Hello and welcome to Zoe Recap, where each week we find the best bits from one of our podcast episodes to help you improve your health. On this podcast, we often talk about things that you can do to improve your diet. However, you're not the only person who has an impact on your health. The truth is that our food system, from government policy to supermarket placement, has a profound influence on what we eat, how we eat, and ultimately how healthy you all are. So what steps can we take to improve not just our own health, but the health of society as a whole? Today, I joined by Professor Brian Elbel and Professor Tim Spector to explore the forces shaping our food system and the changes that could benefit our collective well-being. So maybe we can just start off by explaining like what is population health and how does it impact the individual? I think population health is a couple of things. I think it is really looking at the health of populations. By that we mean we're averaging over a bunch of different people. So while you may be looking at one or two people in certain smaller studies, we're averaging over a whole big group of people. So that means a couple of different things. It means when we're looking at solutions, we may be looking for a 3 to 5% change that could be quite meaningful at a population level that maybe wouldn't be what you're looking for if you're looking at individual studies. So I think that's one big key distinction and difference. I think another is the type of data that we're using. To look at population health stuff, we need a lot of data on a lot of people and that's something that's quite different from smaller studies where you're down there collecting in the weeds individual data. For my studies, I'm using big data that are collected for generally other reasons. They are data that are collected for big national health surveys that are looking at bunches of different things or their data maybe from food companies themselves and directly and looking at some of those studies as well without taking their money to do it. And Tim, from your perspective, what's the biggest threat to dietary health today? It's the fact that we don't know that we're eating very unhealthy foods that are impacting our gut health and making us overeat them. That we just don't know the real properties of the food we're eating and people are being misled into making wrongful food choices. And is there one particular class of food that you're worrying about? Yeah, generally called ultra-processed foods, I think of the number one enemy for healthy eating. And Brian, in your research, how are you seeing that food in general and I guess ultra-processed food in particular is shaping our long-term health? What do you see? So, I would agree that ultra-processed foods are a huge problem in the food supply across the world right now. I think they're actually a particularly tricky one to look at at a population level. They're this huge class of foods that have come on very quickly and really taken over the food supply. So, it's really hard to sort of tease out at a population level what the relative contribution these foods have had. Although, I think in many of the smaller scale studies, we know they're quite problematic, but it's actually quite hard to tease out the overall contribution they have except to say it's probably quite meaningful. And so, if you were going to look at that question, so I think Tim's answer when Heath looks at this is that it's sort of these ultra-processed foods are the biggest issue, would you have had the same answer or would you have said something different? I think I would have had the same answer and I think the next level to that question would be why are they there? What's driving folks to eat them? I think those are some of the next level of questions that are really important to understand why they're problematic, but I think I would agree with that. And Tim, Brian was just saying like it's hard to recognize what a UPF is. How would I recognize a UPF? Well, the ones that we're seeing at the moment are different to the ones when they started 50 years ago. And I think that's what Brahm is talking about. A lot of these nutrition studies, epidemiological ones that look over time and so it's completely changed in that time. So you can't just go back, say, OK, what was, were people eating this 50 years ago or 30 years ago, even 20 years ago? It's completely different. So now up to over 50% to 60% of all our food is this general group of ultra-processed foods in the Western world. And that is the major problem. So what are these foods? Some people call them fake foods. They're created in huge factories from extracts of whole foods. So they don't use whole foods typically. They would use a product of whole foods. They'd never use milk. They'd use some sort of dried form of it. They wouldn't use corn. They'd use some extracted bit of the starch of the corn. And they put it back together to resemble food. So there isn't a unifying definition of ultra-processed food other than it's things that you really couldn't make yourself in your own kitchen, that includes ingredients you wouldn't find in a common kitchen, and that they are also industrially made to make you overeat them. And this is something that is fairly new concept, this hyper-palatability of them, so that their structure and everything about them is made so that it's the least effort to eat them in as fast a possible time. And they want you to eat more and more. They want to eat multiple bags or amounts of them, which is never the case with real natural food. It's more to it than just saying, oh, it's got Red Dye 3 in it. These 10 companies that control 80% of the supply of these foods employ the very best food scientists working around the clock for decades to come up with ways of putting these chemicals together that make us overeat them, that make us love them, and make a percentage of us addicted to it. And so it's necessarily complicated because they've used every trick in the book to do that. And I think we don't quite yet understand, to this point, what components of them are most problematic? Is it the overeating? Is it particular components of them? Is it the combination of those things? But the component of the definition you gave, which I think is one of the most compelling I've heard as well, is it's really things you wouldn't cook with, things you don't recognize in your kitchen. I think those are the best example of some of these ultra-processed foods. And it's most of the stuff you pick up at the grocery store and turn around and look at the label for. Listening to all of this, it's just like one more step in my radicalization, I think, over the last. And then I would say two years, when I think back to before that, Tim, we hardly ever talked about ultra-processed foods. So I think the shift and this focus on this part of what was going on is amazing. And every time I hear more about it, it makes me a bit angry at Brian. Now I would love to switch, though, from just being frustrated to talk about actionable advice. And obviously, in general, I think we're going to have to talk about what individuals can do. But I am interested in what they might also be able to lobby for. But maybe if I start at the individual level, Tim, what's the one thing that you would say to listeners they could do tomorrow in order to eat fewer harmful UPFs? Well, a few months ago, I would have said, look at the back of the pack, number of ingredients, and that's biggest red flag that this is going to make you overeat. And it's going to be ultra-processed food and bad for your gut. But now there's a more sophisticated solution, which is in the Zoe app. So for the last two years, the science team at Zoe have been working on a new way of classifying these ultra-processed foods into not just yes and no, which I think we've agreed was a bit too crude, because you include some stuff that's really quite healthy and you're labeling or lumping them all together, into five categories, including three ultra-processed food categories, one that's pre-neutral or only potentially low risk, and other is moderate risk and the other is extreme risk. And we're taking into account not just additives, not just those chemicals, emulsifiers, sweeteners, but also looking at the structure of the food, how quickly it is to eat it, how it disperses, how fast you can consume calories in per second, whether it needs chewing, and whether it has those ingredients that the chemist put in to make it hyperpalatable, which means you overeat. And that means, as studies have shown, you're going to be overeat by about 500 calories a day, about 25% of your intake. So it's all those things together that actually make up ultra-processed food. And we should think ultra-processed food really is a risk of ill health rather than the processing itself. I think it's a bit of a shift. So I think people can now use this in the app. They can scan things in the store or on their plate and start to learn more and realize there's a gradation of these problems because the worst ones have all of these things. They are the perfect atomic bombs that have nuclear war in your gut and your brain. So that's really what people can do now because it is really difficult otherwise. Otherwise, you've only got the back of the label and we don't know enough about all the ingredients to make a call just on those bases. But if you start to think how the food companies are thinking, then this is an insight and this is using AI and our fantastic database to do it. So I think this is showing much better than the current yes-no idea that has come out of academia, which is pretty good for population level studies, but really doesn't help the consumer. So Brian, I'd love to talk about what our listeners could be pushing governments about in terms of policy change. Definitely be more serious about taxes and moving on from taxes just from sugary beverages to other classes of products that we think are problematic. I would definitely want to look at the availability of foods. I don't think we're going to do much in the States on making food less available, but we can at least make sure that there are helpful foods available in all communities. I think I would really want to think about doing something on marketing. I think this is actually a really, really big one that is going to be quite tricky to think about making solutions for, particularly in a place like the States. But I think it could have really big implications, really for kids, but also more for the broader role that these foods play in our culture is quite prominent. You don't see apples that are the host of a major sporting event. You see- Or cookies. Yeah, or sports drinks or things like that. I think that those are all things that we could do to try to think about it. I do think that many of these solutions brought together could be influential. I also don't want to give the impression that they're going to be solutions by themselves. I think we're going to have to think about a lot of these together. We're going to have to think about much more prominent solutions that are not even on our radar yet. This is such a big problem. It's so ubiquitous. These foods are everywhere in the food supply. They're part of most people's diets. It's really hard to avoid them. We're going to need some more dramatic solutions that maybe aren't even on the table yet. What about schools? I was in California recently and they are talking about having some restrictions on what is served in schools. Areas where there is some state or federal control. I know this is also true in the UK where they could really change the school environment. I do feel we ought to be protecting kids more. Maybe these category four or five, particularly the five ones, could just be banned outright and that would be fairly straightforward to do once it's an accepted system. Do you think that would work? I definitely think schools are a really important area to look at for all the reasons you describe. I think we have made good progress in the states and some other places as well on trying to increase the healthfulness of foods offered in schools by traditional measures, by things like how much whole grain is in there, how much sugar is in there, how much protein is in there. I think we have not moved to the next level you're describing, which is what's really happening with ultra-processed foods. I do think that's an area that we could be focused on for sure. We already know that the average school lunch provided by the school is going to be healthier than the average lunch brought by a kid at home, so that's already there. That's true in the UK as well. The snack box is the worst thing. That's the easiest thing to ban as they do in Japan. That would be a big impact here. But I do think we could do a lot more in schools, including things like that. Some schools do it. In some private schools, for example, non-publicly funded schools, they just don't require you to bring a lunch and they provide it to you. That is something that happens in some places. At Zoe, we never stop being curious about how people respond to food. We recently asked thousands of people about their breakfast, what they eat, and how they feel about it. Their answers may surprise you. Over 70% told us that their breakfast is balanced, yet only 6% get enough fiber. If you've been listening to this podcast, you know that's not enough to be balanced. And it's no wonder that only 16% felt energetic after eating. Clearly, breakfast is broken. But what if you could get a breakfast that actually supports your energy and gut health? Meet Daily 30, our 30-plant gut supplement that's out to fix breakfast one scoop at a time. 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