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That Reciprocal Causation Trap

Pat Hartman May 5, 2026 No Comments

Journalists in the obesity field have written about why poor people become overweight, and also about how overweight people can become economically disadvantaged. Between those two inconvenient facts, a mutual causative relationship exists, which has been mentioned previously by Childhood Obesity News.

To say “mentioned” is an understatement, because the issue has many facets, and to effectively illustrate them all requires more than a few words.

Brief generalization: People on the lower end of the economic scale are vulnerable to obesity because financial conditions often restrict their access to health-inducing foods, and also preclude many sorts of healthcare, both preventive and curative.

Limits and caution

When some thought is invested in the issue, it is easy to pinpoint specifics. For example, people with low or no income are unlikely to travel across town for more reasonable food prices. Volume discounts are tempting, but even if all three of the kids wear backpacks, there is a limit to how many cans of beans can be transported home on the bus.

Vegetables can last a long time in a freezer, if a family is fortunate enough to have one. If the opportunity arises to get hold of multiple large bags of peas or corn on sale, a supply of low-calorie veggies is a wonderful asset for a health-conscious family. But first… You need to have a freezer.

Low-income people often have no choice other than to live in a dangerous neighborhood. A walk after supper, to burn a few calories, sounds like a swell idea, until you get mugged. Low-income people generally can’t afford gym memberships, and while there is no guarantee that a person with that opportunity will make the best use of it, the odds are certainly better than when they are not even allowed through the door.

Official documentation

Let’s look at a typical, fairly recent government-published report on a systematic review and meta-analysis that explored the phenomenon in depth, pointing out that obesity can be a causative factor of poverty, as “obese people drift into lower-income jobs due to labor–market discrimination and public stigmatization.” It was by no means the first document to highlight this reciprocal effect, and will certainly not be the last.

That meta-analysis encompassed 21 studies: two from Canada, three from the United Kingdom, and 16 originating in the United States. Its conclusions did not cause worldwide headlines, but indicated that persistent examination of the topic could potentially lead to a meaningful increase in attention, especially when a growing awareness of what goes into food products does not correlate with any serious efforts to change the habits of food manufacturers.

Society’s ability to ignore signs of corporate malfeasance is only one roadblock. Individuals are acutely aware of inequities in their everyday lives. Even when other factors are equal, obese people tend to be passed over for job opportunities. Clothes that fit may be prohibitively expensive. Even if people can afford gym memberships, the embarrassment factor may prevent them from doing so.

Thousands of individuals, if asked, could add thousands of examples of how body weight and size can turn everyday life into an ordeal:

Findings suggest that there is more consistent evidence for reverse causality. Therefore, there is a need to examine reverse causality processes in more detail to understand the relation between income and obesity… Obesity is a major risk factor for all-cause mortality, a number of non-communicable diseases and reduced quality of life.

Why does this even matter? Because in general, all the associated numbers are going up, with no indication of reversal any time soon. A very specific possibility on the horizon is the shadow of a reinstated military draft, along with hints of war that are more than subtle. Once America wakes up to the reality of how few conscription-ready individuals are suitable to be trained as soldiers, there might be a problem.

Your responses and feedback are welcome!

Source: “Income and obesity: what is the direction of the relationship? A systematic review and meta-analysis,” NIH.gov, January 2018
Images by hellbergstina and Mohamed_hassan/Pixabay

Salt of the Earth, and the Ocean

Pat Hartman April 30, 2026 No Comments

Is any other natural substance so encrusted by myth and practical observations? The number of informal borrowings of the word to imply humanly recognized concepts is staggering. For example,

“To capture unwary investors, they salted the mine.”
“She salted away most of her fortune.”
“He’s not worth his salt.”

Salt is fundamentally sweat, whether generated by brutal forced labor or pleasant voluntary exercise. Everyone has heard salt used as a figure of speech. (A-Z Quotes offers close to 700 sayings by the famous and the obscure.)

All over the world, in many times and places, salt has been an international currency accepted with no questions asked. Despite being an eminently pragmatic commodity, it has been valued like gold or jewels. Even in an era like this one, when salt seems common as dirt and is given away for free in little paper packages, it is universally recognized as having value.

How naughty is it?

On the topic of unwise food choices, the role of salt as accomplice and enabler is paralleled by no other substance. Consider the delightful movie-theater snack combo of salted popcorn and chilled cola drink, so loved, yet only available during recent history. This culinary masterpiece packs such an extraordinary one-two punch that the people who lived before its time can only be pitied.

Salt is probably the single greatest cause for the rise of the soda industry. The unique experience of switching from salty to cold-fizzy-sweet, and then back to the salted potato chips (or salted any sort of chips), and then to the chilled beverage, on and on, interminably… ad infinitum… Is any sensation more heavenly? The poignant contrast can bewitch a person for hours.

Just a side note, but the second-largest accomplice to the insidious rise of cola drinks has to be the refrigerated vending machine. The genius who figured out how to keep bottled beverages cold until some poor sucker came along and dropped a quarter into the slot may be responsible for just as much obesity as salt itself.

A slice of history

Many of us who are middle-aged and beyond grew up very familiar with the experience of sitting at a table where each adult thoughtlessly grabbed a salt shaker and automatically covered everything on their plate with salt, barely pausing to glance, and knowing exactly how much of it should be distributed per square inch of food surface. In every case, it was too much.

Today, a sane person, if one can be found, draws the line at about a level teaspoon (about six grams) of salt per day. But, considering how much sodium is already injected into packaged food items, even that is probably excessive. And, 2,000 mg of salt per day is about the outer limit a conscientious adult should go with.

It was tempting to include here a compendium of examples from this very website, to prove the overwhelming presence of salt in the human diet and consciousness. One alternative would have been a comprehensive list of each Childhood Obesity News post that has thus far mentioned the word “salt,” totaling at least 360 of them. This would be somewhere close to the neighborhood of one out of every 10 posts ever created for this venue.

The likelihood that any American suffers from insufficient sodium intake is vanishingly small.
Okay, someone who sweats a lot may be an exception to that broad generalization. These include competitive athletes and workers exposed to major heat stress, such as foundry workers and firefighters.

But for pretty much everybody else, on the scale of Things to Worry About, a sodium deficiency is way down the list, registering less than a whisper of a dream. This same American Heart Association information source, by the way, warns that sodium can be sneaky, and offers a printable version of its one-page infographic, “7 Salty Myths Busted.”

Additionally, and especially appreciated here at Childhood Obesity News, is a printable poster geared for kids, explaining the myths and the facts of sodium.

P.S. A note: While no doubt full of many virtuous qualities, green salt does not taste salty. Sorry, it just doesn’t.

Your responses and feedback are welcome!

Source: “Isak-Dinesen-The-cure-for-anything-is-salt-water-sweat-tears-or-the-sea,” QuoteFancy.com
Image by Isak Dinesen/QuoteFancy.com

What New Research Says About Childhood Growth and BMI

Tatyana Meshcheryakova April 29, 2026 No Comments

For decades, pediatric health experts have relied on a concept known as “adiposity rebound” to help assess a child’s future risk of obesity. Traditionally, this stage, when body mass index (BMI) begins to rise again after early childhood, has been viewed as a potential warning sign. But new research published in The Journal of Nutrition is challenging that long-held belief and offering a more nuanced understanding of how children grow.

A look at childhood growth patterns

The study analyzed data from 2,410 children and adolescents ages 2 to 19 who participated in the National Health and Nutrition Examination Survey (NHANES) between 2021 and 2023. Researchers observed a familiar trend: BMI decreases in early childhood, then begins to rise again around age 6 — the classic “adiposity rebound.”

However, there was a surprising twist. While BMI increased, another important measurement, the waist-to-height ratio, continued to decline. This metric is considered a more accurate indicator of body fat, particularly abdominal fat.

The implication? The rise in BMI during this stage may not signal increased fat at all. Instead, it may reflect healthy growth in lean tissues like muscle and bone.

Why BMI alone may be misleading

BMI has long been used as a simple screening tool because it relies on such basic measurements as height and weight. But it has a significant limitation, as it cannot distinguish between fat mass and fat-free mass. This distinction is especially important in children, whose bodies are constantly changing.

Lead researcher Andrew Agbaje emphasized this concern, saying:

Recent global consensus statements on redefining and diagnosing obesity have recommended that obesity should not be diagnosed with BMI alone but confirmed with non-invasive measures such as waist-to-height ratio.

He also said:

This new study buttresses the misleading use of BMI in children whose body composition rapidly changes during growth and the potential for attributing physiological functions to pathology, which might lead to unnecessary interventions. Waist-to-height ratio should be incorporated as the first inexpensive measure in diagnosing pediatric obesity with BMI used as a confirmatory tool due to its imprecision.

Introducing the “body composition reset”

One of the most compelling ideas to emerge from the study is what researchers call a “body composition reset.” This term describes the natural shift toward lean tissue development during early childhood. Rather than indicating a buildup of fat, the increase in BMI may actually reflect a healthy phase of growth, one that supports strength, bone development, and overall physical maturation. This finding challenges the assumption that an earlier adiposity rebound automatically signals a higher risk of obesity later in life.

Why waist-to-height ratio matters

Unlike BMI, the waist-to-height ratio focuses on fat distribution, particularly abdominal fat, which is more closely linked to health risks such as heart disease, Type 2 diabetes, high blood pressure, liver disease, and bone fractures. Because it is less influenced by muscle growth, this measurement provides a clearer picture of whether a child is carrying excess body fat.

A shift in pediatric obesity screening

The study adds to a growing body of evidence suggesting that BMI should not be used in isolation when evaluating children’s health. Incorporating waist-to-height ratio could help clinicians better distinguish between normal growth and true obesity risk, avoid unnecessary labeling or interventions, and provide more accurate, individualized care, among other things.

Recognition for innovative research

Agbaje’s contributions to pediatric cardiometabolic health have not gone unnoticed. He is the inaugural recipient of the American Society for Nutrition Foundation/Novo Nordisk Foundation Flemming Quaade Award, which honors early-career physicians making significant strides in obesity prevention and management. The award will be presented again at NUTRITION 2026, scheduled for July 25–28, 2026, in National Harbor, Maryland.

So, in a nutshell, a single number like BMI cannot tell the whole story. The new approach may reduce the chances of misclassifying healthy developmental changes as medical concerns. For parents, it should serve as a reassuring message that not every change in BMI signals a problem. Sometimes, it simply reflects a child growing exactly as they should.

Your responses and feedback are welcome!

Source: “Study Challenges Decades-Old Puzzle About Childhood Body Fat,” American Society for Nutrition, 4/23/26
Source: “Adiposity Rebound or Fat-Free Mass Anabolism in Children…,” The Journal of Nutrition, 3/9/26
Image by beyzahzah/Pexels

It’s Sodi-licious

Pat Hartman April 28, 2026 No Comments

A recent post observed that, rather than decreasing, the amounts of fat, sodium, and sugar in manufactured breakfast cereals have only continued to increase. Over the past decade, journalists in the health field have unrelentingly noted that such products — especially those aimed at children — inevitably include more and more sugar, sodium, and fat. It is almost as if attentive reporting on the topic has perversely led the situation to become even worse.

Plenty of information appears printed on food packaging, and an abundance of articles about the contents of those packages are published through various media. Regarding the boxes, cans, bottles, and other food packages, along with the journalism about what is inside them, why don’t all these information sources just go ahead and say, “Salt”? Is someone just showing off with fancy words, or what? Sodium and salt, aren’t they the same?

As it turns out…

After consulting Sharon Small, a dietitian who specializes in counseling patients about their cardiovascular health, journalist Wendy Bazilian reported:

Sodium is a mineral and a key component of salt. Salt is actually called sodium chloride because it is made up of 40% sodium and 60% chloride… [W]hile your body needs sodium to function properly, too much (typically consumed as salt) can increase the risk of certain health issues.

There can be sodium without salt, but not salt without sodium. A food or drink may contain sodium but no salt. Sodium is an element and a metal. Salt is made of two things, sodium and chlorine, and is not as bad for the body as sodium alone. Sodium does vital things for the body, but unaccompanied and in too large a quantity, it can damage the kidneys and can lead to high blood pressure and stroke risk.

The two main sources, and an additive

Sea salt comes from the ocean and is less processed than table salt. Table salt comes not from tables, but from mines, and is more processed. For many years, sellers of salt have included iodine with their product. Because salt is consumed almost universally, it was seen as the ideal vehicle through which to slip in enough iodine to prevent a massive public health crisis.

If a human thyroid gland is to function effectively, it needs iodine. Without it, the thyroid is unable to properly do its job regarding “metabolic rate, heart and digestive functions, muscle control, brain development, and bone health.” If a fetus does not get enough iodine, the results can include physical deformities and cognitive impairment.

Even with salt vendors doing their best, it is estimated that around two billion members of the earth’s human population experience health issues due to iodine insufficiency.

The food industry

In the USA, the average adult absorbs about 3,400 milligrams per day of sodium, but 2,300 mg (about a teaspoonful) is widely acknowledged to be quite enough. The stodgy old American Heart Association, however, would actually prefer no more than 1,500 mg per day, or less than half the amount actually consumed by the average grownup.

Most of the incoming sodium uses packaged foods and restaurant meals for its delivery system, concentrating on 10 main popular products. Few of those choices contain any form of vegetation, unless you count the sauce on pizza.

Even a responsible eater who never even picks up a salt shaker most likely absorbs way too much sodium. This causes the professionals who spend their lives studying these matters to mention such topics as hypertension, heart disease, and stroke. Oh, and kidney stones. Often, the effects do not manifest until the window of opportunity for redemption has passed.

A question that a reasonable person might ask is, “If sodium is problematic, why don’t the manufacturers just leave it out, and let people salt their food according to taste?” Apparently, because some other, less civic-minded manufacturer will go ahead and include salt, and consequently sell more product.

Your responses and feedback are welcome!

Source: “ Salt vs. Sodium: What’s the Difference? Health Experts Explain,” EatingWell.com, 12/31/25
Source: “Why Does Salt Have Iodine Added To It?,” SeaSalt.com, undated
Image by Couleur/Pixabay

It’s the Newsiest — Breakfast, Cereal, and Kids

Pat Hartman April 23, 2026 No Comments

A particular news story appeared almost exactly a year ago, in response to a major journal’s publication of “Nutritional Content of Ready-to-Eat Breakfast Cereals Marketed to Children.” That all-too-typical piece announced that breakfast cereals are “filled with increasing amounts of sugar, fat and sodium,” a statement equally true at this very moment in time.

Does anyone out there believe that the situation has improved since then? If so, we have a very attractive bridge to sell you. Sorry, but no, the shameful trend has not reversed. Oh, and guess what? “The study also found that cereals’ protein and fiber content — nutrients essential for a healthy diet — have been in decline.” That sobering fact is just as true today as it was 12 months ago, and we feel confident in betting that it will be even more true a year in the future.

The original article concerned the analysis of 1,200 new or reformulated cereal products that had appeared on the market over the previous decade and a half. Most of them were products that had already existed, with a few minor tweaks thrown into the mix. Not improvements, just inconsequential changes. Study co-author Shuoli Zhao mentioned the existence of “evolving consumer awareness about the links between excess consumption of sugar, salt and saturated fat and chronic conditions like diabetes, hypertension and cancer.”

And yet…

But somehow, marketing strategy has not reflected any awareness of increasing customer intelligence, or of elevated industrial integrity. Professor Zhao is quoted as saying,

What’s most surprising to me is that the healthy claims made on the front of these products and the nutritional facts on the back are actually going in the opposite direction.

The study found that the total fat content per serving of newly launched breakfast cereals increased nearly 34% between 2010 and 2023, and sodium content climbed by 32%. Sugar content in the newly introduced products rose by nearly 11%, according to the analysis. Kellogg Company, General Mills and Post Holdings, the three largest makers of breakfast cereals in the United States, did not respond to requests for comment.

Well, what remains to be said? Do we really want them to speak aloud the painful truth? “Hey, you virtuous protectors of the consumer have insisted that all information be revealed. Full disclosure has been duly made. We are as revealing as a striptease artist. The public knows everything about our measurements, and ya know what? The public doesn’t give a tinker’s dam.”

There was some talk of attempting to remove some artificial dyes from the U.S. food supply, but whether any serious attempt will be made to back up the notion with legislation is unclear. Speaking of law, no statute anywhere insists that breakfast cereal must be moistened with milk. Try wetting it down with fruit juice and see what happens.

The Center for Science in the Public Interest, a nutrition advocacy group not involved in the study, published some words from its executive director, Peter Lurie, who was surprised to learn that “large food companies have not made a more concerted effort to reduce the sugar, salt and fat content of their breakfast cereals.”

Well, why should they? If there is a word that describes an attitude more apathetic than apathy, that word would describe the industry’s mental state regarding this issue.

Your responses and feedback are welcome!

Source: “American Breakfast Cereals Are Becoming Less Healthy, Study Finds,” NYTimes.com, 05/21/25
Source: “Nutritional Content of Ready-to-Eat Breakfast Cereals Marketed to Children,” JAMNetwork.com, 05/21/25
Image by Picdream/Pixabay

Genetics May Shape the Future of GLP-1 Medications

Tatyana Meshcheryakova April 22, 2026 No Comments

Childhood obesity treatment is entering a new and highly personalized era. As GLP-1 receptor agonists gain traction as effective tools for weight management in adolescents, emerging research suggests that genetics may play a key role in determining who benefits most (and who experiences side effects).

This evolving intersection of obesity medicine and precision health could transform how providers treat pediatric patients. But it also raises important questions about cost, access, and equity.

The rise of GLP-1 medications in pediatric care

GLP-1 (glucagon-like peptide-1) receptor agonists, including semaglutide and liraglutide, have rapidly become a cornerstone of modern obesity treatment. Originally developed for type 2 diabetes, these medications help regulate appetite, slow digestion, and improve blood sugar control. In adolescents with obesity, clinical trials have demonstrated significant reductions in body mass index (BMI), often far exceeding results from lifestyle interventions alone.

A major study published in The New England Journal of Medicine found that teens treated with semaglutide experienced an average 16% reduction in BMI over 68 weeks. These results have fueled growing adoption in pediatric care and prompted updated treatment guidelines from the American Academy of Pediatrics, which now include pharmacotherapy as part of comprehensive obesity management.

While GLP-1 medications have shown impressive results, not all patients respond the same way. Some adolescents lose significant weight, while others see more modest changes, or struggle with side effects like nausea and vomiting. Recent research highlights a possible explanation: genetic variation. Studies suggest that certain genetic differences may influence how the body regulates appetite and metabolism, how strongly GLP-1 receptors respond to medication, and the likelihood and severity of gastrointestinal side effects.

In fact, new findings reported by Reuters indicate that specific genetic markers may be linked to both greater weight loss outcomes and increased side effect risk in patients taking GLP-1 drugs. This opens the door to a more tailored approach, where treatment decisions are guided not just by BMI or medical history, but by a patient’s genetic profile.

What is personalized (precision) medicine?

Personalized medicine, also known as precision medicine, is an approach that uses individual factors like genetics, environment, and lifestyle to guide healthcare decisions. The National Institutes of Health defines precision medicine as a way to “optimize medical care by tailoring it to individual characteristics.”

In the context of pediatric obesity, this could mean identifying which children are most likely to benefit from GLP-1 medications, predicting who may experience side effects before treatment begins, and adjusting dosages or selecting alternative therapies based on genetic insights. This approach has the potential to make treatment more effective, safer, and more efficient.

Potential benefits for pediatric patients

If successfully implemented, genetically guided obesity treatment could offer several advantages:

Improved Outcomes. Children could receive medications that are more likely to work for their specific biology, increasing the chances of meaningful weight loss and improved health.
Reduced Trial-and-Error. Providers could avoid prescribing medications that are less likely to be effective, saving time and reducing frustration for families.
Better Side Effect Management. Identifying genetic risk factors for side effects may help clinicians proactively manage or avoid adverse reactions.
More Efficient Use of Healthcare Resources. Targeted treatment could reduce unnecessary costs associated with ineffective therapies.

Ethical and equity considerations

While the promise of personalized medicine is compelling, it also introduces new challenges, particularly around access and equity, such as cost barriers, a risk of widening disparities, and data privacy concerns. Genetic testing can be expensive, and insurance coverage is inconsistent. Combined with the already high cost of GLP-1 medications, this could limit access for many families.

Also, communities already disproportionately affected by childhood obesity, such as low-income and minority populations, may have the least access to advanced testing and treatments. And, the Centers for Disease Control and Prevention continues to report higher obesity rates among underserved populations, making equitable access a critical concern. Plus, genetic testing raises questions about how sensitive health data is stored, shared, and protected (especially for children).

The integration of genetics into pediatric obesity treatment represents a major step toward more individualized, science-driven care. However, experts emphasize that medication, personalized or not, should always be part of a broader, holistic approach.

As research continues, the key challenge will be ensuring that innovation does not outpace accessibility. Personalized treatment has the potential to improve outcomes, but only if it is available to all children who need it.

Your responses and feedback are welcome!

Source: “Once-Weekly Semaglutide in Adolescents with Obesity,” The New England Journal of Medicine, 11/2/22
Source: “Semaglutide Treatment Effect in People With Obesity — STEP TEENS,” American College of Cardiology, 12/20/22
Source: “Genetics may help explain why results from weight-loss jabs vary, say scientists,” The Guardian, 4/6/26
Source: “Researchers move closer to matching patients with GLP-1 drug that works best for them,” Reuters, 11/19/25
Source: “The Promise of Precision Medicine,” NIH, undated
Source: “New CDC Data Show Adult Obesity Prevalence Remains High,” CDC, 9/12/24
Image by Tara Winstead/Pexels

Ultra-Processed Foods Cover-up? Part 2

Pat Hartman April 21, 2026 No Comments

Recommended at this point is to catch up by reviewing Part 1, “Is There an Ultra-Processed Foods Coverup?” What makes information about Dr. Dhruv Khullar’s controversial article even more interesting and relevant is this quotation published less than four months previously:

Robert F. Kennedy, Jr., who may soon lead the U.S. Department of Health and Human Services, has made common cause with some lawmakers by railing against ultra-processed food, pledging to remove it from public schools and limit the use of pesticides, artificial dyes, and, perhaps more dubiously, seed oils.

So apparently, Kennedy underwent some changes of opinion about the matter during the few weeks between that publication and his being made head of the Department of Health and Human Services.

Meanwhile, National Institutes of Health investigator Kevin Hall was recalibrating some of his theories based on the advanced work that he had been doing with volunteers, testing four different diets in turn. Dr. Khullar explains:

When the team served ultra-processed foods that were neither calorie-dense nor hyper-palatable — for example, liquid eggs, flavored yogurt and oatmeal, turkey bacon, and burrito bowls with beans — people ate essentially as much as they did on the minimally processed diet. They even lost weight.

Hall had no choice but to conclude that “Weight gain is not a necessary component of a highly ultra-processed diet,” to which Dr. Khullar appended, “He had, in a sense, refuted his hypothesis again.” And that is exactly what any genuine and honest scientist is delighted to do — to discover that he or she had guessed wrong, or drawn conclusions from incomplete data. A true scientist does not care how many times research has to start over, or how often his or her theories need to be revised, as long as truth is reached in the end.

Dr. Khullar also spoke with the venerable Marion Nestle, and introduces her to readers with this description:

[…] a molecular biologist and nutritionist who started the country’s first academic food-studies program, at N.Y.U., helping to bring attention to the roles that culture, capitalism, and politics play in what and how much we eat.

That apparently is exactly the crux of the whole food policy problem: the role being played by factors politely termed culture, capitalism, and politics, when the clashes of opinion are worthy of cruder but more accurate terms for controversy, that some critics would prefer to use. Dr. Khullar recounts how Nestle reminded him of a historical fact:

During the Second World War, U.S. military leaders were alarmed that many recruits, having grown up during the Great Depression, couldn’t join the war effort because of conditions caused by a lack of nutrients, such as rickets, scurvy, anemia, and tooth decay. “That came as a shock, and the military became heavily concerned with nutrition.”

This is very significant in the light of today’s situation, which includes the ineligibility of many young Americans to join the military because they are simply too fat.

At any rate, Nestle is not entirely on board with heaping blame upon ultra-processed food; but is not a big fan of it, either. (She is, incidentally, enthusiastic about Shredded Wheat, and even dusts it with a bit of sugar — to celebrate the fact that she, and not some corporation, is in charge of deciding the amount.)

Together, the two visited some places where food is produced, learning incidental facts, like how giant blocks of cheese should only be grated at the last minute, because “Pre-shredded cheese spoils faster. This way we can avoid preservatives.” This is exactly the sort of knowledge that leaves in the grim landscape some space for hope.

Your responses and feedback are welcome!

Source: “Why Is the American Diet So Deadly?”, Archive.is, 01/06/25
Source: “RFK Jr. aides accused of censoring NIH’s top ultra-processed food scientist,” CBSNews.com, 04/17/25
Image by DanielaElenaTentis/Pixabay

Is There an Ultra-Processed Foods Coverup?

Pat Hartman April 15, 2026 No Comments

Today’s post carries on from “The Nutrition That Never Arrived,” which discusses the work of Dr. Dhruv Khullar, as well as his referencing of Dr. Kevin Hall’s highly-regarded study of ultra-processed foods.

The alarming aspect of this topic is that, almost exactly one year ago, CBS News published a piece titled “RFK Jr. aides accused of censoring NIH’s top ultra-processed food scientist.” That scientist of course was Dr. Hall, described therein as “The National Institutes of Health’s top researcher on ultra-processed foods.”

Hall had announced that, after 21 years at his dream job, he was retiring early because, apparently, the NIH is no longer a place where unbiased science can be conducted. The details are rather shocking, according to journalist Alexander Tin:

Hall told CBS News that he was blocked by the department from being directly interviewed by a reporter from The New York Times, asking about recent research on how ultra-processed foods can be addictive.

Apparently, the NIH leadership did not want any comparison made between being hooked on ultra-processed foods and, for instance, your average meth habit — unless the disease manifests in exactly the same way and causes exactly the same effects as hard-drug addiction.

Hall was allowed to reply to The Times with written answers which “were then edited and sent to the reporter without his consent.” This behavior, needless to say, is normally considered highly unacceptable among professionals in the fields of both medicine and journalism.

Then the situation deteriorated even further when the government denied tampering with Hall’s words, and accused him of untruthfulness about the interference, and acted like the material wasn’t very good or worth being concerned about. Hall, however, maintained that his work on the effects of ultra-processed food on carefully observed subjects…

[…] was the largest study of its kind and no previous study had the same level of dietary control, much less admitted them to a hospital to ensure diet adherence…

Meanwhile, the NIH officials maintained that no censorship was in effect, and that any attempt to portray the government’s position as false would be deliberate distortion. In order to avoid being contradicted, the government agency also prevented Hall from participating in a conference on the subject.

At the same time, Susan Mayne, who had formerly been in charge of the food safety and nutrition center run by the Food and Drug Administration, spoke up for Hall’s research.

This whole controversy surprised many observers because just a few months earlier, reporters were writing passages like this one, published in January of 2025 in The New Yorker:

The dirty little secret is that no one really knows what caused the obesity epidemic. It’s the biggest change to human biology in modern history. But we still don’t have a good handle on why.

That was Dhruv Khullar, quoting what had been said to him by Dariush Mozaffarian, a dean at the Tufts School of Nutrition Science and Policy. The implication is that ultra-processed foods have “probably contributed to rising obesity rates,” although other factors also are involved — like changes in the human microbiome and general metabolism, as well as (probably) epigenetics.

Of course, as always, the possibility exists that the situation is influenced by factors that have not even been suspected yet.

(To be continued… )

Your responses and feedback are welcome!

Source: “RFK Jr. aides accused of censoring NIH’s top ultra-processed food scientist,” CBS News, 04/17/25
Source: “Why Is the American Diet So Deadly?,” The New Yorker, 01/06/25
Image by geralt/Pixabay

The Rise of GLP-1 Medications in Pediatric Obesity: Breakthrough or Barrier?

Tatyana Meshcheryakova April 15, 2026 No Comments

Childhood obesity remains one of the most urgent public health challenges in the United States, affecting roughly one in five children and adolescents. According to the Centers for Disease Control and Prevention, the prevalence of obesity among U.S. youth is about 19.7%, with higher rates among certain racial, ethnic, and low-income populations.

While lifestyle interventions, such as improved nutrition, increased physical activity, and behavioral counseling, have long been the foundation of treatment, a new class of medications is rapidly transforming the field: GLP-1 receptor agonists. These drugs are generating both excitement and debate, especially as their use expands into pediatric care.

So, are GLP-1 medications a true breakthrough, or do they risk widening existing gaps in care?

What are GLP-1 medications?

GLP-1 (glucagon-like peptide-1) receptor agonists are medications that mimic a naturally-occurring hormone involved in regulating appetite, insulin secretion, and digestion. By slowing gastric emptying and increasing satiety, they help reduce food intake and promote weight loss.

Two of the most widely discussed GLP-1 medications are semaglutide and liraglutide. Originally approved for type 2 diabetes, both medications are now FDA-approved for chronic weight management in certain adolescent populations aged 12 and older. Their growing popularity reflects a broader shift toward recognizing obesity as a chronic, biologically complex disease, not simply a result of lifestyle choices.

Clinical trials have demonstrated significant results in adolescents using GLP-1 medications. A landmark study published in The New England Journal of Medicine found that teens treated with semaglutide experienced an average 16.1% reduction in BMI, compared to just 0.6% in the placebo group. Similarly, trials involving liraglutide showed meaningful reductions in BMI and improvements in metabolic health markers.

Beyond weight loss, GLP-1 medications may improve insulin resistance, blood pressure, and lipid profiles (cholesterol levels). These benefits are particularly important given that childhood obesity is strongly linked to long-term risks such as type 2 diabetes, cardiovascular disease, and even certain cancers.

Despite their clinical promise, GLP-1 medications remain out of reach for many families. Without insurance, these drugs can cost $900 to $1,300 per month, a significant financial burden. Even for insured patients, access is often delayed by prior authorization requirements, step therapy protocols, and inconsistent coverage policies.

According to the American Academy of Pediatrics, disparities in access to obesity treatment, including medications, mirror broader inequities in healthcare. Children from underserved communities, who are already at higher risk for obesity, are often the least likely to receive advanced treatments.

Additional barriers include limited availability of pediatric obesity specialists, geographic disparities in care access, and stigma surrounding obesity treatment. This raises a critical concern: Could a breakthrough therapy unintentionally widen health disparities?

While short-term outcomes are encouraging, long-term safety data in pediatric populations is still evolving.

Common side effects include nausea, vomiting, diarrhea, or constipation. In most cases, these symptoms are mild to moderate and improve over time. However, there are still unanswered questions about long-term use in developing bodies, potential impacts on growth and development, weight regain after discontinuation, and more.

Early evidence suggests that stopping GLP-1 therapy often leads to partial or full weight regain, highlighting the chronic nature of obesity and the potential need for ongoing treatment. Experts emphasize that medication should not replace foundational lifestyle interventions but instead serve as part of a comprehensive, multidisciplinary care plan.

The emergence of GLP-1 medications marks a turning point in pediatric obesity treatment. For adolescents who have struggled with traditional approaches, these therapies offer meaningful, evidence-based results, and in many cases, renewed hope. However, their full potential will only be realized if systemic barriers are addressed.

Expanding insurance coverage, improving provider access, and reducing stigma will be essential to ensuring equitable care. As research continues and policies evolve, the challenge is clear: How do we ensure that this medical breakthrough benefits all children, not just a select few?

Your responses and feedback are welcome!

Source: “Once-Weekly Semaglutide in Adolescents with Obesity,” The New England Journal of Medicine, 11/2/22
Source: “Prescriptions for Obesity Medications Among Adolescents Aged 12–17 Years with Obesity — United States, 2018–2023,” CDC, 6/5/25
Source: “Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity,” Pediatrics, February 2023
Source: “New Institute for Clinical and Economic Review Report Shows Significant Jump in Launch Prices, Exceeding Inflation and GDP Growth,” ICER, 10/23/25
Image by Leeloo The First/Pexels

The Nutrition That Never Arrived

Pat Hartman April 14, 2026 No Comments

Pause to visualize a little scenario, a random moment from the days when many young folks actually did pause to rethink their eating habits. The place: a college cafeteria. The girl who has just finished a very healthful lunch blots her lips with a napkin, sighs, and says thoughtfully, “That made me feel… fed.”

It’s a thing that happens now and then, in the presence of genuine nutrients. On the chemical level, the body gets the message: “Something just arrived that will make me healthy, wealthy, and wise.” Millions of tiny cells perk up, and flock to greet and engulf the molecules sent to deliver actual sustenance. A person’s body feels fed. It is an unmistakable sensation, and once felt, never forgotten.

Imagination helps

We have probably all seen something like this in a movie — the scene where a character gets a snootful of an enlivening drug, and shows the immediate effect, so powerful it borders on satire. We can tell that something special just happened. It is the same, on a micro-mini scale, inside the body when an allotment of genuine nutrition manages to get in. Imagine a zillion tiny nutrition junkies suddenly enraptured by a hit of genuine food. It’s the same rush on a different scale of measurement.

Or maybe it is like the scratching of some intolerable itch. Or like the difference between when a baby first wails in frustration, then suddenly latches onto the nipple. Peace at last. Given the opportunity, the body can tell that something extraordinary has just happened — a tsunami of joy, flooding every cell with atoms of pure goodness. When a person gives the body a chance, it can tell.

A closeup view

That is basically what a previous post expressed, in discussing the revolutionary work of Kevin Hall, which “has been cited nearly two thousand times” (as of early 2025, and certainly more by now).

As Dr. Dhruv Khullar wrote in “Why Is the American Diet So Deadly?”,

Hall’s original study […] was the first randomized trial demonstrating that ultra-processed foods disrupt our metabolic health and lead people to overeat. It was hugely influential and is widely recognized as the most rigorous examination of the subject so far.

This is the other side of the coin — the terrible disappointment the body feels at being duped. At being tricked and made a fool of, led to believe that something necessary would be provided, had been provided. Being misled by a scent or even just by a fragment of long-forgotten hope, and then betrayed. Thanks to a scent or a flavor, the anticipation of joy welled up and lasted for a golden instant before being crushed.

Not surprisingly, that work recognizably “sparked controversy and opposition.” The debate over extensive meddling with food began to attract the interest of more scholars, like Dr. Chris van Tulleken. In his book, Ultra-Processed People, these words appear:

With a physiological confusion that barely makes it to the surface of our conscious experience, we find ourselves reaching for another — searching for that nutrition that never arrived.

Sometimes, a phrase absolutely resonates: “Searching for that nutrition that never arrived.” The body has been betrayed. Thanks to the aroma, the bright packaging, the texture of the crispy treats in the plastic bag, and finally their taste… something was promised, but not delivered. That is the junk food experience, which is almost identical to the ultra-processed food experience, because in many cases both categories are applicable.

The experience might be compared with trying to slake thirst with salt water. No matter how dehydrated a person is, that stuff just isn’t going to do the job. In fact, the more of it you drink, the thirstier you will become. Every cell in the body knows the difference, just like it knows the difference between an apple and a merchandised abomination of ingredients that no one in their right mind would want to pronounce or spell, much less ingest.

Disparagement

A critic of Kevin Hall’s work, Walter Willett, led a Harvard study that drew information from “survey data from more than two hundred thousand people,” which resulted in the classification of ultra-processed foods into two major categories. The first contains sugary sodas and processed meats, which increase the risk of cardiovascular trouble.

The second category encompasses “breads and cold cereals, certain dairy products such as flavored yogurts, and savory snacks” that, strangely, apparently decrease cardiovascular risk. (An additional five types of ultra-processed foods apparently do neither.)

When the time came for the government to update its recommendations and endorse or deprecate various food groups, it merely suggested that processed meats be avoided. On the question of whether any amount or impressive source of new information will change American eating, Dr. Khullar seems doubtful:

Our food environments — the type and quality of food that pervades our schools, workplaces, and neighborhoods — influence our diets as much as our tastes do. And our food environments are shaped by our incomes, our government’s choices, and our desire for convenience, as well as active manipulation by the food industry, through things like marketing campaigns and lobbying for agricultural subsidies.

In other words, against what goes on in our neighborhoods, homes, schools, and workplaces — cautious warnings and common sense don’t stand a chance.

Your responses and feedback are welcome!

Source: “Why Is the American Diet So Deadly?”, Archive.is, 01/06/25
Image by tulajbila/Pixabay

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Why BMI alone may be misleading

Introducing the “body composition reset”

Why waist-to-height ratio matters

A shift in pediatric obesity screening

Recognition for innovative research

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Ultra-Processed Foods Cover-up? Part 2

Is There an Ultra-Processed Foods Coverup?

The Rise of GLP-1 Medications in Pediatric Obesity: Breakthrough or Barrier?

What are GLP-1 medications?

The Nutrition That Never Arrived

Imagination helps

A closeup view

Disparagement

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations