Eric Topol links ultraprocessed foods to dementia

Dr. Eric Topol used X on June 3 to amplify two strands of research on ultraprocessed foods: one linking higher intake to greater dementia risk in older Americans, and another arguing that some food-industry tactics resemble those long used by tobacco companies. His post pointed readers to newly published papers rather than to new clinical guidance, but it landed as the latest high-profile intervention in a fast-growing debate over how these products should be studied and regulated. The core dementia finding Topol highlighted came from a study published online June 3 in the *American Journal of Public Health*. That paper, based on U.S. adults in the Health and Retirement Study, reported that people in the highest quintile of ultraprocessed-food intake had higher risks of dementia, cognitive impairment without dementia, and a combined measure of either outcome than those in the lowest quintile. A second paper, published in March in *The Milbank Quarterly*, made the tobacco comparison more directly. Its authors argued that ultraprocessed foods share “key engineering strategies” with tobacco products, including dose optimization and hedonic manipulation, and said tobacco-era policy tools could inform responses to ultraprocessed foods. (ajph.aphapublications.org) ### What did the new dementia paper actually find? The June 3 *AJPH* paper analyzed 5,370 older U.S. adults from 2013 to 2020. Researchers assessed ultraprocessed-food intake from a 2013 nutrition questionnaire and tracked cognition through biennial assessments from 2014 to 2020 using the validated Langa-Weir classification. (milbank.org) Compared with the lowest-intake group, the highest-intake group had a hazard ratio of 1.58 for dementia, 1.46 for cognitive impairment without dementia, and 1.47 for the combined outcome, the paper said. The authors also reported that greater consumption of unprocessed or minimally processed foods was associated with lower risks of those outcomes. (ajph.aphapublications.org) ### Who wrote the dementia study, and how strong is it? Harvard-affiliated researcher Cindy W. Leung was among the paper’s authors, alongside investigators including Heejin Lee, Claire T. McEvoy, Kenneth M. Langa and others. The study was observational, which means it identified associations rather than proving that ultraprocessed foods directly cause dementia. (ajph.aphapublications.org) The authors said their findings “suggest a potential need to reduce UPF consumption for maintaining cognitive health among older adults.” That language is more limited than a claim of causation, and it is consistent with how cohort studies are typically framed in peer-reviewed journals. ### Where does the tobacco comparison come from? (ajph.aphapublications.org) The March *Milbank Quarterly* paper was written by Ashley N. Gearhardt, Kelly D. Brownell and Allan M. Brandt. It argued that ultraprocessed foods are “highly engineered delivery systems” designed to maximize reinforcement and habitual overuse, and said both industries have used similar strategies to increase appeal, shape public perception and evade regulation. (ajph.aphapublications.org) University of Michigan’s Institute for Healthcare Policy and Innovation, summarizing the paper in February, said the researchers were not claiming eating is the same as smoking. Ashley Gearhardt said the point was that some common foods may be designed in ways that make moderation unusually difficult. (milbank.org) ### Why are these papers surfacing together now? June 3 brought the publication of the dementia paper in *AJPH*, while the tobacco-analogy paper had already laid out a broader policy framework earlier this year. Topol’s post tied those two arguments together: one paper on measured cognitive risk in older adults, the other on how researchers think ultraprocessed products are engineered and marketed. (ihpi.umich.edu) The *AJPH* study is available through the American Public Health Association’s journal site, and the industry-engineering paper remains posted by *The Milbank Quarterly*. Topol’s June 3 X post linked readers into that literature as debate over ultraprocessed-food definitions and policy continues. (ajph.aphapublications.org)