Why the 'Big Food’ industry is killing us, and how to fight back with Prof. Brian Elbel

Why do we eat what we eat? It might feel like a personal choice, but hidden forces: industry tactics, government policies, and even cutting-edge food science, shape our decisions every day.

In this compelling episode, Professor Brian Elbel from NYU and Professor Tim Spector unravel the truth behind our ultra-processed food (UPF) obsession and its alarming impact on global health.

But all is not lost. Tim and Brian provide actionable strategies to reclaim control of our health. Discover practical tips for decoding confusing food labels, making healthier choices, and advocating for transformative policies.

Tune in to learn how individual awareness and collective action can challenge—and change—a food system that’s designed against us.

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Transcript

Jonathan Wolf: Brian, thank you for joining me today. 

Prof. Brian Elbel: Glad to be here. 

Jonathan Wolf: And Tim, thank you as always.

Tim Spector: Pleasure. 

Jonathan Wolf: So, Brian, we have a tradition here at ZOE where we always start with a quick fire round of questions. They come from our listeners, and we have very strict rules on purpose to be difficult for professors and scientists.

And the rules are, you can give us a yes or a no, or if you absolutely have to, a one-sentence answer. Are you willing to give it a go? 

Prof. Brian Elbel: Let's give it a go. 

Jonathan Wolf: Alright. Are we getting sicker from the food we eat? 

Prof. Brian Elbel: Yes. 

Jonathan Wolf: Do government policies do enough to protect our health? 

Prof. Brian Elbel: No. 

Jonathan Wolf: Tim, do a few giant corporations control what's on our supermarket shelves?

Tim Spector: Yes, around 10 of them. 

Jonathan Wolf: Do food companies fund nutrition research for their own gang? 

Tim Spector: Yes. It's not all bad, but mostly yes. 

Jonathan Wolf: And Brian can have a whole sentence here. What's the biggest misconception when it comes to unhealthy food choices? 

Prof. Brian Elbel: I think the biggest misconception is that they cannot be part of a healthy diet. And I think they can, on occasion. 

Jonathan Wolf: We often on this podcast talk to scientists who study tiny cells in their labs, or one or two people in great depth. But Brian, you are someone who studies the health of the entire population, so you're focused on the very end of the scale.

And Tim and I actually co-founded ZOE eight years ago because of Tim's realization that the food that we eat is the most important thing that affects our health, and yet we have a crisis in our food system. 

But this is the first time we have sat down with a leading scientist to really understand what's going on at this big picture way. So maybe you could just start off by explaining what is population health and how does it impact the individual? 

Prof. Brian Elbel: So it is quite a contrast to what Tim was studying there. So 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, right?

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 3-5% 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 kind of key distinction and difference. 

I think another is the type of data that we're using, right? 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, right? They are data that are collected for big national health surveys, that are looking at bunches of different things, or their data may be from food companies themselves, and directly, and looking at some of those studies as well, without taking their money to do it.

Jonathan Wolf: And Tim, from your perspective, what's the biggest threat to our dietary health today? 

Tim Spector: 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.

Jonathan Wolf: And is there one particular class of food that you are worrying about? 

Tim Spector: Yeah, generally called ultra-processed foods, I think, are the number one enemy for healthy eating. 

Jonathan Wolf: 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? 

Prof. Brian Elbel: 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 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.

Jonathan Wolf: And so if you were going to look at that question, I think Tim's answer when health looks at this is that it's these ultra-processed foods are the biggest issue. Would you have had the same answer, or would you have said something different? 

Prof. Brian Elbel: I think I would've 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.  

Jonathan Wolf: And Tim Bryan was just saying, for him, it's hard to recognize what A UPF is. How would I recognize a UPF?

Tim Spector: Well, the ones that we are seeing at the moment are different from the ones when they started 50 years ago, and I think that's what Brian was talking about.

A lot of these nutrition studies are epidemiological ones that look over time. And so it's completely changed in that time, you can't just go back and say, okay, were people eating this 50 years ago, and you know, well, 30 years ago, even 20 years ago, it's completely different. 

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We're 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 they are also industrially made to make you overeat them. 

This is something that is a 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 as possible time and they want you to eat more and more. They want you to eat multiple bags or amounts of them, which is never the case with real natural food. 

There'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.

So it's necessarily complicated because they've used every trick in the book to do that. 

Prof. Brian Elbel: I think we don't quite yet understand, to Tim's point, what components of them are most problematic? Is it the overeating, or is it particular components of it? 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 that it's really things you wouldn't cook with, things you don't recognize in your kitchen, right?

I think those are the best examples 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.

Jonathan Wolf: I think it's interesting that you've both said this idea that it's very different from 50 years ago, because I think most people listening will say, well, I'm surprised by that, I feel the food that I'm eating now doesn't seem very different from the food that I might have had as a kid or that I see that my parents eat.

So why are you suggesting that this is different food from what we had back then? 

Prof. Brian Elbel: On average, we know that the food supply and the diet in most countries is quite different than it was 50 years ago, right? So that's sort of statistically true. 

I think the other thing is that most of the foods that are ultra-processed and that do make up a majority of most diets right now, we didn't really have the processing capability 50 years ago to do it. The technology wasn't there, the science behind it wasn't there. 

So there's actually quite a different set of tech that goes into them and science that goes into them. Not the kind of science that we might be propagating on this end of the table, right? But, you know, things that really are quite complex that just weren't there 50 years ago.

Jonathan Wolf: Brian, could you describe a bit what has changed? I mean, 50 years ago, everyone was buying food from a big supermarket already. It's not like everybody was going to their local farmer to collect milk straight out of the cow. So again, I think people will be quite surprised to hear you say that it has changed so much.

Prof. Brian Elbel: So if you think of sort of the things that are generally at the kind of outskirts of the supermarket, right? I'm hoping that's universally. True statement, but the produce, the meats and cheeses, and milks and those sorts of things, you know, I think a lot of those are the same, although some differences, but I think a lot of those things are the same.

It's really the things in the middle of the supermarket that are much different and much processed. And I think what we've seen is people shift from the outskirts to the middle, and they're buying a lot more ready-to-eat foods and food that has a lot more processing before they get to them, and maybe put them on their plate or, as part of their cooking process.

So I think that's a big part of the difference there. 

Tim Spector: Fifty years ago, I think people would be looking at the breakfast cereals as the very first sort of examples of this genre. 

Then a whole range of these other ones started to come, and people realized that there was huge markups to be made, cost very little. You could charge what you like for it. You could spend huge amounts on advertising, and it had a shelf life that was years.

So that itself became people thinking, what else can we do in that line? So that you get into biscuits and cookies, you get all the cakes you got, then it spread to ready meals. And that's a relatively new idea that you just buy these pre-processed lasagnas and chilies and frozen pizzas, and all these meals that now you can buy in bulk in these supermarkets.

Jonathan Wolf: Is it just the level of processing once food hits these big food manufacturers that has changed, or has anything else changed in the food landscape? 

Prof. Brian Elbel: So I think what changed in the food landscape, and another word often used for that is the food environment, is much more than just processing, right?

I think that there's a lot more availability of food, right? So it used to be that food was largely available from supermarkets. Now, if we all left our Midtown New York and walked just a few feet, we'd probably find five different places that we're selling chips and sodas. So I think that sort of availability is a big part.

I think partly because of the processing more and more broadly, pricing is a big part of it as well. We know that the price of foods have generally gone down, particularly unhealthy foods have gone down more than healthy foods. So there's sort of a bigger gap between the prices of healthy and unhealthy foods. I think that's another big one. 

I think another really big one is the marketing of these foods. It's really quite prominent where you go, and you see marketing for foods in a way that you didn't before. It's targeted at children, oftentimes. We think this marketing really, really works quite well to drive particular food consumption behaviors.

So I think it's kind of a combination of those things in the food environment and food landscape that are really all coming together here. 

Tim Spector: I think in the U.K., only 2% of advertising is for real food, 98% is for ultra-processed food. So the landscape is just so twisted that it's not surprising that they're going in these divergent directions.

Jonathan Wolf: Right back to the quick-fire questions, you said we're getting sicker from the food suite, and you're now looking again at this population level. What are you seeing? 

Prof. Brian Elbel: So if you just look at broad population-level data, you see that the percentage of ultra-processed foods in the diet is going up, and you see that in general, folks are getting more unhealthy.

So there's that kind of base-level correlation here. I think that's not enough to directly say that there's a cause and effect there, but I think there's lots of other kind of evidence as well, particularly from these smaller-scale studies. 

Jonathan Wolf: And Brian, in what way are populations getting more unhealthy? 

Prof. Brian Elbel: So I think populations are getting more unhealthy in a couple of different ways. 

So we've seen very much rising rates of obesity, pick most Western countries, and you're going to sort of see that quite dramatic rise in obesity rates in all populations, not just particular populations.

Tim Spector: Yeah, there was that Lancet report showing that by 2050, 50% of the world's population is going to be overweight or obese. I mean, quite frightening, and that mainly the food environment that's doing that. 

Prof. Brian Elbel: Absolutely right. And then I think the other big one that comes along with that, but is also independently a problem, there are things like diabetes, and other sort of metabolic diseases like that, that are really quite problematic and we know are a huge drain on individual's health and a huge drain on the health system as well. 

So those are sort of two quite prominent examples, but there's more. There's fatty liver disease, there's all kinds of things that kind of come along with this unhealthy eating. 

Tim Spector: And some people would say mental health issues, particularly the epidemic in the young, is at least partly caused by the unhealthy eating. 

Jonathan Wolf: So obviously, for any individual who ends up being sick as a result, it's terrible for them. Are there any broader society-wide consequences of this sicker and heavier population? 

Prof. Brian Elbel: So I think there are multiple things that go along with that. I think we can't minimize the individual cost. 

I think that there's also a broader societal cost in terms of changes in productivity, right? And changes in contributions to society.  I think that's another kind of really big one as well, that has quite big financial implications. 

I think the other one that has really big financial implications is just the cost for treating these individuals is very high and going up, and governments are children, a big chunk of those dollars.

So I think that that has real implications for the broader society, not just those that are impacted by potentially the poor nutrition themselves. 

Jonathan Wolf: And is that a big part of the cost of health systems around the world today related to the food we're eating?

Prof. Brian Elbel: It is a big part of it. It's a growing part of it. 

It used to be that in most Western countries, it was sort of smoking that was the number one killer and the number one kind of contribution to healthcare costs at certain periods of time. 

Now it's really shifted to being sort of diet and nutrition and metabolic diseases like that. So I think that that's a big and growing problem. 

Tim Spector: I mean, as a proportion of the cost of the U.K., we know that the food companies are making about £30 billion, $40 billion worth of profit in the U.K., and it's probably costing between £90 and £140 billion pounds in healthcare costs directly, which is getting close to the total NHS budget.

So these are massive, massive numbers that are potentially preventable. 

Jonathan Wolf: And do you see that also, Brian, in your research? I ask because people talk about this, but this is what you really study. I mean, do you really see food as such a big driver of the health costs globally now? 

Prof. Brian Elbel: I think that's true. I mean, I think the stats you're giving from Tim are broadly true across the world, and they're things that we have seen progressively get worse, not better. So I think these are very real costs, and I think those are true statements. 

Jonathan Wolf: This is pretty shocking, isn't it?  I think we all grew up with the idea, okay, smoking is really bad and it causes cancer, and these tobacco companies were sort of hiding this.

But now we figured it out, and it sounds like we're sleepwalking through a situation where now a huge part of our health costs are coming from food, and yet we don't seem to be doing much about it. 

Prof. Brian Elbel: So, one of the things about smoking is that it kills you quickly and pretty dramatically. When you die of lung cancer, at least previously, it was a quick thing, and you came and you were done.

I think for something like nutrition, a lot of these things are slowly building over time. Weight slowly building over time, diabetes slowly building over time. Once you're at these points and have these health conditions, treating them with some recent exception is actually quite difficult.

So I think part of the reason you're seeing that is because it is something that presented very differently than smoking did historically. And it's something that has been a little bit sort of slow-growing right now. 

Tim Spector: I think smoking, interestingly, I don’t know about the U.S., but in the U.K., the tax paid on cigarettes more than compensates for the extra healthcare that is needed for smokers. 

I'm not saying the government gains from people dying of lung cancer, but that's the way it's going, and it's the total opposite for food.

Prof. Brian Elbel: In addition, the taxes for smoking are really keeping a lot of people from smoking as well.

Tim Spector: Yeah, it's preventive. 

Jonathan Wolf: So if I understand this right, we're eating more and more of these ultra-processed foods, and this shift in diet is now making a lot of us sicker. I'd love to understand why they're in everything. What's going on behind that? 

And Tim, I'd like to pick up on some of what you've said earlier about these giant corporations. What's going on there? 

Tim Spector: The giant corporations are these 10 major companies. Massive companies like Nestle or General Mills that control 80% of the food around the world, that's basically in our supermarkets, whichever country you go to. 

They own all these subsidiaries, so they have enormous power and their budgets are the size of medium-sized countries. 

So you've got to start thinking of them as these... As if countries like Kenya or Tanzania were lobbying to buy Kenyan coffee. It's the same idea of all their resources going into Washington or London and influencing what happens to the politics of food. 

So they've kept us off the agenda successfully so that no one until now has really been asking these questions to say, why aren't these companies paying for all the healthcare misery they're causing, instead of just making massive profits that they're keeping and giving back to their shareholders?

They've got no moral rationale when they were set up. They were set up as companies to make money, and they'll do that if nobody stops them. 

Jonathan Wolf: Tim, can you paint me a picture, maybe of an ultra-processed food, just for people trying to get their head around this? 

Why this ends up being much more profitable for them than what a company might have sold before that was in the food business.

Tim Spector: Yeah. The example I like to give is a potato chip-type food, like Pringles. It looks like a potato, it's sort of molded like identical potatoes. You've never seen a potato like that in real life, but it's sort of got that potato shape, and yet its main ingredient is not a potato. 

It's actually cheaper to use rice or tapioca, or some bit of corn extract. A little bit of potato tagged in as a third or fourth ingredient, stuck together, molded like a big bit of dough. 

Then it's pressured. Pressure heaters to make it into these shapes, which are then baked at super high temperature under pressure, and then they add these chemical seasonings to it, about 30 of them, to make it a tasty snack that looks a bit like a potato.

It's done at perhaps a quarter of the price of actually just slicing up a potato and putting it in some vegetable oil and adding salt, which is how it should have been done. 

They've worked out, this is brilliant, and that actually, people will overeat it. 

Jonathan Wolf: And Tim, I just want to check that I've got that right. You're saying that a Pringle actually isn't like a slice of potato fried with some stuff that's just all fake.

Tim Spector: It's fake. Yes, it's made to look like a potato. It has some potato in it, so they can claim that it's made with potatoes, but it's not the main ingredient. 

They use cheaper ones that are easier, more malleable, so they can basically make it into any shape you want. And that's what most of these potato and ‘snacks’ are like. They're made with whatever the cheapest, most usable ingredient is. 

They don't really care about the quality of it. It's all about providing something that looks visually good, has a nice snap to it. It has all these chemicals to make your tongue go delirious with the effects, as if it's doing something to your brain.

Prof. Brian Elbel: And the Pringles could all be made in a factory under controlled conditions, versing the potato chips that you really need to make in real time in front of people or right before they have them with labor there and spaces there. 

So all of those things really contribute to the overall cost. 

Jonathan Wolf: If you are the company running it, it's just much more efficient. You can keep prices down, it can last on your shelves for years, and then you spend all of the money you make on marketing to tell everybody how great this product is, and that you should buy it. 

Prof. Brian Elbel: And developing other science and technology that's going to develop even more tastier, more products that people can't resist.

Tim Spector: More addictive ones. Yes, that's exactly what they do, and they're very, very good at it. 

Jonathan Wolf: I'd like to ask a controversial question now. Do they know that this food that they're making is less healthy than the food that it replaces? 

Tim Spector: Absolutely.

Prof. Brian Elbel: I would agree. It's hard to imagine that anyone engaged in this process wouldn't know that.

Tim Spector: It's a bit like the cigarette industry. They knew it was harmful, but they said, well, people love smoking.

They'll say, people love these snacks. They love their potato chips or whatever it is; let's give them pleasure. So they're justifying working in that field by saying, well, I'm surrounded by the best food scientists in the world, I'm well paid, and we're not forcing anyone to buy these snacks. They love them. 

I've read estimates that about one in 10 people are actually addicted to these types of ultra-processed snacks and foods. So, they really feel a compulsion to keep eating them.

Jonathan Wolf: We mentioned right at the beginning, this question about funding research, and I think it was Tim said, well, actually, these food companies are funding research for their own gain. 

Brian, you were just mentioning that they know that this food isn't healthy. What is going on? What do we know is actually happening?

Prof. Brian Elbel: So the industry does fund food research, and if you step back and look at the kind of research that they're funding, or rather the outcomes of the research, it's generally not things that are showing these products are unhealthy. 

It's very specific questions that tend to kind of look at ancillary things or cherry-pick particular sorts of outcomes that might look better.

The food industry is not funding studies that are taking a global look at whether or not these are healthy foods or not. That's not the kind of questions that they're most interested in. 

Jonathan Wolf: And so why do they fund these studies at all? 

Prof. Brian Elbel: So they can talk about how great their foods are.

Jonathan Wolf: So they're carefully picking studies actually to allow them to say, Hey, this thing is good. Even though they know that if they were to step back and do a fairly designed study, it would say this food is really bad. 

Prof. Brian Elbel: I think that's right. 

Tim Spector: Examples are, so the Diet Cola industry would set up a study to show that these are great, compared to other sodas for helping children not have dental caries, so their teeth don't rot.

Very specific on that, they wouldn't look at anything else. In a way, it's a distraction technique that they use a lot. They have these umbrella organizations that they used to give out the grants, like ILSI, which has largely gone underground, but it was funded by Coca-Cola. 

They gave out lots of grants to people to say that if children run around and have playgrounds and exercise time, they can lose weight. So it sort of meant that it was fine to have your Coke or your Pepsi as long as you did a bit of running in the playground, it didn't matter. 

Jonathan Wolf: And Tim, is that not true? 

Tim Spector: That's not true. No, it's absolutely not true. You only have to look around and see how many obese children there are. Even if they do run around, if you overconsume all these snacks and drinks, you're going to get obese.

So this distraction technique, as well as this ‘make them look good’ technique, is basically what they're doing. Diverting attention. 

So for 10 years, it was all about the only reason the U.S. has an obesity crisis is they're not running enough. The kids are not getting playgrounds. 

Prof. Brian Elbel: To be fair, physical activity is really important. It's just probably not going to help with your obesity very much. Right? 

So I think that was a big part of it for a while. It was activities or advertising around moving and things like that, when obviously that was not the overall problem here.

Jonathan Wolf: It sounds like this is a really conscious policy, Brian, that they are pursuing. This isn't just accidental, 

Prof. Brian Elbel: They're not opening their books to us necessarily to sort of see what they're doing, but there has definitely been evidence of concerted efforts through some of the groups that Tim's mentioning, some of these trade organizations, to focus on things like movement, right?

Or very particular sorts of questions versus the broader, fundamental question of whether or not their products are helpful or not. 

Jonathan Wolf:  Could you tell me a bit more about that? 

Prof. Brian Elbel: Yeah, so there's been a couple of sports organizations that have been funded by the food industry, right, to sort of talk about movement and physical activity.

Even if you look back at sort of during the Obama administration, which I thought was actually quite a good program, the first lady's Let's Move initiative. It was great. It was really important, and a lot of it was still about moving and physical activity versus just kind of looking at the kind of foods that were there as well.

So I think even in sort of quite well-meaning ones, if you wanted to bring the food industry along with you, you really did have to focus on some of these physical activity things versus focusing just on the food. 

Tim Spector: But it's a distraction, it's a brilliant distraction to get everyone thinking about exercises that cure for everything. Then they won't think about all these soda machines in schools and the food environment and the snacks and this other stuff, just not getting enough exercise. 

And that was really brilliant, the way they did it, and I think they delayed any legislation by at least a decade by doing that.

Jonathan Wolf: It sounds incredibly cynical. I just want to check, Brian, I think you are quite a careful academic, and I think I'm just struck that this is quite strong really to talk about what they're doing. 

This does not seem like it's within the reasonable behavior of what we would expect from companies who are providing the food that we live on?

Prof. Brian Elbel: Yeah, I think it's quite reasonable behavior if you look at it from the perspective of what these companies' jobs are.

Their job is to return profits to their shareholders, and I think the best way they can do that is to really focus on some of the foods that are not particularly healthy for us, right, are not healthy for us at all in many cases.

So, I think that that's pretty true. I think it probably shouldn't be a particularly controversial statement. 

What I see, the kind of biggest problem here is a failure from the government to step in and say, this is something that's really not helpful for our citizens, and we want to tackle it a little bit.

Industries doing what they do. Yes, I wish they were different. Yes, I wish that they took more of a, we're going to sacrifice some of our profit in a more dramatic way to help the health of society. But I think the bigger downfall really comes to some of the government for not stepping in, in a bigger sort of way.

Jonathan Wolf: So, could you tell us what role government policy should have around this whole new ultra-processed food that has been clearly filling up the middles of our supermarkets? 

Prof. Brian Elbel: Yeah, so I think there's a couple of problems that have made tackling ultra-processed foods even trickier than tackling other foods.

I think some of it, as you heard from Tim, is that the definition of these things is not super clear, right? If you're going to actually go after something in a regulatory environment or actually come up with a policy against it, you need to have clear definitions of what it is that you're going after. 

So I think that's one of the reasons that it's tricky for the government to do something. 

That said, a couple of things that government can do, I think one of the things we can do, which you've seen in certain scenarios, is change the prices of these foods via taxes. Right. I think that that's one of them. 

You've seen the most work on this in sugary beverage taxes. I think it's the class of ultra-processed foods that we can actually clearly identify and target at some sort of liquid with some sugar in it.

So I think it's a little easier to kind of go after that. It's also a class of products that arguably doesn't have any real nutritional value otherwise. And so it's an easier one to kind of really make the poster child, if you will, of something that we can kind of go after with policy or taxes. I think that's, that's another kind of big one. 

You've seen some governments try to start labeling these foods in a different sort of way, particularly on the front of the package, and that's something that some countries have had more success than others. That's something we're lagging a little farther behind with in the U.S.

The third thing that you can do, which again some countries have had more success than others, is to think about some restrictions on marketing these foods, particularly marketing to kids. And I think that's another real one where some governments, Chile being a prominent one that stands out, have actually had some success in trying to change the marketing of these foods, particularly to children in a way that other countries, particularly in the U.S., we haven't been able to for a number of reasons.

Jonathan Wolf: When you look at the science across those changes, do any of those things work? 

Prof. Brian Elbel: Yeah. So let's sort of take them one by one. There's been most evidence from taxes in things like supermarkets, right? Does it sort of change what people purchase in supermarkets? 

I think the answer to that is a pretty clear yes. People are purchasing fewer of these beverages. Once you start implementing these taxes. 

You have to do the studies in a nuanced way. For example, if you have a tax in one city and not the other, people will cross the border and buy more sodas there. But even if you kind of take that into account, these are things that are definitely decreasing people's purchase of these beverages. So I think there's some pretty good evidence on taxes. 

Jonathan Wolf: And Brian on that one, is the hope that you just make more money out of people who are buying these products, or is the hope that the food manufacturers therefore change the products that they're making in response to these taxes so that they stop saying, well, our only job is to worry about how much profit we make. We don't care that this is killing you. 

It's trying to say, Oh, actually, I am caring now about whether I'm killing you with this or I'm going to use all my great food scientists to make this product that is still tasty, but isn't going to be bad for you. 

Prof. Brian Elbel: Yeah. So let's break down each of those. I think those are each different mechanisms by which this policy could be helpful. 

So, one thing that taxes do is just make people purchase less of those products. And if we think they're unhelpful products, then that's a good thing. 

Tim Spector: And that's what happened in the U.K., by the way, the sugar levy, they didn't make any money on it because nearly everybody, apart from, you know, selling classic Coke and Pepsi switched their formulations and so they just added the artificial sweeteners and drove down the sugar. 

So it didn't generate any money, but it did switch behavior. 

Prof. Brian Elbel: And that's the second reason, by sort of what we call reformulation. So changing your product where it doesn't necessarily qualify for the tax, and hopefully is more helpful. So I think that's another kind of big thing that people can do. 

Then a third example, is it didn't work necessarily this way exactly in the U.K., but if there is money that comes from these policies, then you can hopefully redirect that back into things that will actually help decrease demand for these products even more, or help deal with the consequences of the negative health impacts that they have. 

Jonathan Wolf: I think we're then going to move on to this question about labeling. 

Prof. Brian Elbel: So there's a couple of different ways you can think about labeling. One is what we have in the states is something called menu labeling or calorie labeling in fast food restaurants or other chain restaurants.

So you walk up into a fast food place, you're going to order something. You see not only the product and how much it costs, but also the number of calories that are in it. So this is something that's rolled out over the U.S. over the last sort of 10 or 15 years.

We've done some of these studies and found that, on average, these don't have a whopping effect, but they probably have a smallish effect on the number of calories people are purchasing at these restaurants. 

So that's sort of one way you can kind of go about labeling. 

Tim Spector: It wears off, though, doesn't it? The New York studies show that after a while, people revert. It helps for a little bit, and then it… 

Prof. Brian Elbel: So we have since done better studies than that, that use more detailed, bigger data, and found that the drop off is not quite as much as we thought it was initially. So yes, it does wear off a little bit. 

And I also don't want to oversell the impact of these. So for an average of a thousand-calorie meal, we're talking 20 to 30 calories, right? 

Jonathan Wolf: So instead of eating a thousand-calorie meal, you eat a 980-calorie meal. This seems like a very small return for making every poor company put calories…

Tim Spector: And it’s still rubbish food. 

Prof. Brian Elbel: So you're absolutely right that this alone is not going to do anything to change population-level obesity.

Tim Spector: Glad we clarified that.

Prof. Brian Elbel: But I also want to say, remember we're talking about things at a population level here, so you're not going to find any of these policies that are going to be 300-400 calories sorts of interventions.

You're going to have to find things that are 20, 20, 20, 20, 20 across a whole bunch of realms if you're going to try to think about a broader policy-level solution to some of these problems. 

Jonathan Wolf: Brian, I was just thinking as you talk about labeling, and I think both of you have been talking about this analogy with tobacco in the past, we've sort of been on this long journey. 

If I think back to when I was a kid and they were advertising tobacco everywhere with sort of manly cowboys smoking their Marlboro, this is all… I mean, you're smiling because that seems crazy.

I was describing this to my son last week, and firstly, he couldn't imagine really that tobacco could be associated with a brand in that way. But he just couldn't even imagine somehow it could have that one-to-one relationship because for him it's so sort of impossible.

And so I'm just thinking, when you're talking about labeling, you're talking about the amount of calories, but is it conceivable that you could end up having the huge warning labels on ultra-processed food, and indeed the restrictions, and would that really start to make a difference?

Prof. Brian Elbel: Yeah. So I think you're absolutely pointing towards a different sort of labeling here that could be much more effective. 

You've seen these play out in a couple of different countries, right? Some of the evidence, I think for other countries, particularly Chile, is a little bit more encouraging.

Tim Spector: There's a big black hexagon that goes on. It's very visible. 

Prof. Brian Elbel: And it is more along the lines of what you're describing there, where it's not just a small little nuance thing. It's a much more prominent one. 

There's been talk about, is that even enough? Do you need something skull and crossbones? Do you need various Xs if it's high in fat or sugar, or things like that? 

Jonathan Wolf: Does it work? 

Prof. Brian Elbel: So there is some evidence that it's effective in changing children's or oftentimes parents' food choices for children in places like Chile. 

Again, this is not by itself going to be enough to change things overall.

Tim Spector: Just taking the cartoons off was one thing that did make a big difference, didn't it? 

Prof. Brian Elbel: That kind of gets to the third thing we talked about, which is marketing. 

That was a big change, I think that they did in marketing in a place like Chile, is that they actually changed and said if you want to sell bad cereal, sugary cereal to children, you can't put a cartoon character on the front. It has to be completely unbranded package.

Again, the industry's very smart about getting around these rules, and they had to really kind of go after them in multiple different ways. But, I think that's another potential solution here as well. 

Jonathan Wolf: And does that make a difference? 

Prof. Brian Elbel: Yeah, I think there's some evidence that makes a difference as well.

Lots of evidence that that makes a difference in experimental studies. You show kids in a lab one versus the other, they're definitely going to eat more of the branded character foods, regardless of what kind of foods there are. So it's a bunch of evidence from that. 

Jonathan Wolf: That's really interesting. I'd never really thought about it. 

So the fact that they have these characters on the front of…

Tim Spector: Happy tigers or Batman or whatever it is.

Jonathan Wolf: That’s not just somehow a general trying to differentiate my product; it’s literally going to make kids in particular want this product more. 

Prof. Brian Elbel: So in these lab studies, you randomize the product with and without the kind of character. And when you have the character, they're going to choose them more often and eat more of them. And it's true regardless of the type of product it is.

Jonathan Wolf: So you mean if the character had been on the apple, I could have got the kids to eat more apples.

And going back to the conversation we had before that, there's not a lot of money in selling apples, so nobody is doing the marketing investment to make the apple seem more appealing because it's not this clever thing you've built in the lab yourself.

Tim Spector: Apple man.

Jonathan Wolf:  There's no tiger on my apple package. 

Prof. Brian Elbel: You occasionally see that, and you occasionally see these efforts that pop up that are like, we are going to use the same marketing that goes towards the unhealthy foods and put them towards healthy foods and produce. 

They never really have traction. They never really take hold. It's hard to do it. It's hard to maintain, and it's quite expensive. 

Jonathan Wolf: It's really interesting. I have a 5-year-old as well as a 17-year-old, and I'm often frustrated about the yogurt that she chooses and that she wants. 

It had never occurred to me until now that actually, she really likes the ones that are for kids. Now that I think about it, the packaging is very different from the adult, healthier ones that I want her to eat. 

It's also true that when it's all invisible, she doesn't care as much, you know? And I always thought it was just because they have more sugar put in them, and I'm sure that's part of it.

Prof. Brian Elbel: That's definitely part of it. 

Jonathan Wolf: But it sounds like you're saying that isn't the whole story, you know, she's only five, but you're saying she's already, I. Susceptible to this sort of branded marketing. 

Prof. Brian Elbel: Oh, that's right. And until kids are about that age, five, six, they actually can't necessarily tell the difference between what's an advertisement and what's just a regular program that they're watching or something like that as well. So that makes it doubly bad in that regard. 

But yeah, I think it's definitely the sugar as well. But the branded products absolutely make it trickier for you as a parent. 

Jonathan Wolf: And presumably somewhere like the States, it's particularly hard to restrict things like advertising because of maybe questions around free speech. That might be less of an issue in many of the other countries where people might be listening. 

Prof. Brian Elbel: That's exactly right. So in the States, our Supreme Court thus far has ruled that marketing is really thought of as corporate speech and is given some of the same First Amendment protections.

So it's quite hard for even a state government, if they wanted, to regulate marketing in that way. So it's something that we have made much less progress on. 

There's been a whole bunch of voluntary sorts of things that haven't gone particularly well, but it's something quite hard to do in the States relative to some other places.

Jonathan Wolf: Listening to all of this, it's just one more step in my radicalization. I think over the last really only, two years.

When I think back to before that, Tim, we hardly ever talked about ultra-processed food. So I think the shift in this focus on this part of what was going on is amazing, and every time I hear more about it, it sort of makes me a bit angrier, Brian. 

Prof. Brian Elbel: Well, I can tell you as a parent of a 13-year-old, it's hard to really get too radical about this. 

So in your home environment, right, you can maybe control what's there. You can control even the media they consume. Once your kid starts getting older, and maybe you see this with your older kid going out into the world, it's really hard.

They're passing these doors all the time themselves. They're seeing things, they're making purchases on their own, right? So I think that it becomes even trickier to control. 

Jonathan Wolf: 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? 

Tim Spector: Well, a few months ago, I would've said, look at the back of the pack number of ingredients. And that's the biggest red flag that this is going to make you overeat, and it's going to be ultra-processed food and be 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 has 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 lumping all together, into five categories, including three ultra-processed food categories.

One that's pretty neutral or only potentially low risk, the other is moderate risk, and the other is extreme risk. 

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 chemists put in to make it hyper palatable, which means you overeat. That means, 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 has 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're 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 of the ingredients to make a call just on that basis.

But if you start to think about 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 probably good for population-level studies, but really doesn't help the consumer. 

Jonathan Wolf: First, I think quite a lot of people will be excited. I'm very excited about it and starting to use it all the time.

Tim Spector: Yeah, it's a huge plus because people have been asking me all the time, Why don't you have something in the ZOE app that tells us how ultra-processed it is? 

We sort of thought about that, but now we've got one that's not only ultra-processed, but how does it link to your health risk? 

And that's the key thing here. Because some of these additives might be quite trivial. They're just in there, they might be a natural plant in some way, soy lecithin or something that. If that's the only ingredient, in say some dark chocolate. And the dark chocolate is good quality, that's the only thing there, I'm not going to say that's terrible food, I'm never going to eat it because it's going to be better than many other things that I'm going to eat. 

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Bread's a good example. You go into any store with a range of breads, and you look at the back of the pack, and you don't understand exactly what's going on.

Some of them have 20, 30 ingredients, others will have four. 

But within them, some of those are going to be good and bad, and some of those breads are going to be designed to be hyper-palatable because they've added sugar, they've added salt, other stuff in there that's going to make you overeat it. 

So you will eat much more of that bread than you would one down at the other end of the range, that either may have no ingredients or anything that we call it. So it might have a score of zero or one, or it might just have one emulsifier or something to make the bread stick together, but otherwise, it's a healthy product.

So it allows you to look at the range of foods, discard the ones right at the end, the same as for breakfast, cereals, some cookies, and things like this.

There's always a range, and that's what we're trying to do, is to say, well, we're not trying to stop people eating all these foods, demonize all breads. We just want people to start picking the ones at the good end of the spectrum and try to avoid the ones at the other end, which are definitely harmful.

Jonathan Wolf: You're quite serious about your diet. We know that. Would you try and avoid all UPFs? So, would you use this to avoid all of them, including those that are sort of at the one out of three risk level that you're talking about? 

Tim Spector: No, I'm interested in avoiding definitely the number fives and I sort of know what they are myself anyway now because I've been doing research in it.

I would use it for the number fours, the sort of moderate risk, if I can, because some of those are disguised as healthy foods. So they're the ones I'm avoiding. I'm not too worried about threes because they're sort of neutral.  I want to know about it, but I'd still be happy to eat them because you can't suddenly be a Puritan and eat nothing out there.

I think some of these are interesting, fun treats. I still want to have the occasional cookie or biscuit with my tea. One, we're not going to have it a whole packet every day, but occasionally I think they're fine. 

Chocolate's a great example. Some have that dark chocolate and the polyphenols that I'm always going on about. Am I going to not eat it because it's got one emulsifier to stick it together? No, I'd rather pick something that isn't, but I wouldn't not eat it. That's my view. 

Is there a minimum amount of ultra processing you would eat? 

Prof. Brian Elbel: I do think that there is a huge range of healthfulness in ultra-processed foods, and I think that absolutely true that some of them are worse than others.

I think the bread example is one that I always use as well. Even if you compare local bread from your bakery, fresh baked with completely white flour, versus something from the supermarket that is ultra-processed, but it has a hundred percent whole wheat flour. 

That second one's probably going to be more heathful for you, right?

So I do think that there's a huge range there, and I think the science is still emerging, and even more so, how we transmit that information to consumers is also quite tricky as well. 

Jonathan Wolf: So, Brian, I'd love to talk about what our listeners could be pushing governments about in terms of policy change.

If you could wave your magic wand, what would you be pushing for? 

Prof. Brian Elbel: So I think it's a lot of the things we've talked about before. It would definitely be more serious about taxes. And moving on from taxes, just to sugary 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 healthful foods available in all communities. 

I think I would really want to think about doing something on marketing, right? 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, is quite prominent.

You don't see apples that are the host of a major sporting event, you see cookies or sports drinks or things like that, right? So 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. 

Tim Spector: 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, and this is also true in the U.K., where they could really change the school environment, because 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? 

Prof. Brian Elbel: So 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. So 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. 

Tim Spector: That's true in the U.K. as well. But the snack box is the worst thing that's the easiest thing to ban. 

As they do in Japan. Would that be a big impact here? 

Prof. Brian Elbel: 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. So that is something that happens in some places. 

Jonathan Wolf: And if we go back to maybe the earlier part of the podcast, where I think you were describing quite a close analogy with cigarettes in terms of the impact on health and misalignment, really between companies just trying to make money and the impact on people's health. 

It feels like the responses are all quite cautious. It seems like if you look at the tobacco example, and is that because the reality is it's really just nothing like as bad as tobacco, and after all, who wants to be in a world where you can never have cake or a cookie?

So does that mean that it's just not analogous, or is it that this is all new, and like everything new, it's going to take us another five or 10 years to just realize how serious this is? So we'll be sitting here in 10 years' time saying, well, we were mad to think that we wouldn't need to take much stricter rules on this because basically it's like putting something poisonous in the water.

You change the regulation so you can still have food after all. Nobody's saying you can't have cake, but we just can't have any more of this ultra-processed cake. 

Prof. Brian Elbel: So I think it's a combination of both of those things. People love food. I love food. I mean, this is something that is pretty ubiquitous. It's very culturally driven. It's a huge part of life. 

Jonathan Wolf: We all love food. 

Prof. Brian Elbel: And we all need to eat. So it is a harder class of products to go after than something like cigarettes. You could demonize cigarettes, you could demonize cigarette companies, and in a way that is much, much, much harder to do with food. So I think that that's a big part of it. 

I think partly because of that, I think it is harder to sort of shoulder or gather the political will to do a lot of these population-level solutions.

I mean, even things like taxes, we don't even have them everywhere in the states. It's only a handful of cities and counties that have done these things in some states.

Tim Spector: But isn't that the lobbying of the big food companies stopping the politicians acting like they did for decades in cigarettes, they delayed legislation. They've got huge budgets to impact what goes on in DC and in London? 

Prof. Brian Elbel: I think that's absolutely a huge part of it. And there being a different sort of popular uprising for some of these policies in a way that maybe is quite different than for cigarettes, right?

I think that there was a kind of a clear understanding that cigarettes were bad, and there was a problem, and there was a clear villain in someone to go after. I think when you combine some of that lobbying with this general sort of, but I like those foods, it even becomes trickier to make broader policy-level change there.

Jonathan Wolf: So, Brian, to come to the conclusion. What would your advice be to individuals who are navigating this food system that's clearly stacked against them? 

Prof. Brian Elbel: I would say pay attention to what's driving you to eat particular things. And if it's driving you to eat things that you don't like, try to think about why.

What is it, and how would you like to make the healthier choice, the easier choice? And what are some policies that you can maybe do to do that? 

I think that is, should be a real goal of policies to make the healthier choice, the easier choice. And that's something that I think we can make some movement on, and we're just not quite there yet.

Jonathan Wolf: I think that's really interesting. We talk a lot about mindful eating at ZOE, and it's this sort of realization that a lot of what we're doing with food is, we're not even aware sometimes that we're even eating.

You're snacking and you don’t even realize, you're definitely often not aware of what you're eating, and you're almost suddenly not aware, truly, of what you're eating,  what is actually inside it, and therefore what is its health impact on you.

What we've seen is that when people start this mindful eating and they start to get into this habit, those three things together can have quite a profound impact. 

Because I think anyone listening to this, I doubt that anyone is more keen to eat Pringles. I'm definitely totally shocked that it's not even a potato, and so obviously affects you and it doesn't mean that you're not necessarily going to snack anything, but you might be like, Well, I could quite happily switch to a whole bunch of other things that I suddenly realize so much healthier.

So I love this idea of being mindful, helping you to understand, is suddenly empowering you to make more of a decision.

Prof. Brian Elbel: So I think being mindful is absolutely part of it and part of the solutions. I would also like it to make it slightly easier for you to grab something that's not a Pringle. 

Jonathan Wolf: Brian, Tim, thank you so much for taking the time. I'd like to try and do a quick summary, and we covered a lot of different things.

The thing I guess that’s really on my mind is this analogy with smoking and, I think, Brian, you said at the beginning that smoking used to be the number one killer, and now, actually, it's diet and nutrition.

But it's sort of been slow growing, and it's not as obvious that it's the food that's killed you as it was with smoking, because you don't just have this one disease that is linked to ultra-processed food in the way that we had lung cancer linked to cigarettes.

So this has been happening secretly around us. And it matters not just because it might affect you or your loved ones, but also it's this enormous burden on the health system, which means that you can't be treating all of these other things.

So it's affecting everybody who's listening. And what's really shocking is it might be a surprise to me, but I think you're both telling me it's not at all a surprise to these massive big food corporations. 

They know about the health impact, but they are chasing their profit motive, and as a result, they're like, Well, it's not our problem, it's not banned by the government, so we're going to keep doing this genius food science to make it so tasty.

But also, I think some people here will be shocked. Some very underhand behavior it sounds like, in terms of intentionally funding science that confuses the issue and says, well, but it's really good against dental decay. So don't worry about the fat that it's going to give you diabetes.

Or funding all sorts of sports movements that focus on exercise, you don't think about this. 

My other big takeaway is I'm totally shocked at what's actually in a Pringle because it is designed to look like a potato chip. 

Tim Spector: There's many other examples about, poor old Pringles, if you get the violins out for them now, but every country in the world, I think you can see them these days.

Jonathan Wolf: But it's a brilliant example, I guess, as you described, of just the complexity of how it's put together. And it's rather extraordinary, as I listen to it, that this is cheaper than just taking a potato. 

So again, explaining how somehow this ultra-processing is actually more efficient, a you were saying, Brian.

The other thing I'm really struck by is how much marketing is going to kids, and that there is all this science that says it's really effective. So you said, stick a character on a food and the kids will eat it more. So all of these foods with these cartoon characters, again, they know that this is targeted to children, and it's going to have an impact on sales. 

But on the other hand, I don't want to leave with no positive news. I think the positive news is this idea, Brian, pay attention to what's driving you to eat something. 

You might not even want it that much as you start to think about it because of the ways that Tim was describing it, making you want to eat more.

There are things that governments could do around taxes, about restricting marketing, about food labels, and there's evidence from certain countries starting to do that, that this can have an impact. 

So if anyone's listening to this and wants to do more, then the question is, well, how could you lobby at your local level to start to make those changes?

I guess you didn't say this, but I think my take on this is the idea that we would ever restrict smoking 40 years ago seemed mad. This was, of course, that's how it all has to be. 

Now we think it would be mad to allow cigarette companies to be advertising to our children, and mad to allow you to smoke indoors, and all these things that have shifted.

So I guess I'm quite optimistic that as we start to understand what's going on here, we will look at it in the same way that we think about lead in the water, and we still have water, and we still all have all this food. 

But if we start to understand this better, which is also why I'm very excited by all of Tim and the other ZOE scientists about UPF, understanding this better could allow us to reduce the UPF and still be able to eat snacks and treats we like.

Am I way too optimistic, or is this possible? 

Tim Spector: No, I think we've definitely reached a turning point. Everyone's talking about UPF now, they weren't talking about it before. 

We're starting to understand what's gone into the food, and now we're starting to get tools like the ZOE app that can empower the individual to make the right choices or steer them towards the right choices without having to give up everything. And I think that's really important. 

Jonathan Wolf: Brian, Tim, thank you so much for coming and joining us today. 

Thank you for having me. 

Tim Spector: Thank you.