Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake
Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, Chung ST, Costa E, Courville A, Darcey V, Fletcher LA, Forde CG, Gharib AM, Guo J, Howard R, Joseph PV, McGehee S, Ouwerkerk R, Raisinger K, Rozga I, Stagliano M, Walter M, Walter PJ, Yang S, Zhou M (2019) Cell Metab. 30(1) 67-77.e3. doi: 10.1016/j.cmet.2019.05.008. Epub 2019 May 16.
Web URL: Read this and related articles via PubMed here. Free full text of this article is available online
Abstract:
Highlights
- 20 inpatient adults received ultra-processed and unprocessed diets for 14 days each
- Diets were matched for presented calories, sugar, fat, fiber, and macronutrients
- Ad libitum intake was ∼500 kcal/day more on the ultra-processed versus unprocessed diet
-
Body weight changes were highly correlated with diet differences in energy intake
Summary
Meals were designed to be matched for presented calories, energy density, macronutrients, sugar, sodium, and fiber. Subjects were instructed to consume as much or as little as desired. Energy intake was greater during the ultra-processed diet (508 ± 106 kcal/day; p = 0.0001), with increased consumption of carbohydrate (280 ± 54 kcal/day; p < 0.0001) and fat (230 ± 53 kcal/day; p = 0.0004), but not protein (−2 ± 12 kcal/day; p = 0.85). Weight changes were highly correlated with energy intake (r = 0.8, p < 0.0001), with participants gaining 0.9 ± 0.3 kg (p = 0.009) during the ultra-processed diet and losing 0.9 ± 0.3 kg (p = 0.007) during the unprocessed diet.
Limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment.
FAB RESEARCH COMMENT:
This study - a carefully conducted randomised controlled trial - provides the first definitive evidence in humans that eating a diet high in 'ultra-processed food' actually causes increased appetite and food intake, and therefore weight gain.Evidence from experimental or pre-clinical studies has already shown that ultra-processed foods can override normal appetite regulation and satiety signals, e.g:
There is also abundant evidence from population studies that diets rich in these foods are both linked with, and predict, obesity and related physical and some mental health conditions, such as depression:
What has been lacking - until now - is good controlled clinical trial evidence that ultra-processing itself can confer harmful properties on foods or diets, leading to effects on behaviour and health that cannot be 'explained away' by the calories or nutrients they contain.
For more information on this study and its implications, please see the associated news articles:
For details of the nature of 'Ultra-Processed Foods' (UPF) - including how the classification system used to define them was first developed, and what research into UPF has been showing since then, see also:
For more information on how the UPF classification originated, and what research has shown about the health effects of UPF, see:
And for more information on the effects of ultra-processed foods on mental as well as physical health, please see the following article lists, which are frequently updated:
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