Implications of ultra-processed plant origin foods on cardiovascular risk

This is super interesting. Thanks for sharing!<p>Once nuance is that they seem to have grouped together all ultra-processed plant foods into one category, everything from tomato sauce to tofu to sodas (see supplement: <a href="https:&#x2F;&#x2F;www.thelancet.com&#x2F;journals&#x2F;lanepe&#x2F;article&#x2F;PIIS2666-7762(24)00115-7&#x2F;fulltext#appsec1" rel="nofollow">https:&#x2F;&#x2F;www.thelancet.com&#x2F;journals&#x2F;lanepe&#x2F;article&#x2F;PIIS2666-7...</a>). The nutritional profile of tofu and soda are quite different, but the study measures total consumption in calories, so sodas are going to heavily skew that number.<p>I wonder if that makes enough of a difference (e.g. is someone who eats a lot of ultraprocessed noodles with tofu and tomato sauce going to have similar cardiovascular outcomes as someone who chugged a 2L of coke a day?)<p>I&#x27;m someone who&#x27;s been vegan for 15+ years, but lately I shifted about 50%-70% of my meals to a super-artificial ultra-processed food product (<a href="https:&#x2F;&#x2F;huel.com&#x2F;products&#x2F;huel-instant-meal-pots" rel="nofollow">https:&#x2F;&#x2F;huel.com&#x2F;products&#x2F;huel-instant-meal-pots</a>) that is supposed to &quot;healthy&quot; in that it contains all the macro and micro nutrients a person supposedly needs, in a relatively tasty and satiating 400kcal meal. I wonder if that would still have the same risk as drinking 400kcal of soda or eating potato chips? Heh, maybe it&#x27;ll save me from diabetes only to kill me from heart disease. Alas.

This paper is based on garbage data: 2-4 <i>voluntary food surveys</i> per participant, reflecting 24-hour windows, separated by a median of <i>9 years</i> from the outcome.<p>Try to recall everything you ate in the last 24 hours, including quantities of calories by food group. Accurate? Now, imagine trying to correlate this with a health outcome <i>a decade from now</i>. On top of that, imagine that your study participants can just <i>skip reporting anything at all</i> if they don&#x27;t feel like it. Do you think there might be a bias in the people who respond? That there might be a bias in the people who &quot;remember&quot; eating large quantities of plant-based foods? That there might be a bias in the people who respond to follow-up?<p>In a just world, these kinds of nutritional epi papers wouldn&#x27;t be publishable. No matter how many co-variates you put in the regression, there&#x27;s simply no way to eliminate the bias.

I&#x27;m thankful that the paper clearly defines exactly what UPF food is, with a reference, which is something sorely lacking from popular media on the topic:<p>&gt; UPF, the fourth group of the Nova classification system, are industrial formulations made by deconstructing whole foods into chemical constituents, altering and then recombining them with additives into products that are alternatives to the other three Nova groups and freshly prepared dishes and meals based on them.12 While these three Nova groups (unprocessed&#x2F;minimally processed foods, culinary ingredients, and processed foods) include foods commonly found in traditional diets worldwide, some of which are associated with health and longevity, UPF is identified as a distinct group that poses health risks.<p>Its the Nova classification, something that I have previously only noticed in comments on news articles, rather than in the news articles themselves.

I feel like when people hear &#x27;ultra-processed plant origin foods&#x27; people are thinking stuff like Beyond&#x2F;Impossible meat, but really this study is saying people who eat lots of bread and confectionaries (by far the highest source of UPF in this study) have higher cardiovascular risk.

&gt;&gt;“Plant-sourced dietary patterns, as characterized by low consumption or complete omission of eggs, dairy products, fish, and meat, have been associated with a reduced risk of several chronic diseases, as well as a substantial reduction in impacts on the environment.4 There has been an increase in the consumption of plant-sourced alternative foods in recent years, with a two-fold increase in the proportion of people reporting consuming these products in the UK.5 In 2019, the UK Climate Change Committee recommended a 20% reduction in high-carbon meat and dairy products by 2030, with an increased consumption of plant-sourced products.6 These recommendations are in line with national and international guidelines for a healthy diet that guide the reduction of meat consumption, especially red meat.7 However, plant-sourced dietary patterns are heterogeneous and may differ widely in their dietary composition, type, and quality,8 and evidence has shown the potential protective effect of plant-sourced diets on CVD may vary accordingly.9, 10, 11 Modern plant-sourced diets may incorporate a range of ultra-processed foods (UPF), such as sugar-sweetened beverages, snacks, confectionery, but also the ‘plant-sourced’ sausages, nuggets, and burgers that are produced with ingredients originating from plants and marketed as meat and dairy substitutes.“

This contradicts the oft-cited truism that increase in PUFAs invariably leads to better metabolic outcomes. Much of what makes UPFs high-calorie is their fat content (normally, vegetable&#x2F;canola oil). It seems like there are other mechanisms involved.

This will affect what I eat. I wonder what it will do for the plant-sourced UPF industry.

Does this control for total energy intake because it&#x27;s a way more interesting result if it&#x27;s not &quot;people who eat plants eat less and non-overweight people have less risk of CVD?&quot;<p>Because this study is huge if that&#x27;s the case.

These are small % changes in rates.<p>Now, from an individual’s and philosophical perspective, given probability of death is 1, of what use is small changes in cross-sectional rates of mortality?

Seems like there might be an agenda behind the paper not related to cardiovascular disease?<p>&quot;as well as a substantial reduction in impacts on the environment. ... high-carbon meat and dairy products...&quot;

Eat (edit: <i>whole foods</i>) like your grandparents, don&#x27;t smoke tobacco, exercise.

I don’t know why anyone would find this surprising. Ultra processed foods are practically devoid of any meaningful nutrition. It’s not the calories We need to worry about, but the lack of vitamins and minerals that power the enzymes in our body that we need to worry about.<p>Edit to add: I guess people are down voting this because they’re misinterpreting what I’m saying. I’m not saying that you can eat all the calories you want, but you can’t metabolize calories if you don’t have the nutrition that powers the enzymes for the metabolism of the calories.