766483

research-article2018
AJLXXX10.1177/1559827618766483American Journal of Lifestyle MedicineAmerican Journal of Lifestyle Medicine

vol. 12 • no. 5 American Journal of Lifestyle Medicine

Analytic Joel Fuhrman, MD

The Hidden Dangers of Fast and

Processed Food*
Overview then we find that 88% of Americans are many people don’t realize the harm that
overweight. And out of the processed foods have on Americans
The fundamental concern as we look approximately 10% that are of normal living in urban areas where they don’t
to reform health in America is the known weight, the majority of those so-called have easy access to whole, fresh foods.
reality that most chronic diseases that “normal weight individuals” are either These unfortunate folks live in what we
afflict Americans are predominantly cigarette smokers, or suffer from call “food deserts,” with reduced
lifestyle induced; and the belief is that alcoholism, drug addiction or availability to fresh fruits and vegetables.
the vast majority of heart attacks and dependency, autoimmune disease, occult Because of the limited access to
strokes could be prevented if people cancers, inflammatory disorders, supermarkets, they eat more unhealthy
were willing to adopt healthy lifestyle autoimmune conditions, digestive fast and processed foods and end up
behaviors. In addition, healthy lifestyles disorders, irritable bowel syndrome, and having 7 times the risk of early-life stroke
would impact a significant number of other illnesses that lower their body (before age 45), putting people in
cancers which are also believed to be weight. Therefore, perhaps that only nursing homes in their 30s, 40s, and
related to lifestyle exposures, especially about 5% of the American population is 50s.4-7
to obesity, cigarettes, and other toxins. at a normal weight as a result of eating The vulnerable poor in these areas also
Over the past 50 years, the health of healthy and living a healthy life. A recent have double the risk of heart attack,
Americans has gotten worse, and now study documented that only 2.7% of double the risk of diabetes, and 4 times
71% of Americans are overweight or Americans adopt a relatively healthy the risk of renal failure8-10; Unfortunately,
obese—not 66%, which was reported 5 lifestyle by combining exercise with the decrease in life span due to food
years ago.1 That means a staggering 100 healthy eating.3 The Standard American inequality is shocking but rarely
million people in America are obese. Diet (SAD) is clearly not a healthy diet. discussed. A substantial proportion of
Today, eating processed foods and fast I use the term “Fast Food Genocide” people in these urban environments are
foods may kill more people prematurely because most don’t understand the depth overweight, prediabetic, or fully diabetic.
than cigarette smoking.2 and breadth of the harm as a large Researchers determined that compared
Authorities determined the 71% figure segment of our society eats a diet worse with other areas in America with easy
by classifying people with a body mass than the dangerous SAD. Many people access to supermarket food, that the
index (BMI) over 25 kg/m2 as overweight recognize that junk food, fast food, YPLL (Years of Potential Life Lost) for an
or obese. Yet in long-lived societies such processed food, white flour, sugar, maple overweight diabetic living in a zone
as in the “Blue Zones” (Ikaria, Greece; syrup, honey, agave nectar, and all the classified as a food desert was a
Sardinia, Italy; Okinawa, Japan; the junk people are eating contribute to in shocking 45 years!11,12
Nicoya Peninsula of Costa Rica; and obesity, diabetes, heart attacks, strokes, A link may even exist between fast
Loma, Linda California) and wherever we dementia and cancer, but many don’t food, processed food, commercial baked
find groups of centenarians, we observe realize the strong causative role an goods, and sweets and destruction of
a healthy BMI below 23 kg/m2, not 25 unhealthy diet may have in mental brain cell and a lowering of intelligence.
kg/m2. If we use above 23 kg/m2 as the illness. Currently, 1 in 5 Americans Candy and sweetened baked goods may
demarcation for overweight or obesity, suffers from a psychiatric disorder. And even stimulate the brain in an addictive

DOI: 10.1177/1559827618766483. From Health Science Faculty, Northern Arizona University, Flagstaff, Arizona and Nutritional Research Foundation, Flemington, New
Jersey. Address correspondence to: Joel Fuhrman, MD, Nutritional Research Foundation, 4 Walter E. Foran Boulevard, Flemington, NJ 08822; e-mail: drfuhrman@
drfuhrman.com
*Condensed and adapted from Fast Food Genocide (HarperCollins 2017) for a lecture given at the ACLM annual conference Tuscan, Arizona, October 2017.
For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
Copyright © 2018 The Author(s)

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fashion, which can lead to more serious anorexic, and unhealthy? Would their vegetable-based, utilizing a wide
illnesses. bones fall apart? Obviously not! When assortment of colorful vegetables, root
The nutritional fundamentals you moderately caloric-restrict, even a vegetables, green vegetables, peas,
accepted by the World Health small amount such as 50 to 100 calories beans, mushrooms, onions, nuts, seeds,
Organization and most nutritional a day, weight remains about the same, and some intact whole grains. While the
authorities today include vegetables, the person is slim, not too thin, and standard American diet and most
beans, nuts, seeds, and fruit as healthy healthy. He or she will have a lower traditional diets are grain-based and lack
foods; and salt, saturated fat, and body fat percentage, and the skeletal sufficient exposure to the broad
excess sugar as disease causing. mass, bones, and muscle mass are spectrum of antioxidants and
Excessive amounts of animal products strong. In this scenario, the metabolic phytochemicals (with their anticancer
may lead to premature aging, increased rate would slow down accordingly. The effects), it is important to note that not
risk of chronic disease and higher respiratory quotient, (the number of all plant-based diets are equally
all-cause mortality. Multiple studies calories lost through respiration) would cancer-protective. As an example, a
have been published on hundreds of decrease, the body temperature would rice-heavy, macrobiotic diet limits
thousands of people, followed for lower, and thyroid function would phytochemical diversity, and brown rice
decades showing that the objective decrease slightly, all lowering the produced in this country is contaminated
endpoint of death is increased with metabolic rate, which overall may result with arsenic, extensively documented by
higher amounts of animal product in a slowing of the aging process. The Consumer Reports and white rice is
consumption.13-17 Furthermore, refined secret to a long life and freedom from refined, high glycemic food, and
carbohydrates may not just lead to chronic disease may be simply to therefore not a healthy starch.
being overweight and diabetic but also moderately reduce calories in order to In comparison, the SAD is almost the
contribute to dementia, mental illness, slow down our metabolic rate. The only opposite of a nutritarian diet. Over 55%
and cancer.18-21 There is considerable behavior proven scientifically to of the SAD’s calories are processed
evidence today that heart disease is not dramatically increase life span in every foods, and about 33% of calories come
only promoted by saturated fat and species of animals, including primates, is from animal products. If we are looking
increased animal products but also by to lower caloric intake while maintaining at the amount of fresh produce (fruits
refined carbohydrates, including white an environment of micronutrient and vegetables) consumed in America,
rice, white bread, sugar, honey, maple adequacy, assuring that we have the food consumption data reports about
syrup, and agave nectar.22-25 exposure to every micronutrient humans 10%; but in actuality, it is less than 5%,
Research has shown that excess need. The American diet is also deficient because they include French fries and
calories shorten lifespan, whereas in antioxidants and phytochemicals that ketchup in the definition of “produce!”
moderate caloric restriction slows the are needed for normal immune function, The point here is that processed foods
aging process and protects the body for maximizing brain health, protecting such as bread, pasta, salad oil,
and brain. Americans consume more against dementia, chronic illness, cancer, mayonnaise, doughnuts, cookies, rice
calories than any other population; and and premature aging. cakes, breakfast bars, chips, soda, candy,
they consume foods, many of which A nutritarian diet is designed to and popcorn do not contain a significant
have minimal or no nutritional value establish excellent micronutrient intake micronutrient benefit. A piece of chicken
(soda and alcohol as examples). So let’s without excess calories. A nutritarian diet is like a bagel, because they are both
consider the individual who is is designed to help prolong human life rich sources of macronutrients (calories),
consuming 50 excess calories per day. span, decrease the risk of cancer, and but neither one contains the necessary
What will be the short- and long-term keep the brain functioning well for many amounts of micronutrients, especially the
result? Fifty excess calories per day, over years. This principle is represented by antioxidants and phytochemicals only
and above your basic metabolic needs, the equation I use: H = N /C, which found in plants.
over a 10-year period, adds about 50 means your healthy life expectancy (H) The high glycemic white flour products
pounds of extra body weight. The is proportional to the micronutrient (N) with added sweetening agents, flood the
excess weight increases the risk of per calorie intake (C) over your life span. bloodstream with glucose without fiber,
multiple chronic illnesses, cancers, and This means that we are encouraged to nutrients, or phytochemicals; and these
also takes many years of life away from seek out foods that are rich in nutrients. baked goods are also high in acrylamides
the individual simply as a result of We should try to limit or exclude and advanced glycation end-products,
consuming only 50 calories a day too empty-calorie foods and drinks. We further increasing the glycoproteins in
many. should also limit or avoid calorically our tissues. The resulting spike in
Conversely, if an individual consumed dense foods, and not eat for recreation glucose leads to abnormally high
50 calories a day less that their metabolic or when we are not hungry. amounts of insulin, which will also
requirements what would happen then? A nutritarian diet is rich in promote angiogenesis, which fuels the
Would he or she become too thin, phytochemicals and antioxidants. It is a growth of fat cells, increases cellular

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replication and tumor growth. The liberal blood each minute and therefore you lower your drive to overeat.30 This is
amount of animal protein (including won’t need much of an insulin response extremely important, because even a
chicken which many incorrectly believe to deal with this amount of sugar. As moderate amount of extra fat on the
is the more healthy meat) consumed by mentioned above, the buildup of body induces more rapid aging and
most Americans promotes excessive advanced glycation end products (AGEs) increases the risk of diabetes, heart
insulin-like growth factor–1 (IGF-1), accelerates aging and chronic disease.27,28 disease and cancer. A mild degree of
making a synergistic “sandwich” of When a diabetic suffers from kidney caloric restriction becomes comfortable
insulin and IGF-1, which may accelerate failure, blindness, or a leg amputation, a and achievable when the diet is high in
aging of the brain, interfere with cellular major causative factor is the buildup of micronutrients and fiber. When you have
detoxification and repair, and promote AGEs in the tissues. Interestingly, these enough micronutrients and fiber in your
cancer.26 The SAD has created a same glycated end-products and diet, you don’t feel driven to overeat. But
nutritional disaster and a significant glycoproteins build up in the tissues of when you don’t have enough
health crisis that will not be solved by people who are not diabetic but who micronutrients and fiber in your diet, you
governmental “health care reform.” continually expose themselves to excess become a food-craving, overeating
Now when we think about “fast food” sugar and white flour products. machine.
we’re not just referring to the food in fast Next, it is important to understand that Even worse is what happens when you
food restaurants. Fast foods include oils are also processed foods. When eat food fried in oil because fried food
chips, soda, cookies, candy, breakfast consumed, oil enters the bloodstream may create carcinogenic and mutagenic
cereals, bars, French fries, burgers, pizza, rapidly similar to high glycemic aldehydes.31 Food that is fried such as in a
white flour baked goods, and all other carbohydrates. Anything cooked in oil fast food restaurant is usually cooked in
high-calorie, low-nutrient foods that should be considered a fast food. Beans, oil that has been heated and used multiple
people often eat multiple times per day. nuts, and seeds are whole foods whose times. One serving of French fries or fried
These are processed foods and for many, calories are absorbed gradually over chicken that is cooked in a fast food
are the primary source of calories. These hours. In contrast, the calories from oil restaurant has 100 times the level of
fast foods have certain characteristics: are absorbed rapidly, and are largely aldehydes designated as safe by the World
They can be accessed easily and quickly; empty calories (with insignificant Health Organization. Even the fumes are
they don’t need to be prepared; they micronutrients and no fiber)—a so toxic they increase the risk of cancer.
come out of a bag or box ready to go combination that leads to obesity, People working in restaurants that fry the
right into your mouth. You can eat them disease, and premature aging. food, or those working in a movie theater
rapidly and they’re absorbed very If I set up a buffet dinner and I asked making popcorn, have a heighted risk of
quickly into the bloodstream. These fast all the guests to form 2 lines and then lung and other cancers, even if they don’t
foods typically contain multiple gave everyone on the right side a eat any of the fried foods.32
chemicals and synthetic ingredients. tablespoon of olive oil, and each of The explosion of fast food restaurants
They are calorically dense, highly those on the left side an apple to has significantly increased the intake of
flavored, and nutritionally barren. Fast consume while they were waiting in line, fried foods, and people are now eating
foods typically contain extra corn syrup, those who ate the 65-calorie apple will 1000 times the amount of soybean oil
sugar, artificial sweeteners, salt, coloring generally eat 65 less calories from the compared with the early 1900s.33
agents, and other potentially disease buffet. But those who had the 120-calorie Humans never ate 400 calories of oil a
promoting chemicals. tablespoon of oil will not usually day the way people do in America,
When calories flood the bloodstream consume 120 calories less. The oil especially in the Southern states—which
rapidly they have dramatic biological contains neither fiber, nor micronutrients are known for the highest stroke and
effects. Let’s compare 200 calories of and contains nothing to decrease the heart attack rates in the world.34 When
white bread to 200 calories of beans. The appestat. A matter of fact, if you put oil you use nuts and seeds as your source of
white bread would be metabolized into on food, it may actually increase one’s fat as opposed to oil, we see the
simple sugars (glucose) which enters the appetite. Not only will these individuals opposite effect.
bloodstream in 5 to 10 minutes. This not eat fewer calories—they will eat even The Physician’s Health Study, the
requires a rapid increase in insulin; and more than the 120 calories from the oil.29 Nurses’ Health Study, Iowa Women’s
the rapid insulin response will remain for When added or mixed into food, oil Health Study, the Adventist Health
hours. On the other hand, the drives overeating behavior. Study—any study with large numbers of
carbohydrates from beans will take much Nutrients and fiber are needed to people followed for decades—
more time to be digested and, as a result control the appestat, so you consume a demonstrates the relationship between
these calories enter the bloodstream healthy amount of calories. My nut and seed consumption and longer
slowly. Essentially, the calories will experience has demonstrated with life span. We always have to give more
trickle in over hours. When eating beans, thousands of patients, the more nutrient credence to clinical research studies that
a small amount of glucose enters the and fiber dense your diet becomes the involve large numbers of people

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followed over decades using objective estimate of 10% of calories as an upper uncomfortable symptoms when they stop
endpoints such as mortality. When you limit of safe consumption is for a person digesting food and the body starts to
do that, you find that people who with favorable genetics and is still likely mobilize waste and repair the damage.
consume nuts and seeds regularly have more animal products than ideal for the They typically interpret these symptoms
lower cancer rates, lower cardiovascular nonelderly adults. It may be the case that as hunger or low blood sugar, because
death rates, lower sudden cardiac death, under 5% of calories from animal they feel better if they eat again—even
less irregular heartbeats, and an increase products would be more ideal for life though there is no biological need for
in life span. span and for facilitating disease reversal. calories at this time; and so they just get
A 2015 meta-analysis that included over Of course, any diet designed to optimize fatter and sicker. Every addiction has a
44 000 deaths demonstrated an almost health should include a broad array of “high” during the caloric rush and a
40% decrease in cardiovascular mortality colorful plants with phytochemicals and “low” during withdrawal and repair from
for people eating nuts and seeds antioxidants, which have been shown to the disease-causing diet and resultant
regularly (one serving a day). The increase life span and prevent cancer. metabolic wastes and toxins that accrue
European PreviMed study, which The animal products served at fast food from it. The American diet results in
randomized 7216 individuals to nuts or restaurants are making the health of the withdrawal symptoms and discomfort
olive oil as part of a Mediterranean diet population much worse, creating which promotes overeating and too-
showed a 39% decrease in all-cause dangerous carcinogens from the food frequent eating. The lower the quality of
mortality in the nut eaters.35 being grilled, barbecued, and fried at the food consumed, the more discomfort
When we look at the health high temperatures. The World Health felt when not eating and digesting,
implications of animal protein we should Organization has classified processed which makes it very difficult to maintain
compare this type of nutrition with meats (hot dogs, sausage, bacon, and a healthy body weight.
plant-based proteins, especially when an lunch meats) a class 1 carcinogen. AGEs If you’re healthy and eating nutritious
individual has cardiovascular disease, are also highest in barbecued and fried food, you feel nothing when you enter the
diabetes, obesity, or even cancer. When animal products which also contain catabolic phase, with no desire to eat again
your protein comes from beans, nuts, cancer-causing chemicals such as until glycogen stores are nearly exhausted.
seeds, and greens, the body more heterocyclic amines, polycyclic aromatic True hunger is a mild sensation felt in the
gradually assimilates a complete array of hydrocarbons, and lipid peroxidases, throat and base of the neck. True hunger
amino acids to make functional proteins which are mutagenic. heightens taste sensitivity too, making
and hormones, keeping IGF-1 There are 2 phases of the digestive eating more pleasurable. True hunger
production much lower. Adequate cycle: the anabolic phase, when you are directs when you should eat and therefore
amounts of plant protein keep IGF-1 in eating and digesting, and the catabolic it’s more difficult to become overweight if
that moderate range, between 100 and phase, when digestion has ceased. When you pay attention to the signs your body
175, which is where it should be. The you are eating and digesting food, the sends to your brain. Being overweight
average American’s IGF-1 level is around body turns those calories into stored requires eating outside of the demands of
225, which is a level which has been glycogen, increasing fat storage and the true hunger, either recreationally or
linked to cancer promotion. When we storage of waste. During this phase of because of withdrawal symptoms from
eat a variety of plants, we get a full the digestive cycle, growth hormones improper eating, stimulating the
balance of amino acids, which slowly and fat storage hormones are activated. overconsumption of calories.
enter the blood—and we also digest When your body is finished digesting, Enhanced detoxification—reduction of
some of the bacteria in the digestive you enter the catabolic phase, where the metabolic waste, aldehydes, and
track and some of the cells that slough stored glycogen and fat are utilized for AGEs—occurs most effectively in the
off of the villi endothelium, enabling the energy. This is the phase when your catabolic phase. That means the longer
utilization of partially incomplete plant body can most effectively detoxify and you live in the catabolic phase of the
proteins, now made complete. enhance cellular repair. It is the time digestive cycle, the longer you live. If
Conversely, when you eat large portions when the liver and kidneys work you finish dinner earlier or have a lighter
of meat, eggs, or cheese, the amino acid together to remove aldehydes, AGEs, and dinner, and you have a 13-hour window
mix enters the bloodstream faster and other toxic metabolites. Repair and between the end of dinner and the start
because it is already biologically healing is enhanced during the catabolic of breakfast, you are going to live longer.
complete, it stimulates excessive amounts phase when you are not eating food. A recent study had women with breast
of IGF-1, again increasing the risk of Most Americans have made their bodies cancer followed for 10 years and found
cancer.36-43 so toxic, that when they enter the that those who finished dinner earlier
The average American consumes 10 to catabolic phase of the digestive cycle, and had a 13-hour window before the
20 ounces a day of animal products, they feel uncomfortable. That means start of breakfast had a 26% reduction in
whereas the safe level of consumption is they feel fatigue, headache, stomach the risk of death or recurrence from
likely less than 10 ounces per week. My cramping or fluttering, anxiety, or other breast cancer.44,45 The increased

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nighttime window was also linked to hand. With good information, emotional Ethical Approval
improved glycemic control and a lower support, increased food availability and
HbA1c (glycated hemoglobin). They had food preparation instruction, we have Not applicable, because this article does not contain any
studies with human or animal subjects.
no better diet, no different number of found people enthused and willing to
calories, no better food; they just finished work together for change. They don’t
dinner earlier. have to be convinced of the tragic Informed Consent
The goal for excellent health is to eat dangers of fast food; they see the Not applicable, because this article does not contain any
as infrequently as possible. Many people obesity, diabetes, leg amputations, studies with human or animal subjects.
believe just the opposite and eat frequent strokes, and blindness all around them.
small meals that increase endothelial But if people don’t have good
dysfunction leading to an increased risk information, then they don’t have a Trial Registration
for arteriosclerosis and cardiovascular choice. If they don’t have access to Not applicable, because this article does not contain any
disease. In addition, all the fad diets healthy, affordable food, and they don’t clinical trials. AJLM
encourage people to make the wrong know how to make it taste good, then
choices about what and when to eat. they are not given a chance to change.
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