Controlled feeding trials to separate ultra-processing from calories
We do not know whether ultra-processed food raises cancer risk because it makes people fat, or because of something in the food itself. Feeding volunteers matched diets for a few weeks and measuring cancer-relevant biology can tell the two apart.
The NIH inpatient trial by Hall (2019) showed people ate about 500 kcal/day more on an ultra-processed diet matched for macronutrients, supporting the adiposity route. Whether additives, emulsifiers, nitrites, sweeteners and packaging chemicals have direct effects on the gut microbiome, inflammation and DNA damage independent of energy intake is untested in humans. Controlled feeding with cancer-relevant intermediate endpoints is the only way to answer it before cohorts with 20-year follow-up mature, and it informs whether policy should target processing per se or energy density.
- Prevention we already have is not deployed · Around four in ten cancers are preventable with tools we already own: vaccines, tobacco control, weight, alcohol, sun and infection control.
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