The shocking ways in which ultra processed foods impact women - with Milli Hill

0:02Dr Sophie Shotter:Hi, I'm Sophie and this is Age Well with Dr Sophie Shotter, a space devoted to all things health, wellness and longevity. Because for me, ageing well is about looking and feeling like the best possible version of ourselves, inside as well as out. So together with my producer Fee, I'll be deep diving into the latest research, sifting fact from fiction. I'll also be talking to all kinds of trusted experts tapping into their knowledge, along with bringing you conversations from a range of interesting women and men, finding out how they age well. So, this is my show. Welcome along. And as always, thank you so much for listening.

0:46Dr Sophie Shotter:Millie, you're a writer and journalist with a formidable body of work, largely focused on women and girls. Your book, The Positive Birth Book, has been voted Best Pregnancy Book and sold over 100 ,000 copies to date. The brilliantly titled Give Birth Like a Feminist has been lauded by the press for good reason. You've also written My Period and now you've moved into food with ultra-processed women out in paperback by the time this episode goes live. I think it's probably fair to say the ultra-processed food conversation has been reasonably well socialised, but what we haven't heard about so much is its specific impacts on women.

1:21Dr Sophie Shotter:I'd love to know what surprised you the most in writing and researching the book and perhaps what other women have told you has most surprised them. But before you answer that one, a complex question. Yes. Thank you for that. Thank you for that lovely introduction. But before you answer that one, I know that many people conflate processed and ultra processed foods as the same thing. And we saw a great clip of you at an event talking about exactly that. So would you mind recapping the salient points of why some processed food is OK and a little explainer or the caveats to that? So two questions in one to start with.

1:57OK, yeah, sure, of course. So, yes, I think there is a lot of confusion or there can be a lot of confusion about what ultra processed food is. And I do have a slight conspiracy theory that that is in some ways driven. And it's certainly in the food industry's interest for that confusion to continue, because people who are confused pushing their trolleys around the supermarket are going to perhaps make the wrong choices. So basically, just to try and explain it really clearly, there is this thing called the Nova Scale, which is one way of looking at it, and I think quite a good, clear way. So the Nova Scale has four categories.

2:33You've got your sort of raw ingredients, you've got your whole foods, and then you've got the third and fourth category are processed and ultra processed. So processed food is something that human beings have been doing since the dawn of time for as long as we know. You know, just chopping up an apple is processing it. You're changing it in some way, putting it through a process, cooking a piece of meat, pickling something, making a chutney, making a pie. All of these things are a way of processing food. You're taking that apple and you're turning it into apple sauce. But ultra processing is something quite different.

3:09That's quite a new modern technique. it's all about profit it's all about shelf life it's all about getting the cheapest possible ingredients into something and making you feel like you're getting something great so for example an ultra processed yogurt might say thick and creamy on the front and you might think oh that sounds fantastic you know I love cream and I love thick creamy yogurt wonderful but what's making that yogurt thick and creamy might be a selection of rather strange sort of gums and emulsifiers and things like that to give that sort of what they call in the industry, that mouth feel, which is a rather horrible expression, isn't it?

3:49That makes you think, oh, yummy, this is amazing. And actually, if you flip it over, and I think a lot of people have switched onto this now, that if you flip over that yogurt or whatever the product is and read the ingredients, if it's got a lot of stuff on it that you don't recognize that sound like chemicals, e-numbers and other kind of strange, slightly scientific sounding stuff. That's not food. So processed fine, ultra processed, full of strange ingredients, made for profit, not for health. That's what we're trying to avoid. I was quite surprised that when I looked to try and find how this specifically impacted women, there was actually quite a lot of evidence.

4:30I mean, I wouldn't have been able to write the book if I hadn't found it. So I had been thinking about sort of diet and women's health a little bit, and perhaps we'll come on to that. But when I read Chris Van Tunneken's book, Ultra Processed People, I thought, this is really, really interesting because the female body is so often pathologized, you know, when we're medicalized a lot. And I thought maybe, you know, food could be like a key thing here that we're really overlooking. So then I went to look for the evidence to see whether there was any you know specific spotlights on women's health and ultra processed food and I actually found quite a lot and that's obviously why I then decided that it was enough to make a book but I think so that surprised me and I think one thing that also surprised me is the link between diet and mental health and a lot of women say to me that that's surprised them reading the book as well because I think we tend to think of food as a physical health thing.

5:27And we don't necessarily think that what we're eating could be making us anxious, or sad, or unable to sleep, or worse. So I think those things surprised me, yes.

5:40Dr Sophie Shotter:And actually, what you've just said makes me ask my next question, because we heard you say on the Lizelle podcast, great episode, by the way, that there's so many things we don't know about women's bodies, which if we really dig into the fact that so many medical studies have been and still are predicated on men's bodies, it's actually really shocking. But can we talk about some of the ways that ultra-processed foods impact menopause and perimenopausal symptoms, whether that's bone density or, as you've just said, mental health? And we'd also love you to talk about Western diets versus other cultures and other women's experiences of menopause.

6:16Dr Sophie Shotter:We're kind of shoehorning in lots of questions in one ear again, Millie, sorry. no that's fine I mean it's fascinating to me and and like I just said that was one thing that brought me to writing this book so basically I was working on a different book which is actually going to come out in the summer it's called the body myth um and I was also and this is about three years ago um I was going through my own experience of perimenopause and so and I was writing a chapter about menopause in this book the body myth whilst going through my own experience of menopause. And I write about this in Ultra Process Women because basically I just Googled one question and it kind of changed everything for me.

6:53I Googled how do women experience menopause in other cultures? And the answers that came were so fascinating and changed the way I thought about menopause for myself and sort of led me to write this book in many ways. Because, you know, there are some cultures that don't have words for menopause and there are other cultures that reframe menopause by giving them words that are much more kind of positive and empowering. So I've got some, I think a lot of people now know that in China, it's known as second spring. In the Maori language, it's, I hope I'm saying this right, it's ruahine, which means second woman, but it also means woman of importance or wise woman.

7:38And in Japan, they call menopause koneki, which means a time of renewal and regeneration. So there's all of that psychological side to it. And I think in our Western culture, I mean, the way we treat older women is absolutely appalling. And the way we become invisible, you know, as we age is really noticeable in our culture. So I think that aspect of menopause really impacts on us. But then obviously, there's the diet angle as well. So, you know, looking at cultures where they don't really have words for menopause or they don't really have a concept of it. And obviously, you know, these are all of these cultures are places where they wouldn't really know what a diet Coke was or go ahead.

8:24You can eat this healthy protein bar, you know. And so when you drill into it and you look at what women are eating in these cultures, it really does make a difference. And there is research to support this idea that menopause symptoms can be, you know, dramatically changed. There's a study from Zoe, who I'm sure you're familiar with. They showed dietary change to sort of, I mean, Mediterranean based diet or, you know, no ultra processed foods away from multi-processed and towards lots of whole foods they had a 34 % reduction in menopause symptoms the women in that trial and that was interestingly women who were on HRT and women who are not on HRT so this isn't about saying to women oh you don't need HRT like women in you know this culture don't have HRT all you've got to do is eat a load of sweet potatoes and you'll be fine you know it's absolutely brilliant for women on HRT as well to think about these dietary changes because that can actually make their HRT more effective and, you know, still have a really big impact for them.

9:33So, you know, and with mental health, there's lots of studies around that as well. I mean, all women of all ages are twice as likely to have depression than men, twice as likely to have anxiety than men. But there's one study, for example, that showed middle-aged women on high ultra-priced food diets were 50 % more likely to develop depression. so mental health in midlife is a really big issue and I think it's sometimes something that gets put down to just hormones and you know another sort of thing that we're just supposed to suck up really and put up with but actually there are lots and lots of aspects and angles to it some of it is about how we feel about ourselves and about aging and about how we look some of it is about what we're eating and you know what we're doing to our bodies so and you know it's it's very interesting to dig into that and still take HRT if that's what you want to do.

10:27Yeah. Yeah.

10:29Dr Sophie Shotter:Thank you. Perhaps this is a slight curveball question, but there's been a lot of talk recently around celebrities going ultra thin, almost as if we're headed back to the Kate Moss 90s era. What do you think about Ozempic and other GLP-1s? And I think we have some interesting data emerging around ultra processed food actually causing unwanted weight gain. It might also be interesting to talk about the marketing claims directed at women on many of these ultra processed packaged foods. And I still remember when Special K, which let's face it is a big dose of high GI carbs and an increasing sugar load over the years, was a byword for being healthy and slim.

11:09Dr Sophie Shotter:And looking back, I think a lot of women and girls got really hooked by the messaging of that and then got hooked on actually the sugar content of that particular cereal kept increasing over the years. Many of the ultra processed foods are marketed at women and come from the diet industry angle, you know, with like ice cream called Halo or lots of use of the word sin or sin free. All of those sorts of that labelling that says to women, eat this and you're going to solve your weight problem. And even I even read an interesting thing when I was writing the book that Coke Zero is exactly the same essentially as Diet Coke in terms of ingredients.

11:56It's almost indistinguishable. But they created Coke Zero for men because they knew that men wouldn't buy a product that had the word diet on it and that diet products are essentially for women. I remember reading about that. Yeah, yeah, yeah. Yeah. It's really, really telling, isn't it? I mean, it's just a little soundbite fact that says so much. So yes, you know, all of the pressure to be, to look a certain way and be slim and young is all really focused on women, isn't it? And to your Zempick point, GLP1s, you know, I was thinking about this this morning when I was getting ready for this podcast.

12:38And I was thinking all of the people, in inverted commas, that I have seen in the press being sort of held up as, look, this person has obviously been on the weight loss jabs are female. I can't think of a single man, actually, that I've seen that has been in one of those sort of Daily Mail articles where they say, you know, look how awful they look, basically, because that's what's happening. and we've had some really interesting conversations in my house with my teenage girls about how those women are are being shamed and whether that's okay or not you know like at the recent um awards ceremony where the you know the two was the mother and daughter from the Osborne family for example you know there were lots of pictures going around of them and you know we were having quite an interesting conversation of whether that's okay is it but then sometimes it's like you feel like people are saying what's happening and it's not just about them and how they look It's about what is happening in our culture at the moment.

13:30And that's the thing I find interesting. You know, I think we had this sort of brief blip in time, didn't we? When there was this body positivity thing that happened. I don't know if you remember, if you blinked, you would have missed it. It just literally came and went. It's like, oh, we've got plus size models on the covers of magazines and on the catwalk. And, you know, we're celebrating how women come in all these different shapes and sizes and it's OK to look different. And then now that seems to have just sort of been put aside and the whole focus has gone back onto thinness. Yes. And there is a huge amount of evidence there.

14:05You know, it's well, I would say it's unequivocal that it is our ultra process Western diet that is causing the larger numbers of people who are living with overweight and obesity. And effectively what you've got is one massive industry causing a problem. huge health problems through obesity and another massive industry making loads of money from solving that problem with GLP-1s.

14:32Dr Sophie Shotter:Yeah, so interesting. And this could be an entire podcast episode of itself. I found that since hitting menopause, I'm now post-menopause actually, my gut health has been all over the place to the point I thought I actually might have IBS. I will say, and this is in case it helps other women or men listening, that the one thing that seems to have transformed it is this grass-fed beef organ supplement. So this is a nose to tail, liver, heart, kidney, lung, and spleen supplement. I've checked the ingredients and I'm a vegetarian, but apparently I'm not anymore, but I don't like to eat meat as it were.

15:09Dr Sophie Shotter:This does link into what we've been talking about, which I'm going to circle back to. I saw the founder talk about the fact that he was inspired to create this supplement, let's call it, by his Irish grandparents way of eating back in the day. I thought this was all marketing hype, but do you know what? It has completely worked for me within like two days, not even within weeks. So that's more of an observation than a question, Millie, because I just think this whole idea of going back to how we used to eat and the other cultures you talked about, perhaps eating in a similar way, that is quite interesting.

15:43Dr Sophie Shotter:But the question is, we can't not talk about gut health. Are you as obsessed with gut health as we are on this podcast, as pretty much everyone on every wellness podcast is? Well, I mean, I'm not sure about obsessed because I try really hard, especially in a home where I've got teenage girls, not take anything to the point of obsession when it comes to food. Because I really think that the key to all of it, you know, we were talking at the beginning about what's the difference between processed and ultra processed and all these things that can make us quite anxious. and worried when we're pushing our trolleys around.

16:17But actually what it's about is about really enjoying food and having a really positive relationship with food and food being one of the great pleasures of our lives. So, yeah, I try not to get obsessed. My partner makes a lot of verments and kimchi and things like that, which everyone knows now are really, really good for gut health. But also just not eating ultra-processed food and eating, you know, as many whole foods and plants as possible is really, really good for gut health. Your microbes in your gut want fibre. They want plants. They're quite simple like that. They're not that fussy. They just want you to eat plants.

16:56And when you think about it, you know, you can actually go for days without eating any plants if you don't have an eye on it, if you're not careful. So, yeah, I think in that sense, and I love what you say about, you know, eating the nose to tail eating and stuff. I mean, we've really lost that, You know, even in my childhood, things like I was going to say Kate and Sydney pie, because that's what people used to call it, steak and kidney, you know, and it would be unthinkable to serve that up now. I think my children would probably leave home. So all of those things have got so many fascinating nutritional aspects that we are depleted in.

17:31And another one I find really interesting is if you ever listen to the guy called Professor Michael Crawford. if you look him up he's done lots of like radio 4 podcasts and things like that and he talks a lot about fish oily fish and omega-3 and and all of those things that are actually in a way quite simple they don't necessarily need you to do anything special it's just remembering to put some oily fish in your trolley remembering to put some plants in your trolley so I'm all about kind of keeping it simple really and trying to just focus on the love of actually eating a really tasty plate of food.

18:07Dr Sophie Shotter:You're one of the UK's leading and most outspoken feminists. I wonder how you feel about people who might say, but look, these ready meals finally got women out of the kitchen and freed up their time. What's the rebuttal to that? How hard do you find it to stay on top of good nutrition? And have you discovered any easy wins beyond batch cooking and freezing? Or do you simply feel, as I do, that yes, it takes time and effort, just like exercise, but we can either moan about it and get nowhere or simply accept that we do have to be in the kitchen, all of us, kids included, and get cooking. Well, I think the rebuttal to that is that it actually wasn't Mr Kipling who got women out of the kitchen.

18:49You know, it was women who got women out of the kitchen. It was feminism that got women out of the kitchen. It was women demanding something different. And they really, really had to push to get all of those legislative changes and social changes and cultural changes. They wouldn't have happened if women hadn't fought for them. So I definitely, definitely, definitely don't think we should give any credit to the ultra processed food industry for helping us to become liberated and be able to go to university, vote and work in equal roles to men. but you know I do think that that is a very helpful narrative for those food companies because that is how they sold those products to us in the first place if you look and I've written about this in a book that's you know a lot of the slogans in the sort of 70s and 80s and even back to the 60s that were on these sorts of tv dinner type products and things like that it was always about mum's night off you know and you know liberating women in various ways So I think that they use that idea to make us feel like we were doing something feminist by refusing to cook.

19:59But actually, I think that's something that's worth unpicking, really, because, well, first of all, you know, this is a man-made problem. And almost all, in fact, I think when I wrote the book, certainly every single CEO of the major food companies globally is a man. This is a huge man-made industry and it should not be on women to solve this problem. You know, like we are down to the level of us pushing the mum, the busy harassed mum pushing the trolley around the supermarket with two kids sitting in a trolley. She shouldn't be the one who's got to solve this ridiculous place we've got ourselves into where, you know, the human race's health is at stake.

20:40So it definitely should be about all people being interested in this issue. Legislation happening, campaigns, government led campaigns, all of those things and big cultural change. And down to the grassroots level, obviously, we know men can cook because most of the top chefs in the world are male. So can they please also take the load in their family home as well? That's really important to say. But I also think it's about not seeing, you know, the way that it has been framed is that making dinner is this awful drudgery that women have got to escape from. and actually I don't think it is. I think it's a real, especially in this world we're in at the moment where people are becoming more and more distant from each other because of screen time and, you know, there's been studies that have observed that human eye contact is decreasing because we're just looking at our phones so much basically.

21:42So food is a way through that, I think, and a really enjoyable creative activity. You know, people are being told, on the one hand, they're being told i'll take up you know things like knitting and crochet have come back haven't they because it's like it's really satisfying to make something it's really good for your mental health it's really really um fulfilling so i think we need to bring that back into the idea of of the you know the table and just think of it as an opportunity to do something creative and sit with with the people that we love and look them in the eye um so yeah you know and keep it simple.

22:16Yeah.

22:17Dr Sophie Shotter:And also teach our kids those very basic skills, like how to chop an onion. I mean, it is back to real, real basics that if we don't teach them, they just don't learn them. And yeah, no, absolutely. Absolutely. Absolutely. And I also think that the ultra processed food industry has made us feel like, you know, we have to make all these really complex dishes. You know, I write about this in the book as well, about how I spent some time in France and how, you know, they eat very much the same thing every day and that that should be okay you know really good quality bread really good quality cheese really good quality meat really good beautifully made salads dish it up the same every day I mean you know why does it have to be all of these complex things that are actually quite hard to make like curries and pizzas and pies and things we're used to those quiches and everything they take ages to make we don't want to be you know just fry a piece of fish and chuck it on a plate with some potatoes, you know, and a bit of a salad.

23:13Dr Sophie Shotter:What about you then? What does a good day look and feel like for you? What are the good habits and protocols that you aim for? Not just to do with food and nutrition here, but just your general approach to health and longevity. Do you, for example, do any intermittent fasting? Do you exercise a lot? Do you use any trackers, any wearables? What are your priorities, Millie? Well, this question slightly made me laugh because I'm not really that kind of person. You know, I came to this book as a writer and journalist and researcher, really, and feminist. And so I'm not, I think sort of I've hinted at it earlier that I'm not particularly obsessed with health other than, you know, in the sense of just feeling good.

23:54So I do love to make nice food. I love to eat nice food. I do love to be in nature. I think that's really important. I've got two dogs. I spend a lot of time in nature every day, and I think that's really, really good. I love to write. I love to do creative things. And I think at this point in my life, you know, sort of like just post menopause and my children are a bit bigger. I'm finding it really important to just reconnect with myself a bit more and prioritize myself and not feel guilty for doing that. Because I think the motherhood years are quite a sort of like a sort of drive a bit of a juggernaut through any sort of thoughts you might have had about what you want.

24:34And that's kind of as it should be. You put your needs aside because you've got these small, very needy people to look after. But I think, you know, just thinking now, just I think part of menopause is as well as that kind of reckoning of thinking, what do I actually want from the next bit of my life? And how can I look after myself? So just things like prioritizing good sleep and, you know, doing things that are nice and nurturing to myself for myself. I just think those are the most important things for me. I see all the stuff about longevity and I just, I think I'm the kind of person that looks at that and thinks, what's going on there?

25:17You know, what's the need behind that behaviour? I think we live in a culture that's very, very afraid of death, very distanced from the human body. We're becoming increasingly distanced from the human body through technology and the way we're spending our lives. And again, this does come back to food because food is an absolute way of connecting with the fact that you are actually a living, breathing mammal in a body. You know, it's essential bodily pleasure eating. and you know I think that yeah we are sort of becoming a bit distanced from life from death and from the fact that this this is it you know and it's very scary it's always been something that scared people this human condition and I think that that that the longevity thing is just another response to that in a way and I I'm not sure that I want to become that obsessed with my own health other than just in a very simplistic way of like like I said like you know I lift some weights I try to sleep well I try to spend time in nature I try to be creative and I try to be kind to myself but that's as far as it goes yeah that's enough yeah it is that is enough and that is a really important thing for women to say to themselves you know I am enough I'm doing enough and I am enough.

26:38Dr Sophie Shotter:Time for some quickfire questions. Okay, so which three people, living or dead, would you most like to make dinner for? Well, that's a really interesting question. It's the making dinner for them that made me pause because my first thought was, oh, well, let's think of some really interesting people that I'd like to have around for dinner. So I was thinking, yeah, I'd like to have Virginia Woolf. I wouldn't mind having Jermaine Greer at my table. I really, you know, quite fancy spending the evening with Hugh Grant. But then I thought, God, imagine making dinner for them. You know, how stressful would that be?