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Charles Chen (chrlschn@mastodon.social)'s status on Monday, 18-Mar-2024 23:09:03 JST Charles Chen
- NPR
An @npr article on the link between diets high in processed foods and negative #health conditions fails to mention the socioeconomic angle: cheap, ultraprocessed foods are more economically accessible -- especially in food deserts -- and disproportionately affect the population by #economic strata. Many of the health consequences listed are rather more likely a result of economic disparity.
https://www.npr.org/sections/health-shots/2024/03/18/1238939706/ultra-processed-food-junk-food-disease-cancer-anxiety-depression-diet

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  Paul Cantrell (inthehands@hachyderm.io)'s status on Monday, 18-Mar-2024 23:09:00 JST Paul Cantrell
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  - Misuse Case
  - NPR
  @chrlschn @npr @MisuseCase
  While I’m sure NPR isn’t especially careful about this question, the studies in this meta-review the article’s talking about (https://www.bmj.com/content/384/bmj-2023-077310) are typically going to try to suss out confounding variables like SES, and the meta-review explicitly used “no plausible confounders” as a criterion. The research already have eyes on what you’re talking about; they aren’t fools.
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    Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses
    
    Objective To evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes. Design Systematic umbrella review of existing meta-analyses. Data sources MEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, as well as manual searches of reference lists from 2009 to June 2023. Eligibility criteria for selecting studies Systematic reviews and meta-analyses of cohort, case-control, and/or cross sectional study designs. To evaluate the credibility of evidence, pre-specified evidence classification criteria were applied, graded as convincing (“class I”), highly suggestive (“class II”), suggestive (“class III”), weak (“class IV”), or no evidence (“class V”). The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorised as “high,” “moderate,” “low,” or “very low” quality. Results The search identified 45 unique pooled analyses, including 13 dose-response associations and 32 non-dose-response associations (n=9 888 373). Overall, direct associations were found between exposure to ultra-processed foods and 32 (71%) health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes. Based on the pre-specified evidence classification criteria, convincing evidence (class I) supported direct associations between greater ultra-processed food exposure and higher risks of incident cardiovascular disease related mortality (risk ratio 1.50, 95% confidence interval 1.37 to 1.63; GRADE=very low) and type 2 diabetes (dose-response risk ratio 1.12, 1.11 to 1.13; moderate), as well as higher risks of prevalent anxiety outcomes (odds ratio 1.48, 1.37 to 1.59; low) and combined common mental disorder outcomes (odds ratio 1.53, 1.43 to 1.63; low). Highly suggestive (class II) evidence indicated that greater exposure to ultra-processed foods was directly associated with higher risks of incident all cause mortality (risk ratio 1.21, 1.15 to 1.27; low), heart disease related mortality (hazard ratio 1.66, 1.51 to 1.84; low), type 2 diabetes (odds ratio 1.40, 1.23 to 1.59; very low), and depressive outcomes (hazard ratio 1.22, 1.16 to 1.28; low), together with higher risks of prevalent adverse sleep related outcomes (odds ratio 1.41, 1.24 to 1.61; low), wheezing (risk ratio 1.40, 1.27 to 1.55; low), and obesity (odds ratio 1.55, 1.36 to 1.77; low). Of the remaining 34 pooled analyses, 21 were graded as suggestive or weak strength (class III-IV) and 13 were graded as no evidence (class V). Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality. Conclusions Greater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, and mortality outcomes. These findings provide a rationale to develop and evaluate the effectiveness of using population based and public health measures to target and reduce dietary exposure to ultra-processed foods for improved human health. They also inform and provide support for urgent mechanistic research. Systematic review registration PROSPERO CRD42023412732. To access additional data from this study, the code repository corresponding to the online version of the R statistical package, metaumbrella , can be found on GitHub at . The raw data are available on the Open Science Framework at , and a step-by-step analysis using metaumbrella usage is provided in supplementary table B. For further assistance or inquiries, please contact the corresponding author at m.lane@dealin.edu.au.
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  Paul Cantrell (inthehands@hachyderm.io)'s status on Monday, 18-Mar-2024 23:42:50 JST Paul Cantrell
  in reply to
  - Misuse Case
  - NPR
  @chrlschn @npr @MisuseCase
  My point is that this meta-analysis very specifically finds health effects that are ••not•• fully explained by SES.
  Yes, NPR could also have mentioned SES too and done a public service, but the whole point of these results — the thing that’s actually being reported here — is that researchers assumed like you that “many of the health consequences listed are rather more likely a result of economic disparity,” looked, and found that to be false.
  
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  Charles Chen (chrlschn@mastodon.social)'s status on Monday, 18-Mar-2024 23:42:51 JST Charles Chen
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  @inthehands @npr @MisuseCase While NPR can hardly be considered "mass media", it certainly has wider distribution than the BMJ and source content like research papers. It feels irresponsible for NPR to NOT even make a single mention of #economic drivers of #poverty and poor #health outcomes with respect to diet.
  
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  Chris Johnson (cxj@phpc.social)'s status on Monday, 18-Mar-2024 23:43:07 JST Chris Johnson
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  @inthehands @chrlschn @npr @MisuseCase Exactly. I came here to say this. The actual studies have taken economic factors into account. Whatever criticism one may have of NPR, the negative outcomes of eating ultra refined foods are not due to financial health of the family. Because those same harmful foods are the cheapest just makes our treatment of the poor (and the ultra rich) even more outrageous.
  
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  Paul Cantrell (inthehands@hachyderm.io)'s status on Monday, 18-Mar-2024 23:44:53 JST Paul Cantrell
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  @cxj @chrlschn @npr @MisuseCase
  That’s exactly right. The issue here isn’t that being poor makes ultra processed foods unhealthy; researchers consistently found they’re unhealthy no matter your income. The economic justice issue here is that the most inherently unhealthy foods are the ones we make most accessible to the poor.
  
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  Paul Cantrell (inthehands@hachyderm.io)'s status on Tuesday, 19-Mar-2024 00:10:41 JST Paul Cantrell
  in reply to
  @MisuseCase @cxj @chrlschn @npr
  Yep, all that. So now we’re in the difficult position of conveying two very important messages:
  1. We make it nearly impossible for people who are poor to eat healthy, no matter how much they want to.
  2. Ultraprocessed foods are unhealthy for everyone, no matter who they are.
  Neither one of those messages substitutes for the other. Neither one is secretly just the other in disguise.
  
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  Misuse Case (misusecase@twit.social)'s status on Tuesday, 19-Mar-2024 00:10:42 JST Misuse Case
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  @inthehands @cxj @chrlschn @npr Depending on their family circumstances they may not even have very fundamental cooking skills that you and I take for granted. It’s hard to imagine but if you have grown up in shelters or neglectful families all your life you may not know how to use a stove or oven, how to cook an egg, food safety, etc.
  2/2
  
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  Misuse Case (misusecase@twit.social)'s status on Tuesday, 19-Mar-2024 00:10:43 JST Misuse Case
  in reply to
  @inthehands @cxj @chrlschn @npr Even if poor people have education about good nutritional health (you can’t take it for granted that they do), they don’t have the money or time to buy or prepare healthy foods.
  They may not have a basic working kitchen wherever they live. Like, no working oven or stove.
  1/2
  
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  Michael Dekker (dekk@hachyderm.io)'s status on Tuesday, 19-Mar-2024 00:28:29 JST Michael Dekker
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  - Paul Cantrell
  @inthehands Also the ridiculous tax and food stamps bias against healthy prepared foods in favor of unhealthy processed foods.
  
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