Speaker 1: 0:04

Welcome to the Healthy Matters podcast with Dr. David Hilden, primary care physician and acute care hospitalist at Hennepin Healthcare in downtown Minneapolis, where we cover the latest in health, healthcare and what matters to you. And now here's our host, Dr. David Hilden.

Speaker 2: 0:20

Hey everybody, and welcome to season two, episode two of the Healthy Matters podcast. I'm your host, Dr. David Hilden, and today we are gonna talk about highly processed foods and the effects on your health. Joining me today in studio is Dr. Kate Shafto. Dr. Shafto is, uh, triple board certified physician in internal medicine, pediatrics, and integrative medicine. Kate, thanks for being back on the show. My

Speaker 3: 0:45

Pleasure. Thanks so much for inviting me

Speaker 2: 0:47

Back. Great to have you here. Now we're gonna talk today about processed foods. First of all, can you help define that for us?

Speaker 3: 0:53

Yes, and that's a great place to start because there's a lot of confusion in our language about processed foods. So I don't think we talked about this last time, but I spent a couple of years recently learning how to do organic farming. And so processing food is something that humans have done for a long time. And I had personal experience doing that with the foods that we grew, the vegetables that we grew, you have to actually pull the leaks out of the soil and get the

Speaker 2: 1:18

Dirt off of it.

Speaker 3: 1:19

You get the dirt off, strip off the outer leaves, and then you have to cut off the roots. And that's processing. So most food, if not all food, except for like a banana or an apple that comes right off the tree needs to be processed. And so processing food is something that people have done for ages. But what we're talking about when we say quote processed foods in our day-to-day life and language, currently, usually people are referring to ultra processed foods or highly processed foods. There's actually some definitions of processed foods that have been around for about 15 years that define a couple different categories. The first one is minimally or unprocessed foods. That's kind of the example of an apple, a banana that comes right off the tree. And you can eat it a carrot, you pull it outta the ground, maybe you brush off the dirt, maybe you don't, and you can eat it. But then the next category would be processed culinary ingredients. So this is a type of food ingredient that's derived from a minimally processed source, and then it's been refined or ground up, like grain needs to be shucked out of its hull in order to be eaten. Mm-hmm.<affirmative>. And that would be like a processed culinary ingredient

Speaker 2: 2:34

Applesauce. Would that fit?

Speaker 3: 2:36

I would think that makes sense. Yeah. So it's been processed very slightly. And then the next one is processed foods. Processed foods are from either of the two previous groups that then have added sugar or salt or fats. They're often made ready to eat.

Speaker 2: 2:52

So it's when they took those ingredients and

Speaker 3: 2:55

Then and added, added

Speaker 2: 2:55

Something, add something else to it. Okay.

Speaker 3: 2:57

And then finally, the fourth category is ultra processed foods. And this is also referred to as highly processed foods. And these are when often you don't have much of the original ingredients that are identifiable. So I think of a breakfast cereal as a highly processed food example. That

Speaker 2: 3:15

Surprises

Speaker 3: 3:15

Me. Depends on the type of breakfast cereal. Yeah. Yes. Like in a cheerio, it's a little o shape. There's no existing plant or food ingredient that comes from nature in an O

Speaker 2: 3:28

Shape.<laugh>, you wait a minute. You mean the Cheerios don't grow in Apollo stalk like that?

Speaker 3: 3:34

I don't think they do.

Speaker 2: 3:35

And they cut'em. They don't

Speaker 3: 3:36

Think they do. They don't just chop them up into

Speaker 2: 3:39

Little dish. All right. Somebody had to make it into that shape.

Speaker 3: 3:41

Right. And so the different ingredients, wheat and corn and some sort of oil and other things, and plus added vitamins and minerals are put into some sort of a soup. I don't know how this is made, I'm just making this up as an ingredient. No, but I get that potentially, but like they're mixed together in some form and then poured into a little shape and then spit out as a cheerio, for example. So other things could be frozen pizza or a donut, some things that they're very ready to eat or already prepared.

Speaker 2: 4:13

No, you're not going after donuts in this episode, are you?

Speaker 3: 4:15

Didn't we go over donuts in the

Speaker 2: 4:16

Last I think we maybe. Okay. Okay. All right. So we have<laugh>, uh, I mean, I do like my donuts. I do like my frozen pizzas, so we'll talk about that. Yeah. You know, stuff sometimes that you like. So that's a really helpful framework for me that you've put the processing of foods into those four categories. Do you have a sense, Kate, about how much of our typical diet consists of those highly processed foods and, and how did we get to that place? Mm-hmm.

Speaker 3: 4:42

<affirmative>. Well, so one source, the Harvard Nutrition Source website says that in some cases, um, people in the US are eating up to 60% of their diet from these ultra processed

Speaker 2: 4:54

Foods. I'm gonna guess that's not good. Not

Speaker 3: 4:56

Good. And this would vary widely though, from communities to community and, um, certainly among even individual households. But that's just kind of an average or an estimate from the Harvard Nutrition source.

Speaker 2: 5:08

Is that because it's, it's just cheaper or is it consumer preference, or why do you think is

Speaker 3: 5:15

Oh, I'm sure there's so many different factors that it's complicated isn't, it's complicated. Our food system is complicated. And I've, I've started saying this to patients when I have this conversation, so, so that they don't feel like it's all on them or all on you listeners. It's, it's not so much anymore about our individual choices in this complicated food system. Our food system is complicated because of the many different parties that are involved in getting our food to us. It's no longer, I think we talked about this last time, it's no longer that I know the people who, who grow the food and we have a relationship.

Speaker 2: 5:52

Yeah. Almost never is

Speaker 3: 5:52

That, almost never Right. When we go to the grocery store, it's this huge array of all these different foods and food products. And most of the time we have no idea really where they've come from. Many times these ultra processed foods are cheaper because the ingredients are grown on a huge industrialized scale. And that allows for a great amount of efficiency in processing soy or corn or wheat into lots of different sub products that can then be used in many different foods and food products. And the word food products or the term food products is something that I've seen too in the literature and even in the food science world, they're always developing new food products.

Speaker 2: 6:35

Doesn't sound very appetizing.

Speaker 3: 6:36

No,

Speaker 2: 6:37

No. Mm-hmm. I I'm not gonna go home tonight to eat a food product.

Speaker 3: 6:40

Right. But that's the language that's used because there's so many different ingredients, and not just food ingredients, but chemical preservative dyes and other ingredients that go into making these food products palatable and shelf stable and able to be transported across many, many miles and to get at consumers pallets. There are some terms that the food science industry uses methods called the Bliss Point.

Speaker 2: 7:10

The Bliss point.

Speaker 3: 7:11

Correct. That is the point at which people can't resist eating another food product of whatever variety. Ah, why You can't just eat one

Speaker 2: 7:20

Thing. I never shingled I never heard that term, but I know what you

Speaker 3: 7:22

Mean. It's a thing. And it is a specifically engineered point that interacts with our nervous system and our palate to make us crave that food. There's another term called mouth feel. So when different food products are created, it's intended to feel right in our mouth. Often when food products are engineered with a lot of different ingredients to make up the end result, they have to add different textures so that it's what we expect in our mouth when we're eating that highly processed food.

Speaker 2: 7:52

So yes, it can be made cheaper. And yes, they're, the food processing industry is actively looking for those concepts that you just mentioned. The bliss point. God, that's blowing my mind. That just that comment and I totally know what you mean. Yep. It's, but it's an thing intentional, uh, yes. Intentionally engineered thing. Correct. To get people hooked, for lack of a a better word. Yes. On the, on the highly processed food.

Speaker 3: 8:14

Yes. The element of cost is a major factor in all of this. And results in an unjust food system in our practices every day as physicians, we are faced with the effects of the social determinants of health. The factors in our society, the structural factors in the way that people live, um, in the housing, in the food access, in our environment are built environment, the air, water, land that we drink and breathe and live on. All those factors relate to our food system also. And it is not equitable and it's not just, and so much of the food and food products that are in our cities and in places that are termed food deserts, though I don't like that term, those are some of the cheaper, less nutritious, highly processed

Speaker 2: 9:01

Foods. And that's what populates the convenience stores. Yes. And the and the markets that are available Yes. To a good many of our neighbors.

Speaker 3: 9:08

That's right. So this is not individual responsibility here.

Speaker 2: 9:12

There's no choices.

Speaker 3: 9:12

No. That is not something that we should lay blame on the individual. They didn't create these systems. My patients didn't ask to only have access to a convenience store for their food, and they didn't design the system that has led to that.

Speaker 2: 9:28

So, Dr. Shafta, let's shift if we could to the actual effects on the human body Yeah. Of highly processed foods. And what does the science and what does your, um, background in that? Tell us why are highly processed foods not healthy for the human body?

Speaker 3: 9:44

Yeah. Well, so the nature of highly processed foods is in the name. They've been highly processed, not just the example of washing off the carrots or cutting up an apple or mushing it into sauce, but lots of ingredients, including ones that are for preserving or additives or chemicals or stabilizers to make that highly processed food taste the way that we expect it to and to be shelf stable for transport and for durability on the shelf of a grocery store. And so what's lacking from those highly processed foods a lot of times are the very nutrients that we need from the food that we eat. And fiber, those are my top two that are lacking fiber and micronutrients, vitamins, antioxidants, minerals.

Speaker 2: 10:36

Because they get removed during the process. Correct. Okay. We're gonna talk about that. The lack of nutrients. The lack of fiber. Why the heck does that matter to the human body? We've been talking with Dr. Kate Shafto. We're talking about highly processed foods and the effect on your health. When we come back from this short break, we're gonna get into that in much more detail. Stay with us.

Speaker 1: 10:58

You are listening to the Healthy Matters podcast with Dr. David Hilden. You got a question or comment for the doc? Email us at healthy matters hc m e d.org or give us a call at six one two eight seven three talk. That's 6 1 2 8 7 3 8 2 55. And now let's get back to more healthy conversation.

Speaker 2: 11:22

And we're back talking with Dr. Kate Shafto about highly processed foods. Kate, you said before the break that when foods are highly processed, bunch of nutrients are removed from them and fiber is removed. Those, you said, those are the two things. The loss of nutrients, then the loss of fiber. Let's start with the ladder first. Why does the loss of fiber matter to your health?

Speaker 3: 11:44

Fiber is an unsung hero in our health.

Speaker 2: 11:49

<laugh>

Speaker 3: 11:51

Fiber is so important and the human body has been very well acquainted with fiber for as long as humans have walked the earth. Fiber comes from plant foods alone. You can't find fiber in any animal foods. So that's one key. And fiber is the roughage. It's the stuff that we need teeth to chew. And so fiber has many, many different beneficial effects in the human body in particular related to the gut. What I'm talking about when I say the gut is the digestive system. So from mouth all the way to the other end, we have an amazing system that is designed to break apart and break down foods. And it starts with our teeth. And so we have teeth for a reason. I say that frequently to patients. We have teeth for a reason, meaning we were given these teeth or we've developed these teeth in our mouth to break down tough things. And yes, you can use those teeth to break down animal fibers and proteins totally appropriate. That's one of their uses. And we really need to break down plant proteins and plant fibers too. When we chew plant fibers, they then go into our stomach and later into our intestines. And they have a very important role. It's being found more and more to feed the microbes that live in our intestines. They actually, the fibers actually form kind of a film along the inner walls of our intestines so that the nutrients don't get absorbed right away. And so the microbes can do their thing and so that they can metabolize the different vitamins, they can process different vitamins and minerals and other nutrients in ways that only our microbiota can do. And the fiber also slows down the, um, absorption of sugar into our bloodstream, which is super important because we just, humans don't tolerate quick infusions of sugar very well. But that's happening in so many cases every day in many people's food,

Speaker 2: 13:51

You drink a sugar. Exactly. Sugary pop. It's a glucose or fructose load.

Speaker 3: 13:56

It is, it is. And our body does not handle that well. It's a huge strain on our pancreas, on our liver. It puts our, our nervous system on overdrive because of all that sugar all at once. So the fiber in food mitigates that. It slows it down. It not that I'm recommending you should eat a bunch of roughage and all I

Speaker 2: 14:16

Could pick soda is a bunch of celery. Everybody's going for this and they're chewing on celery, ent, twine,

Speaker 3: 14:21

Celery, and then drinking their mountain dew. No, that's not what I'm recommending. But when you eat food that contains fiber, naturally, and the example I like to think about is fruits, how different it is to eat an apple, then it is to drink apple juice. Apple juice has no fiber. That's the sugar load that's equal to a soda. No different apple.

Speaker 2: 14:42

Because it because it was processed out. Yes. Through all

Speaker 3: 14:44

Of that, the fiber was

Speaker 2: 14:45

Strained out. It was strained out to make it that. Yeah. Syrup. Apple juice.

Speaker 3: 14:49

Apple juice. Right. And, and so when we eat the apple, we're chewing, chewing, chewing. That fiber is going down into our stomach and our intestines where those microbes start working on it, they start deconstructing it. And they also are able to extract the vitamins and the minerals from that apple. And they're not getting overwhelmed by all that sugar because it's kind of packaged in the fiber.

Speaker 2: 15:13

So I'm kidding when I, all I can think of is people chewing on celery all day long. Uh, because it just strikes me as the most stringy, fibrous thing I could think of. Good example. It is, yeah. Where a very practical tip, where can you get fiber in your diet? Is it literally any vegetable or plant product that hasn't been processed? People ask me this a lot. What food should I eat to get fiber? And I'm a little bit at a loss, I always just say, well, maybe if it isn't processed, but that's a flimsy answer. It's

Speaker 3: 15:40

A good start because any vegetable fruit, nut seed, bean grain have fiber. All plant foods have fiber and the less processed the better. Mm-hmm.<affirmative>. But we need processing to make grains and beans available for us to eat. Yeah. Most people aren't growing their beans or grains. Mm-hmm.<affirmative>, I grew, I grew beans, but I didn't grow any grains. And that's really hard. And so thank goodness for the industrialized food system in some ways that like

Speaker 2: 16:09

You didn't have a wheated field

Speaker 3: 16:10

Down on time. Exactly. Cuts down on the time it takes to thresh grain and get the actual grains out for human consumption.<laugh>.

Speaker 2: 16:17

But yeah. And most of us are, our grain threshing skills are a little rusty.

Speaker 3: 16:22

Yeah. Yeah,

Speaker 2: 16:22

Yeah, yeah. Exactly. But, but we can eat whole fruits and vegetables in legumes and everything you just said. We can

Speaker 3: 16:27

Do that. And whole grains. And that's one of the best places to get fiber and to make a shift away from a highly processed food is by eating the whole version of grains.

Speaker 2: 16:38

Now Kate, let's talk about the processing out of nutrients, because we've talked about that. Highly processed foods removed the fiber. You also said that nutrients are removed. Could you say more about that please? And

Speaker 3: 16:50

Yeah, removed might not be the real intention of the processing, but they're, they're

Speaker 2: 16:54

Not lost. They're purposely, they're lost.

Speaker 3: 16:56

Yeah. Yeah. They end up being lost. And part of that is because they, they go with the fiber. Mm-hmm.<affirmative>. And so, um, minerals and vitamins, antioxidants are the things that make fruits and vegetables brightly colored. And so a lot of highly processed foods, I, I don't think of them as being especially true to life. Brightly colored. They may be brightly colored for other reasons. They're

Speaker 2: 17:17

Beige. Must color, they must be added color.

Speaker 3: 17:19

That's right. Or red dye number five or a bright fluorescent blue Gatorade. That's not naturally occurring.

Speaker 2: 17:25

You mean that didn't grow in a field somehow like

Speaker 3: 17:28

That? I promise it didn't.

Speaker 2: 17:29

<laugh>.

Speaker 3: 17:31

So the lack of color is a good sign that there's a lack of nutrients. You've probably heard the phrase eat the rainbow.

Speaker 2: 17:38

Oh yeah.

Speaker 3: 17:38

Yeah. So that's because the different colors in our food represent different antioxidants. Antioxidants is just a fancy nutrition science word for minerals or, or vitamins or substances in our food that fight against oxidative stress, which is basically cellular stress on the the body. And so antioxidants are really important in preventing inflammation, preventing disease. And they come in these colorful packages that nature produces.

Speaker 2: 18:08

So the deep oranges, the deep, exactly. Greens, all of those things are what you're after.

Speaker 3: 18:13

Red, blue, purple,

Speaker 2: 18:15

The naturally occurring colors.

Speaker 3: 18:16

Think of berries or um, other fruits or vegetables. Carrots, sweet potatoes. Have that really rich. Yeah. Deep, beautiful color.

Speaker 2: 18:25

Please don't tell me I have to eat eggplant though. I don't need to have to eat eggplant.

Speaker 3: 18:27

I don't like

Speaker 2: 18:28

Eggplant twice. Okay. Cause it's a deep rich purple. It

Speaker 3: 18:30

Is. And has many antioxidants,

Speaker 2: 18:32

But okay. So go for it. If you like eggplant, that's right's in the group too. Yeah. So you used the word that I've been waiting to talk about a little bit, inflammation. Mm-hmm.<affirmative>, tell me how that is not such a great thing. Yeah. Why is that not good?

Speaker 3: 18:44

Well, so inflammation in the body has a very important role. Like if I cut my finger, I want there to be inflammation to heal that wound. And that's the body's natural response. That's acute inflammation or short

Speaker 2: 18:56

Term. I'm glad you brought that up cuz inflammation is a body's natural response. That's right. It's not a universal evil. It's body doing what it's supposed to.

Speaker 3: 19:02

Exactly. And you could also think about chronic inflammation as the body doing what it's supposed to do also because it's being chronically stimulated with things that evoke inflammation. And the things that do that from our food would be sugar, especially a lot of sugar and those refined grains. So the absence of the bra and the germ where we're left with just that starchy, often white, sugary think, um, pasta that sort of melts in your mouth before you even need to chew it. Remember I said we have teeth for a reason. So if there's food that's melting in your mouth before you even really need to chew it, if it's a plant food, like a potato in the form of a french fry or pasta, that stuff has been so refined that you don't really need to chew it. And so it's being absorbed very quickly into your bloodstream as sugar.

Speaker 2: 19:53

Do the highly processed foods promote more chronic inflammation? They do. Which eventually is counterproductive for sure they do. Is that a fair statement?

Speaker 3: 20:01

They do. They do. And for years now in the medical literature, the nutrition science literature, there have been studies demonstrating this again and again, that regular consumption of highly processed foods leads to elevations in inflammatory markers that we see. When people have infections like C R P C-reactive protein or um, interleukins, those are part of the immune system that go up when there's inflammation. And those things are consistently seen when people have highly processed foods in their diet on a regular

Speaker 2: 20:30

Basis. So another good reason, uh, the long-term ongoing effects of regular eating of highly processed foods might lead to increased inflammatory markers and lead, lead to it to chronic It does. That's known, that's known. And that chronic inflammation, your body responding as it's supposed to Yeah. Eventually has some what we soften say deleterious effects. Yes. Not good effects.

Speaker 3: 20:52

<laugh>. Yes. Some negative effects that are various chronic diseases that nobody wants.

Speaker 2: 20:56

What do you mean? Well,

Speaker 3: 20:57

They're the things that we see in our practice all the time and that millions and millions of people are suffering from like diabetes, heart disease, stroke, cancers of all different types. Autoimmune diseases, digestive and liver diseases, and even mental health conditions including dementia and cognitive decline.

Speaker 2: 21:18

How do you recommend that people reduce, maybe they can't eliminate but reduce highly processed foods from their diet. What practical tips would you give your patients? And now our listeners,

Speaker 3: 21:30

Well we mentioned this last time and it's worth mentioning again, scratch the beverages other than water, tea, coffee. The human body really does not need and does not benefit from in any way sugary beverages. Not diet beverages, not flavored. Our bodies really don't do well with those in our, in our system.

Speaker 2: 21:51

Number one, get rid of Kylie processed beverages.

Speaker 3: 21:53

Yes. Just wrecks our gut. It causes

Speaker 2: 21:56

Inflammation. So attend to your beverage selection. Yes. That's, that's number, number

Speaker 3: 22:00

One. Always number one. And number two, I would say maybe try making a shift from a refined grain to whole grains. So this could be brown rice instead of white rice. Or if that's a too far of a jump, mixing the two. So kind of a blend trying out other grains that humans have eaten for thousands and thousands of years. Like millet, quinoa been labeled as super food of late, but it is a ancient grain.

Speaker 2: 22:31

Are canned foods or maybe also by extension frozen foods, are they minimally processed? Are they something we should be adding to our diet or do they come into this highly processed category? I

Speaker 3: 22:42

Would say they are more toward the minimally processed end of things. Typically canned and frozen vegetables and beans are a really great way to get those fairly minimally processed foods. Endear your diet at a pretty affordable price point. And often they have not been processed a ton for frozen foods, especially. They're picked, they're washed, they're cut, and then they're frozen. And so that's about as much processing as happens. And those can be almost fresher than lettuce that's come from California in the middle of winter in Minnesota.

Speaker 2: 23:16

That's good news for me. You know that you can have, uh, canned tomatoes and you can have canned kidney beans or whatever for your diet. So before I let you go, Kate, what benefits can you expect if you do incorporate more minimally processed foods into your diet?

Speaker 3: 23:31

You'll feel so much better. People tell me when they especially move away from the sugar sweetened beverages, even from a lot of carbonated beverages, from the refined grains and just start eating more real food, their energy feels better. They feel less digestive discomfort, their bowels improve, their mood seems more stable. They generally have more energy. Just kind of an overall sense of wellbeing improves.

Speaker 2: 23:57

That's motivational, that's what most of us want. Right? And it's possible It is to, to move toward that. Yeah.

Speaker 3: 24:03

What's what our body wants.

Speaker 2: 24:05

So I have learned some things from this and I hope you have two listeners, Dr. Kate Shafto. Thanks for being again with us today for another episode about Food and your health. And I look forward to our next episode with

Speaker 3: 24:15

You. Thank you so much. I look forward to talking again too.

Speaker 2: 24:17

Listeners, thank you for tuning into this episode. I hope you have enjoyed it. And if you like what you hear, please give us a review wherever you get your podcast. Thank you for joining us and have a great, healthy and happy new year. And in the meantime, be healthy and be well.

Speaker 1: 24:34

Thanks for listening to the Healthy Matters podcast with Dr. David Hilden. To find out more about the Healthy Matters podcast or browse the archive, visit healthy matters.org. Got a question or a comment for the show, email us at Healthy Matters hc m e d.org or call 6 1 2 8 7 3 talk. There's also a link in the show notes. And finally, if you enjoy the show, please leave us a review and share the show with others. The Healthy Matters Podcast is made possible by Hennepin Healthcare in Minneapolis, Minnesota, and engineered and produced by John Lucas At Highball Executive producers are Jonathan Comito and Christine Hill. Please remember, we can only give general medical advice during this program, and every case is unique. We urge you to consult with your physician if you have a more serious or pressing health concern. Until next time, be healthy and be well.