The degree to which a food has been altered during preparation lies on a continuum. Anything not directly harvested from the vine, ground, bush or tree has undergone some degree of processing. Processing may be as basic as freezing, canning or drying, or it may involve ultra-processing where food is significantly altered — foods you may typically purchase at a gas station.
Unfortunately, Americans not only eat a preponderance of processed foods, but 57.9% is ultra-processed.1 A study in 2013 found health care costs associated with Type 2 diabetes were $140 billion as compared to $90 billion for tobacco products,2 and diabetes is directly linked to a processed food diet.
The difference in the amount of sugar between foods that are ultra-processed and minimally processed is dramatic. Data demonstrate 21.1% of calories in ultra-processed foods come from sugar,3 while unprocessed foods contain no refined or added sugars. As food choices have changed over the past decades, so have the rising numbers of health challenges.
For instance, Type 2 diabetes is rooted in insulin resistance4 and a faulty leptin signaling system. In other words, it is triggered by a sugar-rich diet and the cure is free and readily available to anyone willing to change their eating habits.
An inundation of glyphosate in the food supply,5,6 exposure to organochlorine pesticides7 and heavy metal exposure8 may also be contributing factors to the rising numbers of children diagnosed with autism.
Rising Rates of Autism and Diabetes Are a Public Health Concern
The most recent statistics from the Centers for Disease Control and Prevention9 indicate more than 100 million U.S. adults are living with diabetes or prediabetes. The report is based on 2015 data, which found 30.3 million have diabetes and another 84.1 million have prediabetes.
Diabetes is the seventh leading cause of death10 and may contribute to three other causes of death found in the top 10, including heart disease, stroke and kidney disease. According to the American Diabetes Association,11 1.5 million Americans are diagnosed with diabetes every year and 193,000 under the age of 20 have been diagnosed with diabetes.
The most recent data regarding the financial burden associated with diabetes indicates $327 billion were spent in 2017; direct medical costs were $237 billion, and business lost $90 billion in productivity.12 After adjusting for the age and sex differences of the population, statistics show the average medical cost in those with diabetes was 2.3 times higher than in those without diabetes.
Autism spectrum disorder (ASD) is characterized by repetitive behaviors and ongoing social challenges that vary in degree depending on where you are on the spectrum, including difficulty communicating and socializing.13 Often the symptoms are recognized within the first two years of life.
The CDC began releasing biennial updates of estimated prevalence among 8-year-old children from 11 states in the U.S. based on medical records in 2004. The first estimate recorded 1 in 166 children diagnosed with autism.14 By 2016 this number had risen to 1 in 68, and in 2018 it was 1 in 59, a 15% increase from 2016.
Prevalence of Autism May Be Higher Than Suspected
However, two independent research teams analyzed data from parent questionnaires and independently found different results, including 29.5% of children who were not being treated for the condition at the time of the study.15
The first survey, published in the journal Pediatrics,16 concluded parent reported autism diagnosis was 1 in 40.
The second study, published in the Journal of the American Medical Association,17 found the prevalence of autism varied substantially across states. Of those who were treated, 43.3% receive behavioral treatment only, 6.9% receive medication only and 20.3% received both.
In an evaluation of resources used from the Supplemental Security Income (SSI) program, it’s been determined there was an 8.08% use due to autistic disorder in 2004, which rose to 20.53% in 2014.18
Additionally, the category of autistic disorders has the second highest allowance rate, with little to no indication of a decline in growth of the number of children applying for and receiving SSI benefits for autism.
Calcium Propionate Associated With Exacerbation of Autism Symptoms
While no one factor has been linked to the development of autism, the food additive calcium propionate (E282)19 has been linked to an aggravation of symptoms, and may play a role in the development of the condition.
Calcium propionate is a widely used additive in the food industry as a preservative and antifungal agent routinely sprayed on fruit, packed meat, cheese and bread.
Although the chemical is highly effective as an antifungal, it has a negative effect on the gut microbiome, which can exacerbate autism symptoms.20 Calcium propionate is the calcium salt of propionic acid, which is currently classified as generally recognized as safe (GRAS).21
According to the U.S. Food and Drug Administration, it may be used as an additive in food with no limitation other than “current good manufacturing process” as determined by the manufacturer.22 The European Food Safety Authority23 recognizes calcium propionate as an authorized antimicrobial preservative used in animal feed effective against several strains of bacteria.
In the U.S.,24 it is also used as an additive in cattle feed, as an extra calcium source for cattle and as a treatment for a variety of infections. The ability of the chemical to affect microbial growth does not end once it reaches your gut.
Acetate, propionate and butyrate are short chain fatty acids generated by microbial fermentation in your gut.25 These have been shown to have multiple beneficial effects on energy metabolism, playing a complex role between diet, gut microbiome and energy.26 However, an excess of propionate may induce behavioral effects remarkably consistent with autism.
Propionic Acid Affects Gut-Brain Axis
In one study, researchers noted propionic acid is produced by autism-associated gastrointestinal bacteria27 (clostridia and bacteroides) and may produce reversible behavioral, electrographic and neuroinflammatory changes resembling autism when administered to rodents.28
Propionic acid is naturally produced by gut microbiota as it breaks down digestive fiber. Calcium propionate was designated GRAS as it was assumed to be compatible with human physiology. The rate of propionic metabolism is affected by a variety of genetic, microbiotic and environmental factors.
However, an overabundance is found to have a neurobehavioral effect, especially in those with autism, who are already prone to an excess of propionic acid due to the microbial gut abnormalities, making them vulnerable to further damage.29 While these symptoms are not as easily detected in healthy people, exposure to high levels may trigger reversible autistic-like symptoms in healthy people as well.30
Ideally, your gut microbiome has a balance of harmful and beneficial bacteria (although many so-called harmful bacteria only cause problems when allowed to overgrow). Once a disproportionate number of one species grows,31,32 it may lead to the starvation of others and an excess production of certain chemicals.
When harmful bacteria are allowed to outgrow beneficial bacteria, the resulting inflammation contributes to gastrointestinal challenges associated with autism.33 This may also stimulate the gut-brain axis, triggering behavioral and psychological issues, such as anxiety.34 Propionic acid also has the ability to cross the blood-brain barrier.35
While there have been no human studies demonstrating its potential to affect the development of autism, researchers hypothesize the sensitivity of neurological development during the fetal stage may contribute to the development of autism if the brain is exposed to excess propionic acid.36 There are animal studies suggesting perinatal exposure changes neurobehavior.37
Food Additive Used to Reduce Mold Growth Increases Insulin Resistance
A second study looked at propionate as a dietary disrupter, finding it could trigger a cascade of events leading to insulin resistance and hyperinsulinemia. The study38 was led by researchers from Harvard T.H. Chan School of Public Health in collaboration with Brigham and Women’s Hospital and Sheba Medical Center in Israel.
Propionate administered to mice was found to rapidly activate the animals’ sympathetic nervous system. This in turn led to a rise in glucagon and norepinephrine. The mice produced more glucose from their liver cells, leading to hyperglycemia.39 When the mice were chronically treated with propionate, equivalent to the amounts typically eaten by humans, it led to obesity and insulin resistance.40
The researchers went on to enroll 14 healthy human participants who were randomly placed in two groups. One received a meal with 1 gram of propionate as an additive and the other were given a meal with a placebo. Blood samples were drawn within 15 minutes of eating, and every 30 minutes for four hours.
The participants who ate the experimental meal had a significant increase in norepinephrine and glucagon. Lead author Amir Tirosh, Ph.D., who holds positions at the three collaborating universities, commented:41
“The dramatic increase in the incidence of obesity and diabetes over the past 50 years suggests the involvement of contributing environmental and dietary factors. One such factor that warrants attention is the ingredients in common foods. We are exposed to hundreds of these chemicals on a daily basis, and most have not been tested in detail for their potential long-term metabolic effects.”
Food Additives Increase Your Risk of Health Concerns
The FDA maintains a database of 4,000 ingredients, which by the FDA’s own admission42 “is only a partial list of food ingredients. Inclusion in this inventory of information from non-FDA entities does not indicate an FDA approval or evaluation of this use.”
The World Health Organization43 says there are “several thousand food additives used, all of which are designed to do a specific job in making food safer or more appealing.” Many additives have been linked to health concerns and were granted GRAS status without review or approval. As reported by the Washington Post:44
“The FDA said that although the law allows for food manufacturers to make their own safety determinations, the agency ‘encourages companies to consult with the agency when developing new ingredients.’ Ultimately, the FDA said, manufacturers ‘are responsible for ensuring that their food products are safe and lawful.’”
Unfortunately, while there is little assessment done on individual chemicals in isolation, mounting research suggests when consumed in combination, the health effects may be even more serious. An assessment45 done by the National Food Institute at the Technical University of Denmark found chemicals may amplify each other’s adverse effects when combined, even in small amounts.46
Additionally, food manufacturers are permitted to label chemical compounds as “artificial flavors” without listing them individually. In late 2018,47 the FDA announced a list of seven synthetic compounds no longer allowed to be used as food additives in response to a petition brought by Natural Resources Defense Council and the Environmental Working Group (EWG).
These additives had been linked to cancer in animals and were most commonly used in baked goods, ice cream, candy and chewing gum. Dawn Undurraga, EWG’s nutritionist, said:48
“Consumers will never know which foods were made with these chemicals, since manufacturers have been allowed to hide these ingredients behind the vague term ‘flavor.’ This is a positive step forward, but the FDA should empower consumers to make their own fully informed decisions by requiring full ingredient disclosure.”
The EWG has published a dirty dozen guide to food additives, works to ban other endocrine disrupting chemicals used as preservatives, and has developed a Food Scores49 database — an extensive list of ratings for more than 120,000 food and personal care products, providing information on ingredients and processing.
Strong Gut Microbiome May Reduce Health Risk
Taking care of your gut microbiome may be one of the most important things you can do to optimize your health. Your gut flora influences the function of a variety of internal organs, including your skin, lungs, breasts and liver.50 When your gut microbiome is disrupted, it may automatically disrupt your immune function and have far-reaching consequences.
For instance, the use of checkpoint inhibitors in the treatment of cancer, a class of immunotherapy drugs working by triggering your immune system, appears to be dependent on the gut microbiome.
As reported in Nature,51 a 2015 study found microbe-free mice failed to respond to treatment with checkpoint inhibitors, but those given Bacteroides fragilis responded better. Others have suggested the connection between your gut and mental health appears to be so strong, probiotics may one day take the place of antidepressants.
In an article published in Biological Psychiatry,52 the authors suggested severe and chronic mental health conditions, including post-traumatic stress disorder, may be eliminated through the use of specific probiotics by dampening stress hormones. To learn more about how to balance your gut microbiome and develop a strong microbiota, see my previous article, “Go With Your Gut.”