Highly processed foods and energy drinks do more harm than good—and Americans have a huge appetite for them. That’s bad news for the future health of the country. 

According to a new analysis of data from nearly 41,000 US adults, consumption of ultra-processed foods rose markedly from 2001 to 2018, accounting for nearly 60% of the total calories in the typical adult’s diet in 2018. At the same time, the proportion of minimally processed foods on Americans’ plates dropped from roughly 33% to 27% (Juul F, et al. Am J Clin Nutr. 2022).

If that were not alarming enough, consumption of “energy drinks” is also surging. US sales of these sugar- and caffeine-laden products jumped from $11.05 billion in 2017 to $13.97 billion in 2021. Frequent use—especially on top of a processed food diet—can have many negative health consequences, including weakness, fatigue, nausea, headaches, constipation, and nutrient deficiencies.

In 1999, 34% of all adults were in optimal range for adiposity; by 2018, that dropped to 24%. The number in the optimal glucose range dropped from 59% to 37%. As physicians, we cannot turn blind eyes to these troubling trends.

Because of their astronomical sugar content, energy drinks can severely alter the activity, diversity, and gene expression of intestinal bacteria. They can have negative cardiovascular, neurological, psychological, and GI effects, and they raise the risk of obesity and metabolic syndrome (Alsunni AA. Int J Health Sci. 2015). A recent case study linked energy drinks with atrophic gastritis (AG) and gastric intestinal metaplasia (GIM), which raises the risk of gastric cancer (Garg A, et al. Cureus. 2020).

It’s doubly concerning that energy drinks, like many junk foods, are heavily marketed to youth and young adults, setting them up for decades of metabolic, cardiovascular, mental, dental, and renal disease (Al-Shaar L, et al. Front Public Health, 2017).

Alarming Trends

Given all these trends, should we be surprised that only seven percent of the US population is in optimal cardiometabolic health?

Using data from over 55,000 adults in the National Health and Nutrition Examination Survey, researchers at Tufts University’s Friedman School of Nutrition Science, assessed five core health parameters: blood pressure, blood glucose, blood lipids, adiposity (overweight & obesity), and presence or absence of CVD. They found that only 6.8% of the cohort were in the optimal ranges for all five parameters (O’Hearn M, et al. J Am Coll Cardiol. 2022).

The numbers show an overall downward trend over the last two decades. In 1999, 34% of all adults were in optimal range for adiposity; by 2018, that dropped to 24%. The number in the optimal glucose range dropped from 59% to 37%. 

As physicians, we cannot turn blind eyes to these troubling trends. We need to dive in and find out how much highly processed food and soda our patients are consuming. We need to know who’s leaning on energy drinks to get through the day.

We also need to recognize that some patients try to supplement their way out of poor health using products—especially weight loss, “energy,” or “performance” supplements—that may do more harm than good.

Patients often self-prescribe based on marketing hype or hearsay. While we want to encourage proactivity, we also need to help them understand that some supplements may contain hidden autoimmune triggers that could harm the gut microbiota and cause immune dysregulation. Others may contain undisclosed drugs or adulterants that can seriously disrupt proper physiology.

Focus on the Gut

Processed foods, especially those based on refined grains, are detrimental not only to the gut microbiota, but also to the intestinal barrier, and the immune system. Microbiome dysregulation, and disruption of epithelial integrity are implicated in many GI disorders, including infectious enterocolitis, irritable bowel syndrome, small intestinal bowel overgrowth, and allergic food intolerance (Rinninella E, et al. Nutrients. 2019).

Likewise, changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease (Lerner A, Matthias T. Autoimmun Rev. 2015). Intestinal permeability is linked to a variety of diseases such as Parkinson’s, kidney disease, metabolic syndrome, type 2 diabetes, and CVD (Conlon MA, Bird AR. Nutrients. 2015).

Consumption of ultra-processed foods rose markedly from 2001 to 2018, accounting for nearly 60% of the total calories in the typical US adult’s diet in 2018.

Restoring health requires a shift to a balanced, micronutrient-dense diet. The most effective ones include the Mediterranean (without refined grains), Primal, Paleo, gluten-free and Wahls Protocol. Whatever specific diet someone chooses, it should include: plenty of vegetables, legumes, and fruits, lean protein, and healthy natural fats and oils (like olive oil, avocado oil, grass-fed butter). It should also cut processed fats (especially soy and corn oils), sugar, refined carbs, and sweetened foods and beverages.

It is very important to identify individual autoimmune triggers, so patients can learn to avoid specific foods that are problematic for them. Many people are unaware that their GI distress, autoimmune symptoms, or even cognitive decline may be related to food triggers. Identifying these triggers objectively can be life-changing for many people.

Cyrex Laboratories, a clinical lab specializing in functional immunology and autoimmunity, has developed a wide array of tests to aid in elucidating food triggers. Cyrex’s Array 2 evaluates intestinal integrity, including transcellular damage and paracellular tight junction permeability issues. Array 2 also detects antibodies to bacterial lipopolysaccharides, which can be highly inflammatory and have been linked to many disorders, including neurodegenerative diseases.

Array 3X comprehensively evaluates wheat and gluten antibodies, as well as antibodies to gluten-related self-enzymes. Array 4 identifies foods that are cross-reactive to gluten. It also serves as a thorough anti-dairy antigen profile, and evaluates reactivity to newly introduced foods as well as the most commonly eaten foods.

Chad Larson, NMD, DC, CCN, CSCS, is on the Clinical Consulting Team for Cyrex Laboratories. He holds a Doctor of Naturopathic Medicine degree from Southwest College of Naturopathic Medicine and a Doctor of Chiropractic degree from Southern California University of Health Sciences. He is a Certified Clinical Nutritionist and a Certified Strength and Conditioning Specialist. He has particular interests in the fields of endocrinology, orthopedics, sports medicine, and environmentally-induced chronic disease.

Mark R. Engelman, MD., is Director of Clinical Consulting for Cyrex Laboratories. He is also the Founder and President of the Engelman Health Institute. He served for 23 years as the director of St. Joseph’s Medical Center emergency department, and as a standby physician for two American Presidential administrations. He was a president of the Maricopa County American Heart Association, and is Founder and CEO of AmeriMed American Hospitals in Mexico.