Dr David Bratt

Ul­tra-processed foods (UP­Fs) are in the news these days, if not in T&T, else­where in the civilised world. As hap­pened with the fu­el and in­dus­tri­al paints of the 80s that con­tained harm­ful lead, or with cig­a­rettes in the 90s and as is now hap­pen­ing with cell­phones, their use will be lim­it­ed by pub­lic pres­sure and gov­ern­ment fi­at. The fight to con­trol their use will be long and hard and in the mean­time, mil­lions will suf­fer the un­healthy con­se­quences of eat­ing UP­Fs while the food in­dus­try runs all the way to the banks.

This sto­ry must be told in all its gory de­tail so that peo­ple can un­der­stand the con­se­quences of be­liev­ing the in­dus­try-told fa­ble that re­al­ly, ul­tra-processed foods are not that bad, the ev­i­dence isn’t ful­ly in (it nev­er is, so to wait for full proof is to run the risk of con­tract­ing a UPF caused dis­ease), and any­way, we are al­ways im­prov­ing the prod­uct, just give us a few more years, eat our junk, pray that you do not get sick and all will be hunky do­ry.

This is the same sce­nario used in the past, by the lead in­dus­try, the to­bac­co in­dus­try and now the so­cial me­dia ti­tans, in the face of over­whelm­ing ev­i­dence of de­lib­er­ate wrong­do­ing on their part: de­ny, ob­fus­cate and ad­ver­tise.

Ul­tra-processed foods in­volve ex­treme­ly high lev­els of man­u­fac­tur­ing to pro­duce, and in­clude all in­fant for­mu­las, most com­mer­cial ba­by foods, sweet drinks, fast food, snacks, break­fast ce­re­als and ready-to-go meals and desserts.

You can tell if a food is an UPF if it has a long shelf life, con­tains five or more in­gre­di­ents or con­tains in­gre­di­ents that will not be found in your own kitchen or is pack­aged.

By this de­f­i­n­i­tion, al­most every­thing you buy in a su­per­mar­ket is a UPF but I want to fo­cus on one: in­fant for­mu­la. See (https://pmc.ncbi.nlm.nih.gov/ar­ti­cles/PMC10140693/)

It may come as a sur­prise but the very first ul­tra-processed food you may give to your child is an in­fant for­mu­la. A few pae­di­a­tri­cians have been say­ing this for years but it has nev­er caught on. It must now. All in­fant for­mu­la is ul­tra-processed with all that con­notes in terms of dis­ease. This find­ing needs to be tak­en in­to ac­count when par­ents and the Min­istry of Health make de­ci­sions about what to feed ba­bies.

In­fant for­mu­las or breast­milk sub­sti­tutes, as they should be termed, con­sist of pow­dered milk pro­teins, veg­etable oils, lac­tose, added sug­ars, vi­t­a­mins and min­er­als as well as ad­di­tives to give it a long shelf life. For­mu­las set up the ba­by for acute as well as chron­ic dis­eases, life­long obe­si­ty, di­a­betes, heart dis­ease, strokes etc.

The acute dis­ease are of two types. One, the in­fant’s re­ac­tion to the in­gre­di­ents in the for­mu­la, eg col­ic, gas, ab­dom­i­nal pain, con­sti­pa­tion and di­ar­rhoea, as well as rash­es rang­ing from rough, dry skin to frank eczema and a role in the de­vel­op­ment of “si­nus” and asth­ma.

The sec­ond is in­fec­tion caused by con­t­a­m­i­na­tion of the milk pow­der by bac­te­ria due to im­prop­er­ly con­trolled pro­duc­tion, as has hap­pened many times in the past and as is hap­pen­ing right now. There is to­day a glob­al re­call of var­i­ous makes of in­fant for­mu­la, the first in­volv­ing the US com­pa­ny By­Heart, whose for­mu­las have been found to be con­t­a­m­i­nat­ed with a dead­ly bac­te­ria called Clostrid­i­um Bot­u­linum. Up to this week, 51 in­fants have been hos­pi­talised af­ter drink­ing By­Heart for­mu­la.

On Jan­u­ary 5, Nes­tle be­gan re­call­ing hun­dreds of batch­es of in­fant, fol­low-on, pre-term and spe­cialised for­mu­las af­ter de­tect­ing con­t­a­m­i­na­tion with Bacil­lus cereus bac­te­ria, which pro­duce the tox­in, cerulide. Cerulide caus­es gas­tro and can­not be killed by boil­ing wa­ter.

To deep­en the mess in which mak­ers of in­fant for­mu­la have found them­selves in, the con­t­a­m­i­na­tion that be­gan with Nes­tle has spread to two oth­er in­fant for­mu­la com­pa­nies, Danone and Lac­tal­is. Both are re­call­ing batch­es of for­mu­la due to the po­ten­tial pres­ence of cerulide, and in France, au­thor­i­ties are in­ves­ti­gat­ing the deaths of two in­fants who had con­sumed re­called for­mu­la prod­ucts.

The con­t­a­m­i­na­tion ap­pears linked to one of the many in­gre­di­ents in for­mu­la, arachi­don­ic acid (ARA), re­port­ed­ly sup­plied by a com­pa­ny in Wuhan, Chi­na (Wuhan, again?), un­der­scor­ing the need for man­u­fac­tur­ers of for­mu­las to rig­or­ous­ly ver­i­fy and au­dit their in­gre­di­ent sup­ply chains.

All these re­calls are noth­ing new. Over the past 40 years, there have been about one to two in­fant for­mu­la re­calls a year, but the num­ber seems to be in­creas­ing re­cent­ly with re­calls oc­cur­ring reg­u­lar­ly with such brands as Sim­i­lac & Al­i­men­tum in 2022; Nu­trami­gen, En­famil Prosobee & Ger­ber Good Start Soothe­P­ro in 2023 and SMA, Nan, Ap­tamil, Cow & Gate in 2025 to 2026.

These re­calls do af­fect us but for­tu­nate­ly we have not had any deaths. So far.