The United States spends more on health care per capita than any other developed nation, yet its citizens die younger, suffer more chronic disease, and grow sicker with each passing decade. The paradox has long puzzled researchers, but a growing body of evidence now points to a single, overarching culprit: the American diet itself, and specifically the dominance of ultra-processed foods that account for nearly 60 percent of the calories consumed by the average adult in this country.
A sweeping examination published by The New Yorker lays out in stark terms just how far the nation’s food supply has drifted from anything resembling nourishment. The piece traces the arc from post-World War II industrialization of the food system to the present day, when the typical American grocery cart is filled with products engineered for shelf stability, maximum palatability, and corporate profit — often at the direct expense of human health. The consequences, measured in rates of obesity, Type 2 diabetes, cardiovascular disease, and certain cancers, are now so severe that diet-related illness has become the leading cause of premature death in the United States.
A Food System Built for Profit, Not for People
The story of how America arrived at this point is not simply one of individual choices or personal responsibility. As The New Yorker details, the modern American food system was shaped by deliberate policy decisions, aggressive lobbying by food manufacturers, and a regulatory apparatus that has consistently prioritized industry interests over public health. Federal agricultural subsidies have for decades favored the production of corn, soy, and wheat — the raw materials that are refined into the cheap sugars, oils, and starches forming the backbone of ultra-processed products. The result is that a bag of chips is often cheaper than a bag of apples, and a fast-food meal costs less than the ingredients needed to cook a balanced dinner at home.
The concept of “ultra-processed food” was formalized by Carlos Monteiro, a Brazilian epidemiologist, who developed the NOVA classification system to categorize foods not merely by their nutrient content but by the degree of industrial processing they undergo. Under this framework, ultra-processed foods are defined as formulations of ingredients, mostly derived from foods and additives, with little if any intact whole food. Think soft drinks, packaged snacks, reconstituted meat products, instant noodles, and industrially produced breads and pastries. These products are designed to be hyper-palatable — engineered combinations of sugar, fat, and salt that override the body’s natural satiety signals and encourage overconsumption.
The Science Is Catching Up With What Our Bodies Already Know
For years, the food industry and some nutrition scientists argued that processing per se was not the problem — that what mattered was the nutrient profile of a given food, not how it was made. That argument has become increasingly difficult to sustain. A landmark 2019 randomized controlled trial conducted by Kevin Hall and colleagues at the National Institutes of Health provided some of the most compelling evidence to date. Participants who were given an ultra-processed diet consumed roughly 500 more calories per day than those given a diet of whole and minimally processed foods, even though both diets were matched for calories, sugar, fat, fiber, and macronutrients presented to participants. The ultra-processed group gained weight; the whole-food group lost it. The study suggested that something about the processing itself — perhaps the texture, the speed of eating it encourages, or its effects on gut hormones — drives people to eat more.
Since then, evidence has only mounted. Large observational studies from France, Spain, Brazil, and the United Kingdom have linked higher consumption of ultra-processed foods to increased risks of cardiovascular disease, depression, cancer, and all-cause mortality. A 2024 umbrella review published in The BMJ synthesized evidence from 45 pooled analyses and found that greater exposure to ultra-processed foods was associated with 32 adverse health outcomes, including a 50 percent higher risk of cardiovascular disease-related death and a 12 percent greater risk of Type 2 diabetes.
America’s Unique Vulnerability
What makes the United States particularly susceptible is the sheer saturation of ultra-processed products in the food supply. According to data cited by The New Yorker, ultra-processed foods make up approximately 57 to 60 percent of the average American adult’s caloric intake, and the figure is even higher for children and adolescents — approaching 67 percent. By comparison, in countries like Italy, France, and Japan, ultra-processed foods account for a significantly smaller share of total calories, and those nations consistently outperform the United States on nearly every measure of dietary health and longevity.
The disparity is not accidental. The American food industry is the most powerful and consolidated in the world. A handful of multinational corporations — including Nestlé, PepsiCo, Kraft Heinz, and General Mills — control vast swaths of the grocery aisle. These companies spend billions annually on marketing, much of it targeted at children, and they have fought tenaciously against efforts to impose front-of-package warning labels, restrict advertising of junk food to minors, or reform school lunch programs. Their lobbying arms have deep ties to the U.S. Department of Agriculture, which faces an inherent conflict of interest: the same agency charged with promoting American agricultural products is also responsible for issuing dietary guidelines.
The Inequality of Eating Well
The health toll of the ultra-processed diet falls disproportionately on lower-income Americans and communities of color. Food deserts — areas with limited access to grocery stores selling fresh produce — remain widespread in rural and urban neighborhoods alike. When the nearest source of food is a gas station or a dollar store, the options available are overwhelmingly ultra-processed. The economic calculus is brutal: families stretched thin by stagnant wages and rising housing costs turn to the cheapest available calories, which are almost invariably the most heavily processed.
This dynamic creates a vicious feedback loop. Poor diet leads to chronic disease, which leads to higher medical costs, which leads to greater financial strain, which leads to continued reliance on cheap, processed food. The Supplemental Nutrition Assistance Program (SNAP), which serves roughly 42 million Americans, places no restrictions on the types of food that can be purchased with benefits. Proposals to limit SNAP purchases to healthier options have been met with resistance from both the food industry and some anti-hunger advocates who argue that such restrictions would be paternalistic and difficult to administer.
The GLP-1 Drug Boom and the Limits of Pharmaceutical Fixes
The rise of GLP-1 receptor agonist drugs like Ozempic and Wegovy has introduced a new variable into the conversation. These medications, originally developed for Type 2 diabetes, have proven remarkably effective at inducing weight loss by mimicking a gut hormone that reduces appetite. Their popularity has exploded, with prescriptions surging and pharmaceutical companies racing to develop next-generation versions. Some public health experts have hailed the drugs as a potential turning point in the obesity crisis.
But others caution that pharmaceutical intervention, however effective for individual patients, cannot substitute for systemic reform of the food supply. The drugs are expensive — often exceeding $1,000 per month without insurance — and must be taken indefinitely to maintain weight loss. They also carry side effects, including nausea, pancreatitis risk, and muscle loss. More fundamentally, treating the consequences of a toxic food environment with medication, while leaving that environment intact, addresses symptoms rather than causes. As Marion Nestle, the New York University professor emerita of nutrition and food studies, has repeatedly argued, the most effective public health interventions are those that change the conditions in which people live and eat, not those that ask individuals to compensate for a broken system.
Regulatory Stirrings and Political Headwinds
There are signs that the political winds may be shifting, however unevenly. Robert F. Kennedy Jr.’s appointment to lead the Department of Health and Human Services under the incoming Trump administration has drawn attention to food policy, albeit in controversial fashion. Kennedy has spoken frequently about the dangers of processed food and food additives, though critics have noted that his positions often conflate legitimate concerns about diet with unfounded claims about vaccines and other health topics. Whether his tenure will produce meaningful regulatory action on food remains to be seen.
Meanwhile, other countries are moving ahead. Chile, Mexico, and Colombia have implemented mandatory front-of-package warning labels — black octagonal symbols that alert consumers when products are high in sugar, sodium, saturated fat, or calories. Early evidence from Chile suggests the labels have led to reformulation of products and modest reductions in purchases of the least healthy items. The United Kingdom has imposed restrictions on the advertising of foods high in fat, sugar, and salt to children. France has adopted the Nutri-Score system, a color-coded label that grades foods from A (healthiest) to E. The United States, by contrast, still relies on the Nutrition Facts panel — a format that requires consumers to parse serving sizes, percentage daily values, and ingredient lists that can run dozens of items long.
What a Real Solution Would Require
Addressing the crisis would demand action on multiple fronts simultaneously. Agricultural policy would need to be reoriented to support the production and distribution of fruits, vegetables, legumes, and whole grains rather than commodity crops destined for industrial processing. Marketing of ultra-processed foods to children would need to be curtailed. School meal programs would need adequate funding to serve genuinely nutritious food. SNAP benefits could be structured to incentivize — not merely permit — the purchase of whole foods, as pilot programs like the USDA’s Gus Schumacher Nutrition Incentive Program have begun to do on a small scale.
The food industry itself would need to be held to higher standards, whether through reformulation mandates, advertising restrictions, or taxation of the most harmful products. Soda taxes, already in effect in several U.S. cities including Philadelphia and Seattle, have shown modest but measurable effects on consumption. Scaling such measures nationally would face fierce industry opposition, but the public health rationale grows stronger with each new study linking ultra-processed diets to disease and death. The American diet did not become deadly by accident. It was made that way, product by product, policy by policy, dollar by dollar. Reversing the damage will require an equally deliberate effort — one that treats food not as a commodity to be optimized for profit, but as the foundation of a nation’s health.