As a family medicine physician, I bear witness daily to the devastating impacts of these low-cost, highly addictive, highly unhealthy foods on the health of my patients and their communities.

The hidden danger on our plates

After taking on tobacco, David Kessler now challenges ultraprocessed foods with the same hard science.

The consumption of ultraprocessed foods accounts for up to 60 percent of the American adult diet and nearly 70 percent of the diet of American children aged 2 to 10.John Tlumacki/Globe Staff

Dr. Katherine Gergen Barnett is associate professor of family medicine at Boston University Chobanian & Avedisian School of Medicine, vice chair of primary care innovation and transformation at Boston Medical Center, and communications fellow at Primary Care Collaborative.

On my first day at Yale School of Medicine, my classmates and I sat in hard wooden chairs, waiting expectantly for the words of Dean David Kessler. He dove into the principles and importance of evidence-based medicine, the application of the best available scientific evidence to inform the care of patients. Kessler had served as head of the US Food and Drug Administration from 1990 to 1997, and he shared with us that using the irrefutable evidence of the harms of tobacco had been critical in bringing regulatory action against tobacco.

Nearly three decades later, Kessler is at it again, this time with the perhaps unlikely bedfellow of US Health and Human Services Secretary Robert F. Kennedy Jr. in the fight against ultraprocessed foods.

While there is no settled definition of ultraprocessed foods, we largely understand them to mean industrially designed foods that are designed for a long shelf life, palatability, and convenience. They typically contain additives such as emulsifiers, colors, flavors, stabilizers, and artificial sweeteners. We see them everywhere in the form of packaged snacks, ready-made meals, and sugary drinks.

The consumption of ultraprocessed foods accounts for up to 60 percent of the American adult diet and nearly 70 percent of the diet of American children aged 2 to 10. While the FDA has the ability to oversee additives to foods and determine whether they are “generally recognized as safe,” it has deemed only 15 food ingredients unsafe since 2010 and officially regulated only one, partially hydrogenated oils — the primary source of artificial trans fats in processed foods.

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The health effects of ultraprocessed foods have been studied intensively in recent years. In a recently published umbrella review of 45 scientific meta-analyses encompassing nearly 10 million people, higher consumption of them was directly associated with increased all-cause mortality risk, cardiovascular-related deaths, type 2 diabetes, depression, poor sleep, wheezing, and obesity.

Last month, the HHS and the US Department of Agriculture released the 2025–2030 Dietary Guidelines for Americans, which explicitly advises against ultraprocessed foods.

While advising against ultraprocessed foods may help raise awareness and reduce the amount in lunches provided by schools, these guidelines fall short of regulatory action. Kessler submitted a citizens petition to the FDA in August 2025 in which he argued that Americans need to view processed refined carbohydrates as something that we have allowed to be widely used without appropriate regulatory oversight and that “continues to cause and contribute to great harm.”

While the FDA takes Kessler’s petition into consideration, leaders in health care and food policy cannot wait to act. As a family medicine physician, I bear witness daily to the devastating impacts of these low-cost, highly addictive, highly unhealthy foods on the health of my patients and their communities. The health burden of ultraprocessed foods falls most heavily on patients who live in neighborhoods described as “food deserts” where there is limited access to affordable and nutritious foods, adding to the health inequities of our country.

There are places of hope and action. For example, at Boston Medical Center, where I work, we have a multi-pronged approach to “Nourishing our Community” that includes two farms on the rooftops of our hospital. In 2024 alone, these farms produced nearly 10,000 pounds of produce, including more than 46 varieties of crops. This harvest contributed to meals for our hospitalized patients, cafeteria food, food pantry produce, demonstration kitchen foods, and even foods for local shelters. While we alone cannot stop the onslaught of ultraprocessed foods in our patients’ lives, we can help provide healthier options.

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It has been nearly 30 years since I first learned about evidence-based medicine. At the time, I thought Kessler’s story was interesting, but I was anxious to get to the study of what I considered “real medicine.” Little did I know at the time how invaluable evidence-based medicine is in shaping the health of our communities. Using it to create and expand access to healthy foods should be something we can all stand behind.

 https://www.bostonglobe.com/2026/03/10/opinion/hidden-danger-our-plates/