Ultra processed food and women's health

Q&A on why this issue really matters if you're female

Today I did my first Q&A about ultra processed food and women’s health, for a sports and health magazine. I thought I’d share it with you. I’m working away on the book, which, if you haven’t heard, is out next Feb! I really liked the questions this journalist asked me, as I thought they cut right to the heart of what this book is going to be about.

Here comes that paywall, this post is only for my paid subscribers…

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Are ultra-processed foods a women’s health issue?

Ultra-processed foods are a health issue for both sexes but there are specific impacts on women - both their bodies and their lives - that it’s important that we don’t overlook in any discussion about UPF. Right from the advent of UPF in the 1950s, women have been heavily marketed to by food companies who even cleverly adopted our very identities in order to present their products as something nurturing and wholesome, “just like mama used to make”! Although we now have more equality between the sexes, in a lot of households women still do much of the shopping and cooking. So the conversation about UPF needs to bear this in mind and make sure it doesn’t just become yet another man made problem that women are expected to carry the burden of solving. Then of course there are the specific impacts of a diet high in UPF on the female body, for example on the menstrual cycle, pregnancy related issues, or menopause.

Is there evidence that UPFs have a more damaging impact on women?

I think you could make a case for this yes, because the female body is both under researched and over medicalised. So high consumption of UPF is potentially exacerbating health issues in women that will then take longer to be diagnosed, as often happens in female health. I have spoken to a lot of women who have told me a similar story, too, that when seeking help for chronic health issues, their diet was never mentioned by health care professionals, and that they were given various prescriptions that didn’t really work. Often they find that the answer is diet through their own research or experimentation. We also know that women over-consume UPF for different reasons to men - usually through stress eating and emotional eating - and also, that obesity rates in adult women are far higher than those in adult men. Women are also then much more likely than men to opt for extreme measures such as bariartic surgery or weight loss drugs. UPF has also been linked to increased risk of both developing and dying from female cancers, specifically breast and ovarian. Conditions that disproportionately affect women, such as auto-immune, are also affected by UPF: for example one study found a 50% increased risk of lupus in women with diets high in UPF. 

What are some of the lesser-known effects of UPFs on women’s health?

Well one area that is particularly interesting is the emerging knowledge about the microbiome, and specifically the female microbiome. So, for example, although people are most familiar with the idea of the gut microbiome, we have a completely different microbiome in our vagina - although there is a relationship between the two, an ‘axis’. So what we eat has an impact on our vaginal microbes, and a diet high in UPF can therefore make us more vulnerable to very common women’s issues like bacterial vaginosis, urinary tract infection, and even endometriosis. In pregnancy, dysbiosis of the vaginal microbiome could also be related to adverse outcomes such as preterm birth. All of these areas are still being understood, but in the meantime, eating less UPF, and eating more fibre and plants could probably have a positive impact.

Could some of the symptoms or conditions we accept as ‘bad luck’ or a natural part of the menstrual cycle, menopause or ageing process actually be caused by or exacerbated by UPF? 

Yes I think this is absolutely spot on! Not just ‘bad luck’ but almost worse than that, ‘bad luck you drew the short straw - you’re female’! As if being a woman means that a lifetime of health struggles of one sort or another are a given. It was looking into menopause for a different book I’ve been working on that first got me thinking about diet, in particular when I discovered there are some parts of the world and some cultures that don’t really talk about menopause as a problem and don’t medicalise it all. And those cultures all have something in common - a non UPF diet that is high in all the obvious things we know are good for us, vegetables, fruit, pulses, nuts, seeds, fish etc. It’s not rocket science - we just need to start looking to diet as the first port of call with any women’s health issue, rather than the last. 

What is the most surprising or alarming discovery you’ve made about the link between women’s health and UPF?

I think the mental health link is perhaps surprisingly strong. A lot of women really struggle with depression and mental health, and even, as I’ve said, turn to UPF as a ‘comfort food’, the classic ‘crying and eating ice cream out of the tub’ scenario. When you realise that rather than making us feel better, this UPF consumption could actually be driving our mental ill health, that is actually quite concerning. Recent research has linked UPF to a 22% increased risk of depression, and another study showed that middle aged women eating high levels of UPF have a 50% higher risk of depression than women eating lower levels of UPF. Again, depression in middle age is something women almost come to expect as part of the female package, and may put down to ‘hormones’ or even blame themselves, their relationships, their life choices etc. But what if a change in diet could transform their emotional state? That could be life changing – or even life saving – we know that suicide rates in middle aged women in the UK have risen in recent years – and in the US, where UPF consumption is the highest in the world, they are described as ‘soaring’. What if diet was to blame?

Any foods or ingredients we should be especially wary of?

I think that’s the million dollar question at the moment! But on the other hand, I think we should also be wary of becoming obsessive over UPF, because anxiety over food is also very much a women’s issue and can in itself lead to ill health. Once you start looking at food ingredients you begin to realise that a LOT of our standard products, even things like tinned lentils and pulses that can contain preservatives, qualify as UPF, and that cutting it out completely is going to be extremely difficult. So I would advise taking a slightly laid back approach, focusing on changing your cooking and eating habits gradually. For most of us, UPF has been in the shopping trolley all our lives, so this is not something we can fix overnight. For a good place to start, I would say have a rethink about breakfast. Most boxed cereals and most supermarket breads are really highly processed. So start your day with pancakes or porridge rather than coco pops or toast and you’re already off to a great start! 

How can we begin to take back control of our diet and food choices? Any top tips?

I think it’s about rethinking the role that food and food preparation plays in our lives, and reprioritising it. We need to think like the French, with their passion for food production, their national pride in it, and their long, family orientated meal times. In a world that is becoming increasingly disconnected and dehumanised, with everyone on little screens, food offers us an opportunity to come together, cook and talk about food and recipes, savour flavours, laugh, make eye contact, and hear each other’s stories. I think if we rediscover these pleasures that have been such a core part of human existence for millennia, our UPF consumption will drop automatically. Added to this, I think we need to change our expectations - we have got so used to being able to have quite complex meals at the drop of a hat, from different cuisines all over the world. More simple plates, like pasta, salads, good cheeses, decent bread, meat, fresh veg - these can all be insanely delicious and quick to prepare. We probably need to pick quality of ingredients over variety of dishes. 

What is your own approach to UPF like now? Have your food choices changed, and have you noticed any changes to your own health as a result?

I have always loved food and loved cooking, but I’m definitely more mindful now of what’s going in my trolley from a UPF point of view. I am not fastidious about it because I don’t think that’s realistic in a busy life with three children! But yes, I have definitely moved away from some UPF standards like sliced bread, cereal, snack bars and crisps. Over the past few years I’ve been in perimenopause and have tried to increase my intake of phytoestrogens - foods like walnuts, seeds (especially flax seed), apples and oats - in fact I start my day with a big bowl of this! It’s hard to say as I am only a sample of one, but it’s worked for me in that I’ve got through menopause fairly unscathed and so far I’ve not taken HRT - not that I am against it, but I haven’t had hot flushes for example, so haven’t felt the need. It’s different for everyone though - but for me the main takeaway about cutting down on UPF is that this will make space for more fresh produce in your diet and this will definitely improve both your mental and physical health.

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As always I’d love your thoughts in the comments!

Thanks for sticking with me while I write this very complex book! Milli x