Researchers at the Johns Hopkins Bloomberg School of Public Health have conducted a groundbreaking analysis. It reveals that a significant majority, more than half, of the calories consumed at home by adults in the United States originate from ultraprocessed foods. These foods contain substances with minimal to no nutritional value, such as colorings, emulsifiers, artificial flavors, and sweeteners. A wide range of products fall under this category, including common items like chips, hot dogs, and prepackaged meals.

Uncover the Hidden Calorie Sources in Home Cooking

Understanding Ultraprocessed Foods

Ultraprocessed foods encompass a vast array of products beyond just the typical notion of "junk food" or "fast food". They include most of the items found on grocery store shelves. This study used data from the 2003–2018 National Health and Nutrition Examination Survey (NHANES), which surveyed over 34,000 adults aged 20 and above. On two separate days, participants were asked about their recent food consumption and where it took place. By using the Nova Food Group Classification, foods were categorized into four groups: unprocessed or minimally processed, processed culinary ingredient, processed, and ultraprocessed.Artificial ingredient and color-containing foods, such as many fast foods and prepacked grocery store meals, were classified as ultraprocessed. On the other hand, fruits, vegetables, and other whole foods, including frozen and dried varieties without added salt or other ingredients, were considered minimally processed.Overall, ultraprocessed foods made up more than half of all home-consumed calories, increasing from 51% in 2003 to 54% in 2018. Interestingly, there were only minor differences in trends of ultraprocessed food intake at home based on sex, age, race/ethnicity, income, and education during the study period. In some years from 2003 to 2018, ultraprocessed food intake at home was slightly lower than 50% for two groups: Hispanics and higher-income households. However, the proportion of at-home calories from ultraprocessed foods never dropped below 49% for the high-income group or 47% among Hispanics.

Impact on Health and Consumption Patterns

Consuming high amounts of ultraprocessed food has been associated with various chronic health conditions, such as cardiovascular disease, obesity, and colorectal cancer. About one-third of all calories came from eating away from home. For those with less than a high school degree, the away-from-home consumption of ultraprocessed foods increased by nearly eight percentage points, from 59.2% in 2003 to 67.1% in 2018. Among individuals with a high school degree or more, this proportion hovered around 60%.Overall, the proportion of total calories from minimally processed foods decreased by nearly five percentage points from 33.2% in 2003 to 28.5% in 2018. Minimally processed food intake declined both at home and away from home for most groups. This highlights the challenges of procuring and preparing fresh vegetables, meat, and fish, as ultraprocessed foods are often easier and faster to prepare, and more cost-effective and shelf-stable.

Call to Action

The authors emphasize the need for strategies to assist people in choosing less processed foods and avoiding unhealthy ultraprocessed foods, whether for at-home or away-from-home consumption. Strong nutrition labels that warn of high ultraprocessed food content may also be necessary. It's crucial to address these issues as the study period predates the pandemic and does not reflect recent changes in at-home food consumption.The study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (#K01DK119166) and the National Heart, Lung, and Blood Institute (R01 HL153178 and T32 HL007024).Trends in Adults’ Intake of Un-processed/Minimally Processed, and Ultra-processed foods at Home and Away from Home in the United States from 2003–2018 was written by Julia A. Wolfson, Anna Claire Tucker, Cindy W. Leung, Casey M. Rebholz, Vanessa Garcia-Larsen, and Euridice Martinez-Steele.

On Saturday mornings, a dedicated group of Duke University School of Medicine students, who are on the path to treating cancer or performing surgeries in the future, come together. Their purpose? To ensure that the residents of Durham County have an adequate supply of nutritious food. This is a crucial aspect of their work as they strive to make a positive impact on the community.

Transforming Patient Care through Fresh Produce

Origins and Growth of the Program

The Fresh Produce Program is an integral part of Root Causes, a medical student organization committed to addressing the social determinants of health. It delivers fresh food to families in Durham County twice a month. In 2020, it started as a small initiative but has now grown into a direct-to-door delivery model, supporting around 450 community members. This growth has been made possible by a collaborative network involving medical school students, undergraduates, and faculty from Duke Health and Duke University. They have formed partnerships with various community organizations like Farmer Foodshare, the Food Bank of Central and Eastern North Carolina, El Centro Hispano, and Bagging It 4 Kids.Local fresh foods such as watermelon, collard greens, sweet potatoes, and onions are delivered along with recipes to inspire healthy eating. The program has no time limit, providing continuous support to families as long as they need it and live in the area.

Challenges and Opportunities Ahead

Although the program has achieved significant success, it now faces a crucial moment. Relying heavily on student volunteers who balance their service with rigorous academic schedules, it has reached its limits. As a small non-profit, it has unique legal and financial demands. Additionally, there is more interest from Duke providers who want to refer their patients than the program can handle with its current resources. To sustain and expand, the program is exploring a transition to become an independent entity within Duke. This could unlock new funding sources and provide the necessary organizational structure for growth."We've always been driven by the energy and creativity of our students," said fourth-year medical student Trevor Sytsma, a leader of the program. "But now, we're focused on building a sustainable model that can meet the growing needs of our community while maintaining our innovative spirit."

The Link between Food Insecurity and Health

Food insecurity and obesity often go hand in hand, which is a surprising paradox for those struggling to get enough to eat. When people face food shortages, they often turn to cheaper, unhealthy food options. These foods are highly processed, contain high levels of salt, and are rich in easily digested carbohydrates. They do not provide a lasting sense of fullness, leading to increased food consumption. Research shows that limited access to nutritious food also makes it more difficult to manage conditions like diabetes.The Fresh Produce Program stands out by focusing not only on hunger but also on nutrition. It recognizes that food is a key part of a person's overall well-being. Scott "Esko" Brummel, the program manager and assistant director for Food and Nutrition Security in Duke's Office of Community Health, and his colleagues are researching how the program is affecting health outcomes.This innovative approach is a reflection of the people behind it. The Fresh Produce Program is one of the few, if not the only, medical school-led initiatives of its kind. It shows the type of students that Duke Medical School admits - those who focus on treating patients as whole individuals, beyond their condition or disease."If the medical school had been admitting a different type of person, I don't think this club would have gotten started, and it would never have continued to succeed through the years," said Spratt.You can support Root Causes by making a pledge to Duke Health at: https://www.gifts.duke.edu/dukehealth?designation=399000173