This is an excellent (and overdue) course correction: moving food processing to the center of dietary guidance aligns far better with human physiology than the old “macro math” framing. Your use of the Kevin Hall NIH metabolic-ward trial is especially powerful because it isolates processing itself, when the diets were matched for offered calories/macros/sugar/fiber, participants still ate ~500 kcal/day more and gained weight on the ultra-processed diet, largely via faster eating and weaker satiety signaling. That’s causal evidence, not moralizing. 
I also really appreciated the brain-health lens and the timing argument: midlife metabolic dysfunction (insulin resistance, hypertension, visceral adiposity) is upstream of later cognitive decline, and dietary patterns that displace ultra-processed foods are a practical way to reduce that risk years before symptoms ever appear. 
Your nuance on “meat vs processed meat” is another important public-service point; people get stuck in ideology when the biology often comes down to structure, additives, sodium/nitrites, and hyper-palatability. And the APOE ε4 discussion is clinically helpful: it makes it easier to understand why late-stage nutrition trials can disappoint without implying diet is irrelevant; risk biology and therapeutic windows matter.
Thanks Dr. Yassine for this interesting article. Glad I've just discovered your Substack. I miss seeing your posts since leaving the Facebook 4/4 group.
The discussion on APOE ε4 makes it easier to understand why some nutrition trials disappoint and why that doesn’t mean diet is irrelevant. Thank you, Hussein!
This is an excellent (and overdue) course correction: moving food processing to the center of dietary guidance aligns far better with human physiology than the old “macro math” framing. Your use of the Kevin Hall NIH metabolic-ward trial is especially powerful because it isolates processing itself, when the diets were matched for offered calories/macros/sugar/fiber, participants still ate ~500 kcal/day more and gained weight on the ultra-processed diet, largely via faster eating and weaker satiety signaling. That’s causal evidence, not moralizing. 
I also really appreciated the brain-health lens and the timing argument: midlife metabolic dysfunction (insulin resistance, hypertension, visceral adiposity) is upstream of later cognitive decline, and dietary patterns that displace ultra-processed foods are a practical way to reduce that risk years before symptoms ever appear. 
Your nuance on “meat vs processed meat” is another important public-service point; people get stuck in ideology when the biology often comes down to structure, additives, sodium/nitrites, and hyper-palatability. And the APOE ε4 discussion is clinically helpful: it makes it easier to understand why late-stage nutrition trials can disappoint without implying diet is irrelevant; risk biology and therapeutic windows matter.
Thanks Dr. Yassine for this interesting article. Glad I've just discovered your Substack. I miss seeing your posts since leaving the Facebook 4/4 group.
The discussion on APOE ε4 makes it easier to understand why some nutrition trials disappoint and why that doesn’t mean diet is irrelevant. Thank you, Hussein!
Dr. Yassine is one of my favorite #ApoE4 experts!