HJNO Jul/Aug 2025

HEALTHCARE JOURNAL OF NEW ORLEANS I  JUL / AUG 2025 25 121 Warner, J. O. (2024). Artificial food additives: hazardous to long-term health?. Archives of disease in childhood, 109(11), 882-885. 122 McCann, D., Barrett, A., Cooper, A., Crumpler, D., Dalen, L., Grimshaw, K., ... Stevenson, J. (2007). Food additives and hyperactive behaviour in 3-year-old and 8/9-year- old children in the community: A randomized, double-blinded, placebo-controlled trial. The Lancet, 370(9598), 1560– 1567. 123 Miller, M. D., Steinmaus, C., Golub, M. S., Castorina, R., Thilakartne, R., Bradman, A., & Marty, M. A. (2022). Potential impacts of synthetic food dyes on activity and attention in children: A review of the human and animal evidence. Environmental Health, 21(1), 45. 124 Nigg, J. T., Lewis, K., Edinger, T., & Falk, M. (2012). Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. 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Nature, 514(7521), 181-186. 133 World Health Organization. (2023, July 14). Aspartame hazard and risk assessment results released. https://www.who.int/news/item/14-07- 2023-aspartame-hazard- and-risk-assessment-results-released. 134 Szalinski, C. ( 2022, June 24 2021, March 12 ). Why US parents are choosing European baby formula. The New York Times Wirecutter. https://www.nytimes.com/ wirecutter/blog/us-parents-european-baby-formula/:contentReference[oaicite:7]{index=7} https://www.nytimes.com/wirecutter/blog/us-parents-european-baby- cancer, type 2 diabetes, mental health disorders, and all-cause mortality. 139 • A study published in JAMA Internal Medicine followed over 44,000 adults and found that every 10% increase in the intake of UPFs was associated with a 14% increased risk of all-cause mortality. 140 This study adjusted for confounding factors like age, sex, physical activity, and overall diet quality to isolate the impact of UPF consumption on mortality risk. As the consumption of UPFs has surged, children are increasingly neglecting the whole foods essential for their health. 141142 Approximately 50% of children ages 2 to 18 skip discrete fruit entirely on any given day. 143 Research consistently shows that key micronutrients such as cal- cium, iron, potassium, and vitamin D, which are found in fruits and vegetables, are essential for children’s physiological functioning. 144145146 Research also consistently links diets centered on whole foods to lower rates of obesity, type 2 diabetes, heart disease, certain cancers, and mental illness. 147 148 This is not surprising. Diet and lifestyle significantly influence gene expression and cellular biology - ultimately determining our health outcomes. 149 150 For instance: • Leafy greens supply magnesium and folate critical for energy production and other benefits. 151 • Salmon delivers omega-3 fatty acids that help reduce cardiovascular risk and support brain health. 152 153 • Legumes offer fiber and resistant starch that help nourish beneficial gut bacteria. 154 155 • Nuts contain magnesium that helps reduces oxidative stress and enhances activity of mitochondrial enzymes. 156 157 158 • Beef contains protein that maintains skeletal muscle, which plays a key role in regulating metabolic health. 159 160 • Whole milk and other dairy products are rich sources of calcium, vitamin D, and bioactive fatty acids, which support bone health, help regulate inflammation and may reduce the risk of type 2 diabetes. 161 Some of the most compelling dietary intervention data comes from randomized controlled trials (RCTs) of reduced-carbohydrate diets in adults and children to reverse obesity, 162 type 2 diabetes, 163 Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), and risk factors for heart disease 164 such as hypertension. Both UPF reduction and reduced-carbohydrate diets are hypothesized to work by addressing the root cause of these diseases: insulin resistance. 165 While reduced-carbohydrate diets have been studied in several two-year trials, including one with five-year follow-up data, 166 RCTs on UPFs have typically lasted only two weeks, highlighting the critical need for more extensive research, especially with children. The Driving Forces Behind American Children’s Food Crisis UPFs are built into the fabric of the post-WorldWar II American society and economy. The convenience of “fast food”and the food pro- cessing and delivery industry that facilitates them is viewed, internationally, as a distinctly “American” innovation. UPFs have allowed us to save money and to “eat on the run,”but today’s over-reliance on UPFs is damaging the health of American children. This crisis results, in large part, from decades of policies that have undermined the food system and perpetuated the delivery of unhealthy food to our children. Consolidation of the Food System Our agricultural system has historically focused on abundance and affordability. The progress we have made is largely thanks to the hard work of American farmers, ranchers, and food scientists. However, the rise of UPFs has corresponded with a pattern of corporatiza- tion and consolidation in our food system. Today’s diet-related chronic disease crisis, demand a closer examination of this pattern and its broader impact. Key observations include: • Farmers today receive a small share of consumer food spending; in 2023, only 16 cents of every dollar spent on food went to farmers, while 84 cents was absorbed by food manufacturers, marketers, and distributors. 167