Impact of Processed Foods and Additives on Heart Health

Podcast Transcript

Announcer:

Welcome to Love Your Heart, brought to you by Cleveland Clinic's Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute. This podcast will explore disease prevention, testing, medical and surgical treatments, new innovations and more. Enjoy.

Steven Nissen, MD:
I'm Doctor Steve Nissen. I am the Chief Academic Officer of the Heart, Vascular and Thoracic Institute. I'm here with one of my colleagues, one of the dieticians who works with us in preventive cardiology.

Julia Zumpano, RDN, LD:
Yes, my name is Julia Zumpano. I'm a registered dietitian in preventive cardiology.

Steven Nissen, MD:

Today, we're going to talk about ultra-processed foods and the concerns about their health. When we talk about ultra-processed foods, what are we talking about?

Julia Zumpano, RDN, LD:
Great question. Ultra-processed foods make up a majority of the standard American diet, unfortunately. We're looking at foods that are highly processed, meaning they have a high shelf life. They have a lot of preservatives and additives. The foundational food is very minimal, so there's not a lot of nutrients.

It's highly processed. Think of things like crackers, pretzels, chips, packaged foods, snack foods, processed meats, processed cheeses, baked goods and desserts, any commercial baked goods, sugar-sweetened beverages. So really, when you look at the grocery store, we're looking at those center aisles is where we're going to find those food items.

Steven Nissen, MD:

There are concerns about these foods. Let's talk for a minute about why we have concerns. So, the nutritional content and the things that they have and don't have. Perhaps you could talk a little bit about that.

Julia Zumpano, RDN, LD:
Sure. These ultra-processed foods are very high in saturated fat, and may contain some trans fat. They will have high amounts of sodium, and they will be very low in the nutrients we really need for overall health and specifically heart health. Like fiber, dietary fiber is key for heart health. These foods are void of fiber. They are also low in protein and vitamins and minerals. The things that we need for our bodies to function, essentially.

Steven Nissen, MD:

They're very quick and easy to eat.

Julia Zumpano, RDN, LD:
They are. We like to call them hyperpalatable foods. The reason we call them hyperpalatable, because they're designed to make you want to eat them more and more in high quantities and have a lack of control over how much you're going to consume of them.

Steven Nissen, MD:

Yeah. Of course, you know, one of the problems we're facing is the epidemic of obesity. These foods do contribute to that problem, do they not?

Julia Zumpano, RDN, LD:
They absolutely do because they're so hyper palatable, we're over-consuming them, which means we're over-consuming calories and especially calories in the form of saturated fat, trans fat and sugar. So, not only are they contributing to obesity, but they're also contributing to diabetes, heart disease and a lot of other chronic conditions.

Steven Nissen, MD:

How do we manage this problem? What are other ways we can substitute healthier choices for these less healthy choices?

Julia Zumpano, RDN, LD:
Absolutely. There are so many ways. You have to think of the grocery store. We're looking at the outside of the grocery store, simply just having fruits and vegetables there. I like to say one-ingredient food. An apple has one ingredient. You don't have to question what else is in there. So, fresh fruits and vegetables.

I often recommend buying a veggie tray for my patients and having it out every day in the afternoon so they can snack on it. Putting fresh fruit on the table, like you mentioned you have at your house. That's the same thing we do at our house. We always add fruits and vegetables first as a snack or as a foundation part of the meal.

Steven Nissen, MD:
Interestingly, of course, as they're less calorie-dense, aren't they?

Julia Zumpano, RDN, LD:
They're way less calorie-dense. They don't have any added sodium or saturated fat. They're packed in fiber, vitamins and minerals, and there's really no prep needed. You can eat a carrot fresh, maybe just washing it.

All we need to do with our fruits and vegetables is wash most of them. Some may require cooking, but most of them very simply can be consumed. They're just as simple as consuming some of these hyper- palatable foods.

Steven Nissen, MD:

Interestingly enough, they take a little longer to eat. A handful of chips you can consume very quickly, but an apple takes a little time.

Julia Zumpano, RDN, LD:

That chewing factor tells your brain that you're consuming. It tells your stomach that food's going to be in there. So, if we slow down when we eat, we tend to eat less and savor the food and actually absorb it better, too.

Steven Nissen, MD:
Is there strong research on the effects of ultra-processed foods? What do we know?

Julia Zumpano, RDN, LD:

Well, I think the research is murky. It's really hard to do studies. We do know observationally that when people consume these ultra-processed foods, they are more likely to have heart disease, diabetes, cancer and obesity.

Steven Nissen, MD:
Yeah. The gold standard in medicine, of course, is a randomized controlled trial. By that, we mean you take a new drug and half the people get a placebo pill and half of them get the drug, and you find out who does better.

We can't really do that here because you can't say to a large group of people, “This group should eat ultra-processed food, and this group should eat healthier choices.” Our research data here isn't as solid as we would find in some other areas of medicine. Nonetheless, there is so much observational data to suggest that these ultra-processed foods are not good for us.

If you think about what we were like 100 years ago, before we had a lot of these ultra-processed foods, we didn't have an obesity epidemic. We had a much lower incidence of diabetes. I think there's enough evidence that if you're thinking about choices, making the choices of these healthier, high fiber, low sugar, dietary choices really does make an awful lot of sense.

Julia Zumpano, RDN, LD:

Absolutely. It makes such a big difference. Small little changes can make a big impact, too. Usually starting with sugar-sweetened beverages. I usually say start to cut those out, increase water intake and then look at your snack foods. Try to eliminate snack foods.

Steven Nissen, MD:
One more point I'd like to talk about with you is children. Children learn at a pretty young age to make eating choices. Your advice to people about how to manage this with their children, who may really want to go for those ultra-processed foods.

Julia Zumpano, RDN, LD:
Yeah. It's hard because those ultra-processed foods are everywhere we turn. They're the default. They're always the one that's there.

It really starts at home, making sure that there are adequate amounts of fruits and vegetables, fresh food, minimizing processed foods, and letting those ultra-processed foods be there on occasion. They'll come into your life because if you ever go out of the house, they're there. Right. What you can really control is what's in the home. So, really try to avoid any of those ultra-processed foods in the home.

Steven Nissen, MD:
Thank you very much, Julia. This was a great discussion, and I hope that people found it useful. These are choices that make a big difference in health over a long period of time. But it takes a little bit of thinking and a thought process to actually make the right choices.

Julia Zumpano, RDN, LD:

Yeah, a little bit of planning. And again, starting one step at a time.

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