Food Industry Engineering Is Less Important Than Access to Gut Microbiota-Accessible Foods for Preventing Chronic Disease.

Authors

William J McCarthy, Darren Lov, Frederick Ferguson

Published in

The Milbank quarterly. Jul 18, 2026. Epub Jul 18, 2026.

Abstract

Policy Points Acute dietary switching from ultra-processed food to minimally processed food elicits no physiological withdrawal, a key indicator that people rely on ultra-processed foods for reasons other than food addiction. France and Japan are countries with low adult obesity prevalence attributable to agricultural and school nutrition policies that encourage greater consumer reliance on a diversity of fiber-rich, polyphenol-rich, minimally processed foods. Traditional, high-fiber dietary patterns optimize gut-microbiota function, elevating the biological precursors required for the natural expression of the satiety hormone glucagon-like peptide-1 (GLP-1). Public health progress in reducing US obesity prevalence will be more effectively achieved by subsidizing and expanding consumer access to whole foods than from efforts to prevent the food industry from making their ultra-processed food products hyperpalatable.
In this commentary, we applaud Gearhardt and colleagues' focus on the negative health effects of consuming ultra-processed foods but suggest that the bigger dietary contributor to obesity risk is American consumers' lack of access to a diverse range of gut microbiota-accessible foods.
We cite scientific literature supportive of the health benefits of consuming fiber-rich, polyphenol-rich, minimally processed plant foods, which are more likely to provide substrate to one's commensal gut microbes than would consuming ultra-processed foods. We also cite results from randomized, controlled feeding studies showing that study participants who were switched from an ultra-processed food condition to a minimally processed food condition did not report withdrawal symptoms or evidence of tolerance, thereby undermining Gearhardt and colleagues' thesis that consumers' overconsumption of calories could be attributed to the addictiveness of ultra-processed foods.
We cite scientific literature illustrating the health benefits of consuming traditional dietary patterns, such as the Mediterranean dietary pattern, which feature a diversity of fiber-rich, polyphenol-rich, minimally processed foods.
We conclude that government agricultural and educational policies that increase consumer access to gut microbiota-accessible foods may be a more effective long-term approach to reducing nutrition-related chronic diseases than policies that limit the ability of the food industry to increase the hyper-palatability of ultra-processed foods.

PMID:
42470169
Bibliographic data and abstract were imported from PubMed on 18 Jul 2026.

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