Current Treatment Options in Gastroenterology

, Volume 17, Issue 4, pp 577–586 | Cite as

Beyond the Calories—Is the Problem in the Processing?

  • Janese Laster
  • Leigh A. Frame
Obesity and Nutrition (O Pickett-Blakely, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Obesity and Nutrition


Purpose of review

The purpose of this review is to describe the trends in dietary patterns and food quality over time along with the possible role of ultra-processed foods in obesity, chronic diseases, and all-cause mortality in the US population.

Recent findings

There is a rising obesity epidemic, corresponding chronic diseases, and increases in ultra-processed food consumption. In mice and in vitro trials, emulsifiers, found in processed foods, have been found to alter microbiome compositions, elevate fasting blood glucose, cause hyperphagia, increase weight gain and adiposity, and induce hepatic steatosis. Recent human trials have found ultra-processed foods as a contributor to decreased satiety, increased meal eating rates, worsening biochemical markers, and more weight gain. In contrast, Blue Zone, indigenous South American, and Mediterranean populations with low meat intake, high fiber, and minimally processed foods have far less chronic diseases, obesity rates, and live longer disease-free.


As the USA continues to industrialize, food has become more processed and cheaper and more convenient along with the coexistent rise in obesity prevalence. This review highlights the overall trends in food: mild improvements in dietary quality in higher socioeconomic populations, but no significant increases in whole fruit, vegetables, legumes, or nuts. Consumption of ultra-processed food is associated with weight gain and may contribute to metabolic syndrome and chronic disease. To combat this epidemic, we must create and disseminate detailed recommendations to improve diet quality and overall nutrition.


Obesity Dietary trends Ultra-processed foods Emulsifiers Calories Fiber 


Compliance with Ethical Standards

Conflict of Interest

Janese Laster declares that she has no conflict of interest. Leigh Frame declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Janese Laster
    • 1
  • Leigh A. Frame
    • 2
  1. 1.WashingtonUSA
  2. 2.The George Washington School of Medicine and Health SciencesWashington, DCUSA

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