Coke." The next day he sent out another one. "The more Diet Coke, Diet
Pepsi, etc that you drink, the more weight you gain?" The next day another one, "Diet Coke tweet had a monster response, dammit, I wish the stuff worked." The next day, "The Coca Cola
company is not happy with me. That's okay, I'll still
keep drinking that garbage." (audience laughing) Then he let it rest for a few days and came back with I think a tweet that in just 140 characters, less than 140 characters, sums up more than a decade later the state of the art,
the state of the science that we now have about
non-nutritive sweetness. "People are going crazy with
my comments on Diet Coke, soda. Let's face it, this
stuff just doesn't work. It makes you hungry." (audience laughing) Now he's-
(audience laughing) That was the face he pulled
as he sent the tweet. So my proposition to you is if
you can understand Diet Coke and how it interacts with your body, then you're a long way into understanding what ultra-processed food is. This is Diet Coke labelling
from the United Kingdom, but this is more or less how
it's marketed around the world. This gets four green traffic
lights on the bottle. So this isn't just a health food. This is the healthiest
product you can possibly buy. Very few foods get four
green traffic lights. It's a sparkling low calorie soft drink with vegetable extracts with sweeteners. Let's read the ingredients. Carbonated, water fine. Now, caramel E150d might make
you think of creme brulee, of traditional treats of
19th century French cooking. In fact, it has nothing
to do with caramel. It's carbohydrate being put through a set of industrial processes using chemical modifications
with acids, alkalis, and heat. It contains ammonia, it contains sulfites, and you can read more about it on the WHO Committee on
Food Additives website. There are sweeteners,
aspartame and acesulfame K. Now, aspartame hit the headlines recently because of concerns that it
seems to be carcinogenic. There's some nuance about that. I'm not very concerned about
its carcinogenic properties. Much more important was
a very significant paper published in one of the world's leading scientific journals this summer, "Cell," and it was an analysis of
what the non-nutritive, or we call them artificial, but the natural ones do the same thing, it's what non-nutritive
sweeteners do to our health. So we now think, if you look
at the independent studies, the non-industry funded ones, there is something that seems to be really tricky for the body when you put sweet taste on the tongue, which you haven't just
evolved for fun, right? We've really evolved a
sophisticated internal system for detecting what food does. So when you taste
sweetness on your tongue, it prepares your body to receive sugar, to receive refined carbohydrates, and humans have been eating
significant quantities of refined carbohydrates
for many, many millennia. When that sugar doesn't arrive, it seems to cause problems. So people used to think
that the problem was that you released insulin and that dropped your blood glucose, 'cause insulin lowers blood glucose, and that made you hungry and you then went and
ate more carbohydrates, and that might be why they don't seem to
promote weight loss. It seems now from the research this summer that a lot of them actually
increase your blood glucose, and we're not really sure why that is. It may be part of a stress response. The brain is a prediction engine. It's constantly making
predictions about the world. And when you get a mismatch between a prediction
like sugar is on its way and the sugar doesn't arrive, there may be a stress response. No one really knows. But the artificial sweeteners, according to the World Health Organisation and I think the best evidence, don't seem to be metabolically
superior to sugar and they don't seem to be linked
to significant weight loss, and that is a huge problem. There are natural flavourings
including caffeine. I mean, I would frame caffeine
as an addictive stimulant, but, you know, whatever you like. There's phosphoric acid. Now, it's particularly significant for the people born women in the audience. Phosphoric acid doesn't
just dissolve your teeth. It can also leach
minerals out of your bones and reduce bone density, and citric acid will
also dissolve your teeth. This is not a healthy product. It will not help anyone lose weight. It is a way of commodifying ill
health, I would frame it as. So let's look at the logic of UPF. What I want you all to start doing, in fact, what I'm sure
you will all start doing is you're gonna go out of here and you can start reading
ingredients packets. Some of you may already
be obsessively doing this, 'cause there's been a lot of coverage about UPF in the last six months. You will notice that themes, tropes emerge as you read these ingredients lists. They all start with commodity crops. We only eat a tiny number of plants. Our carbs come from four plants, rice, corn, soy, and wheat. They might be mixed with
some commodity oils. There's a short list of them. There's palm, sunflower,
some mixed vegetable oils. You take those crops and you, this is the Mato Grosso
in Brazil, by the way. So that's primary forest
on the right of the picture and then on the left
is the soy plantations. So you grow these crops at scale. They're often fed to animals, corn, soy, they're animal food. And you take leftovers
and to add value to them, you put them into the human food chain. So you break your crop,
whether it's corn or soy, you break it down into powders of fats, proteins, and carbohydrates. They have a nearly infinite shelf life and they cost very, very little. You can ship them all over the
world in enormous quantities. Now, to make them edible again, you can mix them with a little
bit of meat if you want. We eat three animals mainly. You could mix them with some fish, but primarily we just eat
beef, chicken, and pork. But you then need the additives. In the UK and in Europe we have around two and a
half thousand additives that we use in food, and they're somewhat regulated. In the United States, there are between 5 and 15,000 additives. No one has a list. The FDA who regulate, or are
supposed to regulate additives, don't have a list of all the additives that are added to food. But the additives broadly, the ones you'll notice is they
emulsify and they stabilise. They bind those basic ingredients together and they create textures. And then you can press them,
extrude them, fry them, bake them, and turn them
into any shape you want. But these ingredient
lists will be the same from your breads, to your
cakes, to your puddings, to your pizzas, to your ready meals. They will all have the same
basic ingredients patterns, cheap crop, additives to make it edible. So let's look at some example. Now, some ultra-processed food
is really kind of obvious. I've used the word junk there. It's a bit pejorative about Ms Molly's, but some of it we might
casually refer to as junk food. And you'll see there on
that list of ingredients, we start with some dairy fat and then there's this
reconstituted whey powder. Whey powder was a waste byproduct of the dairy industry for a long time, adding it used to be spread
on fields or fed to animals. Now it's, if you can add it to food, it has huge value. Glucose syrup, sugar, dextrose, so three different kinds of sugar. Palm stearin, palm oil, palm
kernel oil, different oils, emulsified, stabilised,
flavoured, and coloured. Palm oil, of course, is
a traditional ingredient. Many of you may have eaten it. It's used widely across
West and Central Africa where I've eaten it. There's a bottle of it there. The palm oil or palm stearin or palm fat that you'll see on your biscuits and in almost everything you can read is it's nothing to do with that
spicy red traditional liquid that you see there on your left. It's been through an edible oil refinery, and there's a picture there in the middle. They look like crude oil refineries, and it's turned into, that's
palm stearin on the left. So using processes of refining,
bleaching, deodorising, interesterifying, and hydrogenating, you can take any oil
you want from any palm. You'll see mango kernel
oil on your biscuits. You'll see shea oil,
you'll see coconut fats, you'll see palm fats. You put it through the RBD process and you can create any melting point, any texture, anything you want, and it all tastes of nothing. So it becomes a way of adding fat to food that is extraordinarily cheap. But a lot of ultra-processed food is sold to us as being healthy. So I've used an Eat Natural bar, but almost all of these snack bars that are marketed to us are
in fact ultra-processed. There's a Nutri-Grain bar. Marketed as strawberry, there's a picture of a strawberry there. It's just 5% strawberry. And it's that same list of cereal flours, vegetable oils, sugars, all stabilised and emulsified together. This might be my favourite example, 'cause this was my favourite
sandwich for a long time, and this is a brand that we associate with organic food, with good health. And I'm constantly having a debate about what the riskiest kind
of ultra-processed food is. Is it the stuff that we
know is harmful for us or is it this stuff that we
think is probably quite healthy, but which contains mono- and
diacetyl tartaric acid esters of mono- and diglycerides of fatty acids? Now, that's DATEM, that's one of the most common emulsifiers. That means that almost all the bread you buy in a supermarket
will be ultra-processed food. In the UK, ultra-processed food
is now most of what we eat. 60% of our calories come
from ultra-processed food. 80% is typical for teens. One in five people in this country get 80% of their calories
from ultra-processed food. For many, many people, particularly those
living in disadvantaged, those with low incomes, this is the only food that is available and it's the only food that's affordable. And we have libraries of data on that. And there's often a politician
who is happy to explain to us that lentils or porridge
are very cheap to buy. You can make a meal out of
pasta and some tomatoes. And what's never factored
into that calculation is the fact that you need
energy to cook that food, you need skills, you
need a chopping board, you need a knife. You need to make it in quantity. No one makes a bowl of pasta. You need make it in quantity, put it in some Tupperware
that you need to buy, stick it in a chest freezer
that you don't have. Real food is fantastically expensive, it spoils very quickly, and time is money. It takes a long time to prepare it. So never let anyone tell you that real food can be made cheaply. It is enormously expensive. So what are the effects on our health? The most important effect that
most of us are concerned with is it seems to cause
unhealthy weight gain. And this is a really important study. So lots of the evidence I'm gonna show you is epidemiological,
it's population studies. Now, the best evidence we have in science is when we do randomised control trials. And this was a really excellent
randomised control trial undertaken by a guy called Kevin Hall, who's one of the world's
leading nutritional scientists, he's an ex physicist, he works in the States at the
National Institutes of Health. And he did what's called
a crossover design. So it was as if we took this room, he used fewer people, and we cut you in half and we said, you guys are all gonna eat an unprocessed diet for two weeks. And you're gonna be locked in our lab and you are gonna have an unprocessed diet and you're gonna have access
to 5,000 calories a day, and you guys are gonna eat an ultra-processed diet for two weeks and you're also gonna have
access to 5,000 calories a day. So you all get far more food
than you could possibly want. And the two diets are the same for fat, salt, sugar, and fibre and the two diets are equally delicious. And you all agreed on this, you've all tried it and
you all say the same thing. And after two weeks are up, you're all gonna swap over and
we're gonna see what happens. And these are pictures of the diet. And I would say, I know Kevin, and I've said to Kevin, it looks almost like you tried to rig it, because lots of people would much rather eat the food that's on your
right than on your left. And Kevin said, "Well,
that actually isn't at all. We really studied hard and did
lots of focus group testing to make sure that both plates
were equally palatable." And this is what happened. This is just the weight graph. You can see that just over two weeks, there was almost a
kilogramme weight change for the two groups in opposite directions, over just two weeks. The group on the ultra-processed diet ate around 500 calories more per day, despite saying the food
was equally delicious, despite the fact that both
diets had the same amount of salt, fat, sugar, and fibre. So there is something beyond the salt, fat, sugar, and fibre and something beyond the
amount that people liked it that was driving this excess consumption. But ultra-processed food
doesn't just cause obesity. Now, I'm using the word cause here because I think the evidence we have has met the threshold for causality. And I'm happy to discuss, I think this is probably a pretty scientifically literate audience. What we should probably say is the ultra-processed
food is strongly associated with this very long list
of different diseases, cardiovascular disease, cancers, all cancers, but particularly
breast, prostate, and colon, metabolic disease like type two diabetes, obesity, high blood pressure,
gestational diabetes, fatty liver disease,
inflammatory bowel disease, anxiety, depression, frailty, irritable bowel syndrome and lots of those other
gastrointestinal complaints that we all just think
are part of growing old and being a normal 45-year-old, dementia, and an increased
risk of early death. And this is a paper published
by my PhD student, Sam Dicken. It's a really important study. And what Sam did is a formal review, and every single one of the studies that is used to generate that evidence controlled for fat, salt, sugar,
fibre, and dietary pattern. They also control for
educational standards and poverty and gender and age. So while those studies have flaws, no epidemiology is perfect, it's really hard to correct
for all of those biases. We have very, very good evidence that there is more than just
fat, salt, sugar, and fibre that is mediating these harmful effects. Processing is important, and that this is a revolutionary
way of thinking about food should I think surprise all of you. Perhaps the best example of
why processing is important, it was an experiment done in the '70s by a group in Bristol. It was a very simple experiment. They got some apples and
they left them unprocessed and they chopped them into
chunks and then they pureed them and then they pureed them
and squashed the fibre out, and they did it all immediately before
participants drank or ate them. And what we see is that
when you eat a whole apple, you feel much fuller for much longer. (phone ringing)
Do get it if you need to, don't worry about me.
(audience chuckling) If you eat a whole apple, it leaves you feeling fuller for longer, it doesn't spike your blood sugar, and you don't get a sort
of rebound hypoglycemia. If you drink the apple juice, you get a big spike of blood sugar, you don't feel full at all. Now, when you back-add the fibre, so it's whole pureed apple, you still get that sugar spike, you still don't feel satisfied. So even when we have a pureed whole apple, it's very, very different
to eating the whole apple, to dismantling the apple with your teeth. Eating, the act of chewing, of manipulating food with your tongue, causes all sorts of internal
physiological changes that are really, really important. So we do need to process
food with our mouths. Processing does affect nutrition. Now, before we go on, when
we're talking about obesity, we have to address some elephants, because there are some
other proposed causes of pandemic obesity. So if I'm here saying the primary cause, perhaps not the entire cause, but the primary cause
of the obesity change that we've seen since the 1970s where childhood obesity
was around 1 or 2%, the fact that obesity in
childhood is now more than 20%, it's around a tenfold increase, that that tenfold increase is
due to ultra-processed food, I have to answer some questions. You should all have some questions, like, well what about exercise? I mean, exercise is medicine. We've all become far less active. Our jobs have become automated. None of us work in heavy industry. Very few of us are out tilling fields. Even farmers get to sit in
mechanised processes these days. So it seems very obvious that
if we live more active lives, we must surely burn more calories. And that's a picture of me
filming a television series I did a very long time ago
that some of you may have seen called "Medicine Men Go Wild." And my brother and I went and lived with remote Indigenous
peoples all around the world to learn about their food and
their diet and their medicine. And we got far more out, we learned far more from these communities than we we could possibly ever give them. So I went and lived as a hunter-gatherer in the rainforest at the borders
between Brazzaville, Congo and Central African
Republic for several months. And a scientist called Herman Pontzer did quite a similar thing. He went to live with Hadza
hunter-gatherers in Tanzania. And the question he wanted to answer was, how much more calories do
they burn than we burn? It seems very obvious that
hunter-gatherers would burn more. And what he found was that for someone of the same
sex, body composition, and age, they don't seem to burn any more calories when they're running 14
kilometres a day hunting antelope or digging tubers out of the ground. And he was so puzzled by this data he went back and reanalyzed it all. And then he reviewed the literature, and we have studies
going back to the 1990s. Some of them compare subsistence farmers to similar populations, to matched populations in the States and find exactly the same thing. The subsistence farmers don't
burn many more calories. In fact, all the studies we've ever done using a technique called the
doubly labelled water technique have shown more or less the same thing, that over the long term, increases in activity that
we do for a very long time don't seem to substantially increase the number of calories we burn. Now, this would seem,
especially in this setting, to violate the laws of physics, but Pontzer came up with
a really, really good theoretical explanation of
why this seems to be true. Exercise is good for us, not because we burn more calories, but because we steal
calories from other budgets. So I'm a 85-kilogram, 45-year-old man. I burn around 3,000 calories a day, and I do that whether I'm
here or I'm in Tanzania. Now, if I were to move to Tanzania, I would spend many of those
calories moving around, preparing food, hunting
food, gathering food. In the UK I still spend the calories, but I'm not moving. So I seem to spend on
inflammation and anxiety and on hormone levels
that may be quite toxic, and there's lots and lots of
data coalescing around this. And Pontzer's theory
makes sense in two ways. First of all, it explains evolutionary something really, really important, that when food is scarce, you wouldn't burn more calories to get it. So it would be really peculiar if we had evolved in times of scarcity to have to expend more
energy gathering scarce food. Instead, we steal from
reproductive budgets, we steal from immune budgets. So it's coherent with evolution. It also explains why
exercise is good for us and the benefit we all feel, which is that it damps down
inflammation, pain, anxiety, and has all these other benefits. It also explains all the data, and the lived experience
I'm sure of people here, that exercise isn't a
great way of losing weight. We've done lots of trials of this. You can show it's quite a good way of helping to maintain weight loss, but it's not a great way
of promoting weight loss. And so he made a huge
contribution to the literature, and that was published in science and it's really, really robust science. There's some details that need tidying up, but it is very robust. I should say some exceptions. I've also done Arctic exploration, or if we look at elite athletes,
they do burn more calories. You can increase your
calorific expenditure briefly, you just can't do it for very long. So exercise, if you do it
intensively at a high level, you will burn more calories. So where does this idea, because I was very surprised by this, where did my idea, as someone who spent six
years at medical school, I spent five years doing a PhD and I was sure this wasn't
the way I understood the body, and I think it's probably not the way you all understand the body. What about the idea
that exercise, you know, calories in, calories out, that the obesity pandemic
is partly due to inactivity? Well, the exercise is medicine phrase is actually trademarked, and it's trademarked by
the Coca-Cola Company. And it was a partnership with the American College of
Sports Medicine and Coca-Cola. It was a huge public health programme. And some colleagues of mine at the London School of
Hygiene & Tropical Medicine, a very senior group of scientists there, particularly Martin McKee, they did a network analysis to look at Coca-Cola's scientific funding, 'cause they noticed Coca-Cola were funding scientific conferences. They did some freedom
of information requests. There are hundreds of papers
in the scientific literature, all of them promoting this
idea of energy balance, that we can drink some
fizzy calorific liquid and then we can run it off, and this is why Coke sponsors so many different sporting events. So the entire understanding
of calories in, calories out in part comes from this
network of research funded by Coca-Cola. There's very little other
evidence to support it. And I would say that the
best people in nutrition when it comes to obesity, no one serious believes that inactivity is a significant contributor
to pandemic obesity. What about willpower? We hear a lot about willpower. Now, what I want to do
is equip you as a room to destroy people who bring up willpower, who say that, well, they often mix it in with
calories in, calories out, it's just all about effort, and people who don't live with obesity have the daily experience that
they use a bit of willpower to just decline the food. It's entirely untrue. That, by the way, is my daughter Sasha. She's not blessed with
any amount of willpower. (audience chuckling) What you're looking at
there is some US data, and you don't have to look
at the details of the graph, but it's a graph of
prevalence of obesity by date. And you'll see there's
a sudden inflexion point where all those lines on the graph go up in the mid '70s. That's when weight gain took off. Now, there are different
lines on the graph because they're men and
women of different ages. Now, that's a graph of the
Caucasian part of the population, but the graphs for Black
groups and Hispanic groups look exactly the same. So at some point in the mid 1970s, something happened which made everyone across every age and both
genders, across all demographics, start to gain weight at the same time. Now, unless you propose
that simultaneously there was some failure
of moral responsibility in all those different communities, the willpower argument doesn't stack up. It really doesn't. We have a huge amount of data that willpower is usually
a proxy for poverty, that people who live in poverty make very, very sensible decisions. And particularly many of you may have heard of this
experiment, the marshmallow test, where you give a child a
marshmallow and you say, if you don't eat the marshmallow, I'm gonna leave the room. If you don't eat the marshmallow, when I come back, you can
have another marshmallow. And the children who are unable
to resist the marshmallow, as they were followed over
a very long time period, and this predicted an awful
lot about their life courses. Predicted their jobs, their
incomes, and their weight. And so this provided this evidence that people without willpower
do seem to gain weight. In fact, there was a
re-analysis of the data, and there's a lot of nuance around this. So I say this with some caution. But when the data was reanalyzed, what they hadn't controlled for was the educational level of the mothers. And essentially, if you
are born into poverty, you make the sensible decision to take rewards when they are available, because often in context
of poverty and deprivation, promises aren't fulfilled. And so you're really smart
to take that marshmallow. The kids were making smart choices. When you adjusted for that, the effect more or less went away. Willpower is something we have
very few ways of measuring. It's not an interesting
part of this discussion. My patients who have lost weight have frequently lost their own
body weight many times over. They exhibit far more
willpower every day than I do. Personal responsibility,
especially in terms of policy, has no place in this discussion. What about stress and genes? This comes up a lot because I have, whether it's patients or friends, a lot of people say to me, "Look, I know you think it's UPF, but I eat for emotional reasons. I eat because I'm traumatised,
I eat when I'm stressed." Well, ultra-processed food is a little like tobacco in that sense. It's one of the ways that
the harms of poverty, of stress, of trauma are made manifest. So it's always the
ultra-processed products that people eating for
emotional reasons turn to in the same way tobacco products or drugs of abuse or alcohol, those are the substances
that people turn to, and I'll talk more about addiction. So the deep cause of a huge amount of the pandemic of diet-related
disease is poverty, but it is the marketing
of ultra-processed food along with the marketing of gambling, tobacco, alcohol products,
these other harmful substances, that causes the proximal harm. But if we could fix
poverty, we would deal with, the data shows, around
about half of the problem. And poverty, I think,
is a political choice that we can deal with. So I hope I've persuaded
you that UPF does harm us, that it is the primary driver, and that those other questions that swirl around the debate
and confuse us can actually, we can use evidence to get rid
of them pretty effectively. But how does ultra-processed
food cause its harms? Well, one of the effects
is it's very soft. It's very soft and it's very energy dense. And the way of testing this is to go and buy a loaf
of this kind of bread. And I've put up Hovis, because this is the bread
that I always used to buy. And go and buy a loaf of
sourdough or rye bread or any traditional real bread. And what you'll find is the
emulsified supermarket bread takes about twice as long
or three times as long, sorry, it's about three
times quicker to eat. It's very fast to eat. Now, the softness has two effects. Partly there's a particle size difference. We absorb ultra-processed
food very, very quickly because all the bits of real food have been fractionated down virtually into their
molecular constituents. But it also means we
eat it very, very fast. And we have very, very good
data going back to the 1990s, that soft food that is quickly consumed is strongly linked with weight gain, especially when that food is energy dense. And the other thing about
ultra-processed food, it is bone dry. Real food is wet. Almost all the real food you can think of has moisture in it. Now, moisture is a problem if you want something to
have a long shelf life, and long shelf life is vital for cost. So there are illusions of
wetness in ultra-processed food. If you think of a moist burger, and there are those famous, there's lots of instances on social media of people buying burgers from
popular burger restaurants and leaving them in their packets and photographing them over
a year and nothing happens. They don't decompose. In fact, those burgers, they don't contain many preservatives, they're just dry, and dry things, bugs can't
get a grip on dry things. Dry goods don't decompose. So the dryness, the water isn't there. They're very energy dense because the water should displace energy. They're drying this off,
so we eat them quickly, so we get calories quicker than our bodies can say we're full. And remember, we do all
have an internal mechanism that is able to say I am full. There is no obesity in wild animals, and that is not to do
with scarcity of food. Many animals live with
very plentiful food, but they have homeostatic mechanisms. The first thing we all learn
in biology is homeostasis. We all have a way of keeping all of our internal physiology the same. Our temperature, our blood pressure, our oxygen levels, our
carbon dioxide levels, our blood pH, our sodium, our potassium, we regulate it all tightly. It would be bizarre if we didn't do the
same for calorie intake, and we can if we eat real food. UPF tells us lies. So there's sweetness without sugar, but there's also smoothness without fat. So around the 1980s when fat
became the first big molecule to be started to be demonised, we replaced all the fat. So we had the evolution
of low-fat mayonnaises. Some of that was just to save money. Some of it was because you
can make a health claim. If you can replace a dairy fat with a modified starch or
xanthan gum or guar gum, you can actually, if you're skillful, and the scientists at
the food companies are, you can create fatty
textures in the mouth, the sliminess of fat but
without any real fat there. Again, your mouth isn't
just tasting stuff for fun. Taste is an early warning system. So you've got bitter tastes
which identify toxins. That's why most poisonous
things are bitter. Most plant toxins are bitter. You've got sweet to identify sugar. We think your mouth is able to detect fat. And so if you have a slippery
gum but no fat arrives, we think that will be a problem. And we have savoury
tastes without protein. So many of you will be
familiar with umami. There's also another
savoury taste called kokumi. And these tastes come
from free amino acids and other similar molecules
that you get in the mouth, and they taste savoury and
they should be present. They're present in cheese,
they're present in ramen broth, they're present throughout amazing food, and they signal particular nutrition is coming into the body. When you get the flavour enhancers, the synergistic umami of
glutamate, inosinate, and guanylate that you find in huge
numbers of potato crisps, when those molecules arrive in
the context of potato starch and real protein never arises, we think that also drives
excess consumption. And you may be familiar
with some of these products, have the once you pop,
you can't stop slogan, and that may be part
of what's driving that. It's flavoured. UPF has to be flavoured because flavour comes from a huge range of different aromatic molecules. And by the time you've
processed the basic ingredients, they don't really have flavour, so you have to back-add flavour. So the flavouring is a proxy
for a lack of phytonutrients. If you look at the number of chemicals in a clove of garlic, say, or any plant, it's in the many, many thousands. By the time you've put that plant, you've turned it into its oil, its carb, and its protein isolate, there's none of those molecules left. So flavouring signals a
lack of phytonutrients. And UPF affects, this is my daughter Lyra, and both my kids, neither
of them have engaged with any of this content, by the way. So I do wanna say, you know, my kids eat quite a lot
of ultra-processed food, because food binds us
to the people around us. It creates community. And ideally we would eat real food that connected us to, you know, our family and our community in a way that had cultural and historic meaning and would form society. You know, food is the
building block of society. In the absence of that, I do think it's important they eat the same food as their friends, that they're not weird in some way. So my kids do eat some of this, and I'm happy to answer questions about how I feed my kids or
how I try and feed my kids. My kids largely feed themselves. It affects the microbiome. So the particular molecules, non-nutritive sweeteners we
think affect the microbiome and the emulsifiers. So emulsifiers are present in everything from your fizzy
drinks, to your ice cream, to the bread, to the ready
meals, to all the confectionery. They are everywhere. And emulsifiers, as
lots of you in this room with scientific training will know, emulsifiers allow you
to mix fat and water. And so egg yolk, when
you make a mayonnaise, it's an emulsion made
by the use of egg yolk. You know, you can use mustard as well. Emulsion paint is a mix
of kind of fatty droplets. Suspended milk is an emulsion. So emulsifiers occur throughout nature. You can make an argument that
almost every cell in your body is a kind of emulsion. You are an emulsion of
aqueous cellular contents with a fatty layer surrounding them. So emulsions in themselves aren't harmful. But when we study the
synthetic emulsifiers, the polysorbate 80, the
carboxy methylcellulose, and they work in lots of different ways, it seems like they have
very significant effects on the friendly bugs that live inside us. And the friendly bugs
have much more agency over the way our bodies work
than we previously thought. So we recruit around a trillion bugs. I might be out by an order of
magnitude either way there, but we've got about
around a trillion bugs, and they act as a kind of metabolic engine and they help us eat
food that we can't eat. So when we eat fibre, we all know that fiber's good for us. You can't actually digest fibre. Fibre is fermented or eaten by
the friendly bugs inside you and they turn it into lots of things, but particularly things
called short-chain fatty acids that are released into your bloodstream. And some of them nourish your brain, some of them are good for your heart, lots of them modulate your immune system. But this microbiome,
you live in a delicate negotiated balance with it. And if you keep it healthy,
it will keep you healthy. It keeps out invaders, it protects the lining of the gut and it controls your immune system. And so mucking around with it
seems to be a very bad idea that we're only just discovering why. As well as its effect on the human body, ultra-processed food
also affects the planet. And so we pay for it many times over. The map there you see is of Brazil, and the green lines are the other river, sorry, South America, the other river that
flows through the Amazon. So there's a river that
we know called the Amazon, flows along the ground. A much greater volume of water flows through the airborne river, and it evaporates from trees. And I'm sure I don't have
to explain to lots of you that rain comes from trees. Rain can't get very far from the sea. It has to fall on a tree, the tree breathes it out, and that's what carries rain inland. So we've now cut down so much
of the forest to grow soy that there's no longer rain falling, and if the rain doesn't fall, there isn't even a river you can divert. We're gonna see desertification. We're already seeing water shortages in the soy growing regions. So ironically, the biggest threat to, say, Brazilian agribusiness
is Brazilian agribusiness. The food system that seems to be creating all this food security for
us is actually creating enormous instability and food insecurity. Ultra-processed food and
the system that produces it is the second leading cause of emissions, and as I say, the leading
cause of loss of biodiversity. We pay for it in the lawsuits. You may remember, when
I was writing the book, my brother Xand said to me, "Wasn't there a lawsuit
where someone sued Pringles 'cause there wasn't enough potato in it to actually call it a crisp?" And I was like, "Oh, this is a cool story, I'll write about this," so I looked it up, and in fact, he'd got it a bit wrong. It was the manufacturers of
Pringles, Procter & Gamble, who got involved in legal
action with the treasury. They were the ones trying to say there is not enough potato in a Pringle to justify calling it a potato crisp. And if it's a potato crisp, it's VATable, you pay 20% VAT. And other crisps, so corn-based chips, for arcane reasons that
tax lawyers will explain, corn-based chips and other
chips you don't pay tax on. So it was Pringle suing about
their low potato content and trying to claim that
it was much more like a sort of extruded cake. This is the homepage of Coca-Cola. This is the global website
homepage just a few weeks ago. I think it was a few months ago. And you'll see they're
creating a world without waste. And this kind of homepage is a feature of many of the corporations
that make our food. I mean, there are about 15 companies that make almost all of our calories. In fact, around 75% of our calories come from just six primary producers. They produce most of the
world's grain and oil. So this idea of the companies as cleaner-uppers of plastic, and they almost look like NGOs
dedicated to plastic cleanup, is really weird, because if you then search the world's biggest plastic polluter, it is in fact Coca-Cola. So the plastic pollution caused by ultra-processed
food is enormous. But the biggest harm really is because ultra-processed
food is addictive. Now, food addiction for a long
time was very unfashionable. It's problematic, because
inextricably tangled up with the idea of addiction
is the idea of abstinence. You can't propose something be addictive if you can't then propose
being abstinent from it. So food addiction for a long time was considered a behavioural addiction. And yet the substance itself, and there will be people in this audience who recognise this in themselves, the substances themselves do feel like the thing that drives the addiction. And the definition is
the use of a substance continues despite knowledge of harm, despite repeated attempts to quit. this is a picture of
Lyra eating Coco Pops. Lyra can eat, she's now six and she can eat five adult portions of Coco Pops. If you look at those traffic
light labels on Coco Pops, you'll see there are two
oranges and two greens. It's a relatively healthy food. Now, that's if a grownup eats 30 grammes. If a six-year-old eats
more than 120 grammes, all those lights obviously turn red. When she's eating, it's kind of hilarious, but it's also as if
she's eating in a trance. So we have a huge amount of evidence that for many people, food is addictive. And I'm speaking to lots of
senior research psychiatrists about the links between
ultra-processed food and binge eating and
other eating disorders. This evidence is still very early. It's really potentially traumatic and sensitising to talk about, so I say that with caution. But I would say if you recognise that you have an addicted
relationship with food, it will almost certainly be
ultra-processed products, and we are working very
hard to try and work out how that works and how to quit it, but there's a lot of
different evidence around it. And the reason it's addictive is because the purpose of ultra processing is not just profit, it's
financialized growth. So for the book, I spoke to a huge number
of different people who work within the food system, and the most interesting people to speak to were the bankers, because the bankers understand
how everything works. And they explained that the foods, what we think about as
a food supply system is actually an inverted
money supply system. It's a way of extracting money from us and handing a little bit
of it to the farmers, but most of it to the
intermediary processing companies. And some of the food companies have made very sincere, concerted efforts to stop selling so many
ultra-processed products. Danone have. So Emmanuel Faber at Danone tried to turn it into a social enterprise to really realign the portfolio. Similar efforts happened
at Pepsi and at Unilever. In every case, those senior
executives were replaced. Activist investors often voted them out. And the analyst at BlackRock
explained this to me. These companies are not in
control of their business model. It's a very small number
of institutional investors owns an integer percentage
of all of the companies. And so the purpose of these companies is to provide financial growth for our pensions, to some extent. Certainly my pension, part of
my pension is at BlackRock, so I'm very intimately
part of the problem. And so a lot of my research
now is trying to use, and I'm working with a
number of economists now to try and demonstrate that these companies are financialized, that the food system is financialized, that all of the incentives about the way we produce
food are financial. And we can show that when
public health activist investors put public health proposals
to boards and to companies, they're almost always voted down by hedge funds, by pension funds, and by financial institutional investors. So the companies are trapped
inside the incentives. And so that leads me to a
thought of some solutions, but I'm really interested to discuss in more detail with you. I put here the British
Nutrition Foundation logo. So this is one of our leading charities that produces information on food. They advise the government, they collaborate with policy makers, and in almost every article
that I've been quoted in over the last few months, there is someone, a nutritionist, a scientist from the British
Nutrition Foundation, who also has an opinion
on ultra-processed food. Their opinion is it's not usually a very useful way of thinking about food. The reason those food
company logos are there is they're just some of the people who pay the British Nutrition Foundation, which is majority funded by companies that make
ultra-processed food. The number one change we
need is a cultural change where we come to regard the
companies that make our food as being like tobacco companies. Their money is dirty, and
if we accept their money, we become part of the marketing
division of the companies. And so we need to disentangle all the charities that influence policy from the companies that make
the food that is harming us. We need to put ultra-processed food in our national nutrition guidance. Many, many countries around
the world are doing this. So I just came back from New York. I was speaking at the
Global Obesity Federation, it's a UN World Health
Organization-aligned body, and there is no question in
countries around the globe that ultra-processed food is, as I say, the primary cause of diet-related disease and it needs to be regulated. This is a pack of Frosted
Flakes from Mexico. The tiger is gone and you can see the black
hexagons on the pack. There are marketing restrictions. And the argument I make
is not anti-capitalist, it's not anti-growth,
it's not neo-Marxist. It's all compatible, it all makes sense with
really good economic policy. We want to increase choice and freedoms. We don't want to nanny anyone. I wouldn't ban this food and
I wouldn't tax most of it. I mean, we could have some
progressive taxes with caution, but in this country I wouldn't
tax ultra-processed food because it's the food that we depend on. I'd put the warning labels on. I'd change institutional food. It's really good economics
to have food in hospitals, prisons, and schools being real food. It's really important. We've got lots of evidence about that. And I'd like to see the rise of not-for-profit food companies. There are pharmaceutical models of this. You can build a competitive company, you can build a company that pays back some investors, in fact, that competes with for-profit companies but isn't hamstrung by a
relationship with those investors. And there's an example of
the kind of policies we need. In Brazil, we see a US Coke can there, very similar to a UK Coke can. In Brazil, the label's on the back. In Chile, the activists
learned the lessons and managed to get the label on the front. And in Argentina, the label
is bigger than the logo. There is no justification, however you think about food, whether you believe in
high fat, salt, sugar, and there is value to that classification, there is no justification for
not having a warning label on fizzy pop. And there are some foods in Mexico, all the cartoons gone
and warning labels on it. Thank you very much for listening, and I'm happy to take some questions now. (audience applauding)
