Abstract
Over the past 70 years, the prevalence of obesity, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), cardiovascular disease, autoimmune disorders, and common mental-health conditions has increased sharply. During the same period, Western diets shifted toward industrial formulations rich in ultra-processed foods (UPFs), seed oils, refined starches, and added sugars. Evidence from prospective cohort studies, umbrella reviews, and controlled feeding trials demonstrates that a small set of dietary exposures—UPFs, sugar-sweetened beverages, refined carbohydrates, and foods fried in industrial seed oils—accounts for a disproportionate share of modern disease burden (Lane et al., 2024; Vitale et al., 2023; Hall et al., 2019).
This paper reviews the evidence linking these foods to major chronic diseases, explains why government institutions don’t openly connect these dots, and presents a unified, practical framework—The Four Cuts Diet—that removes the most harmful components of the modern food environment.
Introduction
Chronic non-communicable diseases represent the leading causes of death and disability in the United States, where more than half of all adults now live with at least one chronic condition (Wang et al., 2024). Since the mid-20th century, rates of obesity, cardiovascular disease, NAFLD, autoimmune disorders, chronic kidney disease (CKD), type 2 diabetes, and mental-health disorders have escalated dramatically (Wang et al., 2023; Vitale et al., 2023).
This period coincides with a fundamental transformation of the American food system. Traditional dietary patterns centered on home-cooked meals, whole grains, minimally processed fats, and whole foods have been replaced by UPFs, refined starches, sugar-sweetened beverages (SSBs), and foods formulated or fried with industrial seed oils (Lane et al., 2024).
Evidence increasingly indicates that these specific food categories—not “overeating” or “willpower failure”—represent the primary drivers of metabolic dysfunction (Hall et al., 2019; Estruch et al., 2018).
The sections below synthesize the strongest evidence available, reveal why U.S. health institutions avoid making these connections publicly, and outline a simple framework that removes the worst offenders without requiring calorie counting or extreme dieting.
Ultra-Processed Foods
UPFs are industrial formulations made from refined starches, seed oils, added sugars, emulsifiers, and additives—with minimal whole-food components (Lane et al., 2024). An umbrella review covering 45 cohort studies found that higher UPF consumption is associated with increased risk of cardiovascular disease, metabolic dysfunction, obesity, depression, and all-cause mortality (Lane et al., 2024). A separate meta-analysis showed that each 10% increase in UPF intake elevates all-cause mortality risk (Wang et al., 2023).
Controlled feeding trials provide the strongest evidence. In a landmark inpatient crossover study, participants consuming an ultra-processed diet ate approximately 500 additional calories per day and gained weight, while the same individuals lost weight on a minimally processed diet—despite identical macronutrient compositions (Hall et al., 2019). An eight-week controlled diet trial replicated this pattern, showing roughly double the fat loss with minimally processed diets compared to UPF-matched diets (Vitale et al., 2023).
Mechanisms include:
• hyper-palatability driving excess energy intake (Hall et al., 2019)
• impaired satiety signaling and faster eating rates (Vitale et al., 2023)
• emulsifier-induced gut-barrier disruption (Lane et al., 2024)
• chronic inflammation, insulin surges, and metabolic dysregulation (Wang et al., 2023)
The evidence is clear: UPFs are one of the strongest dietary predictors of modern chronic disease.
Sugar-Sweetened Beverages and Added Sugars
SSBs consistently increase the risk of obesity, weight gain, type 2 diabetes, and metabolic syndrome (Malik et al., 2010; Nguyen et al., 2022). A large meta-analysis found that SSB intake increases diabetes risk independent of total body weight (Imamura et al., 2015).
WHO guidelines also identify reduction of liquid sugars as a critical strategy for preventing childhood obesity (WHO, 2014; Yan et al., 2022).
Intervention trials demonstrate that replacing caloric beverages with water or non-caloric drinks improves weight, fasting glucose, and blood pressure (Nguyen et al., 2022).
Mechanistically, liquid sugars bypass normal satiety pathways and rapidly increase liver fat, contributing to NAFLD (Wang et al., 2024).
Cutting SSBs is one of the single most effective dietary changes available.
Refined Carbohydrates
While whole grains offer metabolic protection (Aune et al., 2013; Hu et al., 2020), refined starches drive insulin surges, rapid digestion, and overeating—effects amplified when combined with sugar or seed oils (Shanahan, 2025). High intake of refined grains such as white flour and white rice is associated with increased type 2 diabetes risk (Aune et al., 2013).
Refined carbs are also the backbone of UPFs, forming the “bliss-point” matrix of sugar, starch, and fat that encourages overconsumption.
Fried Foods and Oxidized Seed Oils
Fried foods increase cardiovascular disease, diabetes risk, and mortality (Qin et al., 2021; Djoussé et al., 2015). Each additional weekly serving of fried food increases cardiovascular risk by ~3% (Qin et al., 2021).
Industrially produced seed oils used in frying—including soybean, corn, cottonseed, canola, sunflower, and safflower oils—are high in linoleic acid (LA). When repeatedly heated, LA generates oxidized lipid products (OXLAMs) that damage vascular function and increase inflammation (Mercola et al., 2023).
Repeated-use fryer oil in restaurants is particularly harmful.
Seed Oils and Linoleic Acid
Research on seed oils is mixed. Some randomized trials suggest replacing saturated fat with polyunsaturated fats can reduce LDL cholesterol and possibly cardiovascular events (Santos et al., 2022; Estruch et al., 2018).
Conversely, narrative and mechanistic reviews highlight risks of excessive LA intake—including oxidative stress, mitochondrial dysfunction, and inflammation—particularly when consumed via UPFs or fried foods (Mercola et al., 2023; Shanahan, 2025).
Consensus: seed oils are most harmful when consumed:
• in high quantities
• in fried foods
• in UPFs
• alongside sugar and refined starch
Minimally processed fats (olive oil, avocado oil, dairy fats) align best with protective dietary patterns (Estruch et al., 2013).
Diet and Mental Health
UPFs correlate strongly with depression and anxiety in large observational reviews (Lane et al., 2024; Vitale et al., 2023). Mechanisms include inflammation, gut microbiome disruption, and glycemic volatility (Shanahan, 2025).
Mediterranean-style diets improve depressive symptoms in randomized controlled trials, suggesting dietary patterns directly influence mood (Estruch et al., 2018).
Why Government Agencies Have Not Connected These Dots
Despite seven decades of escalating chronic disease—and the availability of clear evidence—no U.S. agency has publicly stated that UPFs, seed oils, refined starches, and added sugars are the primary drivers of modern metabolic decline.
Government Datasets Quietly Reveal the Pattern
The CDC, USDA, NIH, and NIMH each publish data showing:
• seed-oil consumption explosion
• UPFs rising above 50–60% of calories
• sugar peaking in the 1990s
• obesity, diabetes, CKD, NAFLD increasing
• autoimmune disorders and mental-health diagnoses rising
• autism prevalence rising
• heart-disease diagnoses persisting
These datasets exist in isolation. No agency overlays them or draws joint conclusions. When viewed together—as in the chart accompanying this paper—the correlations become impossible to ignore.
Medical Professionals Are Starting to Acknowledge the Pattern
Independent researchers increasingly highlight these same findings:
• Robert Lustig — sugar and UPFs drive metabolic syndrome
• Chris Knobbe — seed oils and refined carbs drive metabolic collapse
• Kevin Hall (NIH) — UPFs increase caloric intake and weight gain
• Zoe Harcombe — dietary guidelines accelerated obesity
• Georgia Ede — mental health strongly linked to diet quality
• Tim Noakes — high-carb patterns created insulin-resistant populations
These are respected scientists, not fringe voices; they are simply speaking more directly than federal agencies allow themselves to.
Why Institutions Avoid Making a Public Statement
Several forces silence clear public communication:
Economic Dependence
USDA guidelines support the grain industry, seed-oil producers, and packaged-food manufacturers.
Federal programs—including school lunches, prisons, the military, and hospitals—depend on low-cost processed foods.
Liability and Political Risk
Admitting that decades of official dietary advice contributed to chronic disease would create:
• political fallout
• institutional distrust
• potential legal liability
Medical-Education Gaps
Physicians receive minimal training in nutrition, metabolism, or food processing. They rely on federal guidelines—not root-cause dietary frameworks.
The Four Cuts Diet
The Four Cuts Diet is a practical application of the evidence discussed above. It removes the four highest-impact drivers of metabolic dysfunction without requiring calorie counting.
The Four Things to Cut
- Ultra-processed foods
- Seed oils (especially fried foods)
- Added sugar and sugary drinks
- Refined starches
What to Eat Instead
• meat, poultry, fish
• eggs
• vegetables
• fruit
• potatoes, rice
• beans, lentils
• nuts, seeds
• dairy
• olive oil, avocado oil, butter
The 90/10 Rule
90% of calories from whole foods
10% from clean, minimally processed items (protein powder, electrolyte mixes, frozen vegetables, canned beans)
Expected Results
2 weeks: more energy, fewer cravings, better sleep
4–12 weeks: weight loss, improved mood, lower BP
6–12 months: lower disease risk, improved metabolic stability
Conclusion
The rise of chronic disease mirrors the rise of UPFs, seed oils, refined starches, and added sugars. Evidence from randomized trials, mechanistic research, and large cohort studies overwhelmingly demonstrates that removing these foods leads to spontaneous reductions in calorie intake, improved metabolic regulation, and better mental and physical health.
The Four Cuts Diet provides a simple, evidence-driven framework that targets the most harmful components of the modern food environment—components that government institutions, for political and economic reasons, have avoided addressing directly.
The data exists. The pattern is clear. And the solution is far simpler than the public has been led to believe.
References
Aune, D., Norat, T., Romundstad, P., & Vatten, L. J. (2013). Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis of cohort studies. European Journal of Epidemiology, 28(11), 845–858. https://doi.org/10.1007/s10654-013-9852-5
Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M., Corella, D., Arós, F., Gómez-Gracia, E., Ruiz-Gutiérrez, V., Fiol, M., Lapetra, J., Lamuela-Raventos, R. M., Serra-Majem, L., Pintó, X., Basora, J., Muñoz, M. A., Sorlí, J. V., Martínez, J. A., Fitó, M., Gea, A., . . . Martínez-González, M. A. (2018). Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. New England Journal of Medicine, 378(25), e34. https://doi.org/10.1056/nejmoa1800389
Hall, K. D., Ayuketah, A., Brychta, R., Cai, H., Cassimatis, T., Chen, K. Y., Chung, S. T., Costa, E., Courville, A., Darcey, V., Fletcher, L. A., Forde, C. G., Gharib, A. M., Guo, J., Howard, R., Joseph, P. V., McGehee, S., Ouwerkerk, R., Raisinger, K., . . . Zhou, M. (2019). Ultra-Processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake. Cell Metabolism, 30(1), 67-77.e3. https://doi.org/10.1016/j.cmet.2019.05.008
Hu, Y., Ding, M., Sampson, L., Willett, W. C., Manson, J. E., Wang, M., Rosner, B., Hu, F. B., & Sun, Q. (2020). Intake of whole grain foods and risk of type 2 diabetes: results from three prospective cohort studies. BMJ, 370, m2206. https://doi.org/10.1136/bmj.m2206
Imamura, F., O’Connor, L., Ye, Z., Mursu, J., Hayashino, Y., Bhupathiraju, S. N., & Forouhi, N. G. (2015). Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ, 351, h3576. https://doi.org/10.1136/bmj.h3576
Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S., Baker, P., Lawrence, M., Rebholz, C. M., Srour, B., Touvier, M., Jacka, F. N., O’Neil, A., Segasby, T., & Marx, W. (2024). Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ, 384, e077310. https://doi.org/10.1136/bmj-2023-077310
Malik, V. S., Popkin, B. M., Bray, G. A., Després, J., Willett, W. C., & Hu, F. B. (2010). Sugar-Sweetened beverages and risk of metabolic syndrome and type 2 diabetes. Diabetes Care, 33(11), 2477–2483. https://doi.org/10.2337/dc10-1079
Mercola, J., & D’Adamo, C. R. (2023). Linoleic Acid: A Narrative Review of the Effects of Increased Intake in the Standard American Diet and Associations with Chronic Disease. Nutrients, 15(14), 3129. https://doi.org/10.3390/nu15143129
Nguyen, M., Jarvis, S. E., Tinajero, M. G., Yu, J., Chiavaroli, L., Mejia, S. B., Khan, T. A., Tobias, D. K., Willett, W. C., Hu, F. B., Hanley, A. J., Birken, C. S., Sievenpiper, J. L., & Malik, V. S. (2022). Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials. American Journal of Clinical Nutrition, 117(1), 160–174. https://doi.org/10.1016/j.ajcnut.2022.11.008
Qin, P., Zhang, M., Han, M., Liu, D., Luo, X., Xu, L., Zeng, Y., Chen, Q., Wang, T., Chen, X., Zhou, Q., Li, Q., Qie, R., Wu, X., Li, Y., Zhang, Y., Wu, Y., Hu, D., & Hu, F. (2021). Fried-food consumption and risk of cardiovascular disease and all-cause mortality: a meta-analysis of observational studies. Heart, 107(19), 1567–1575. https://doi.org/10.1136/heartjnl-2020-317883
Santos, L. P., Gigante, D. P., Delpino, F. M., Maciel, A. P., & Bielemann, R. M. (2022). Sugar sweetened beverages intake and risk of obesity and cardiometabolic diseases in longitudinal studies: A systematic review and meta-analysis with 1.5 million individuals. Clinical Nutrition ESPEN, 51, 128–142. https://doi.org/10.1016/j.clnesp.2022.08.021
Shanahan, C. (2025). The energy model of insulin resistance: A unifying theory linking seed oils to metabolic disease and cancer. Frontiers in Nutrition, 12, 1532961. https://doi.org/10.3389/fnut.2025.1532961
Vitale, M., Costabile, G., Testa, R., D’Abbronzo, G., Nettore, I. C., Macchia, P. E., & Giacco, R. (2023). Ultra-Processed Foods and Human Health: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Advances in Nutrition, 15(1), 100121. https://doi.org/10.1016/j.advnut.2023.09.009
Wang, F., Kong, X., Guo, Z., Li, L., & Zhang, S. (2024). Global, regional, and national burden of diet high in processed meat from 1990 to 2019: a systematic analysis from the global burden of disease study 2019. Frontiers in Nutrition, 11, 1354287. https://doi.org/10.3389/fnut.2024.1354287
Wang, L., Pan, X., Munro, H. M., Shrubsole, M. J., & Yu, D. (2023). Consumption of ultra-processed foods and all-cause and cause-specific mortality in the Southern Community Cohort Study. Clinical Nutrition, 42(10), 1866–1874. https://doi.org/10.1016/j.clnu.2023.08.012
WHO. (2014). Commentary. https://www.who.int/tools/elena/commentary/ssbs-childhood-obesity
Yan, R. R., Chan, C. B., & Louie, J. C. Y. (2022). Current WHO recommendation to reduce free sugar intake from all sources to below 10% of daily energy intake for supporting overall health is not well supported by available evidence. American Journal of Clinical Nutrition, 116(1), 15–39. https://doi.org/10.1093/ajcn/nqac084
Sources for the chart
Blasbalg, T. L., Hibbeln, J. R., Ramsden, C. E., Majchrzak, S. F., & Rawlings, R. R. (2011). Changes in consumption of omega-3 and omega-6 fatty acids in the United States during the 20th century. American Journal of Clinical Nutrition, 93(5), 950–962. https://doi.org/10.3945/ajcn.110.006643
CDC. (2024a, May 15). National Diabetes Statistics Report. Diabetes. https://www.cdc.gov/diabetes/php/data-research/index.html
CDC. (2024b, December 18). National Health and Nutrition Examination Survey. National Health and Nutrition Examination Survey. https://www.cdc.gov/nchs/nhanes/index.html
CDC. (2025, May 27). Autism and Developmental Disabilities Monitoring (ADDM) network. Autism Spectrum Disorder (ASD). https://www.cdc.gov/autism/addm-network/index.html
Djoussé, L., Petrone, A. B., & Gaziano, J. M. (2015). Consumption of fried foods and risk of heart failure in the physicians’ health study. Journal of the American Heart Association, 4(4). https://doi.org/10.1161/jaha.114.001740
Lerner, A., & Matthias, T. (2015). Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease. Autoimmunity Reviews, 14(6), 479–489. https://doi.org/10.1016/j.autrev.2015.01.009
Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J., Louzada, M. L., Rauber, F., Khandpur, N., Cediel, G., Neri, D., Martinez-Steele, E., Baraldi, L. G., & Jaime, P. C. (2019). Ultra-processed foods: what they are and how to identify them. Public Health Nutrition, 22(5), 936–941. https://doi.org/10.1017/s1368980018003762
National Institute of Mental Health (NIMH). (n.d.). Mental illness. https://www.nimh.nih.gov/health/statistics/mental-illness
Nguyen, V., Middleton, L. Y. M., Zhao, N., Huang, L., Verly, E., Kvasnicka, J., Sagers, L., Patel, C., Colacino, J., & Jolliet, O. (2025). Cleaned NHANES 1988-2018 [Dataset]. https://doi.org/10.6084/m9.figshare.21743372
Popkin, B. M., & Hawkes, C. (2015). Sweetening of the global diet, particularly beverages: patterns, trends, and policy responses. The Lancet Diabetes & Endocrinology, 4(2), 174–186. https://doi.org/10.1016/s2213-8587(15)00419-2
Steele, E. M., Baraldi, L. G., Da Costa Louzada, M. L., Moubarac, J., Mozaffarian, D., & Monteiro, C. A. (2016). Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study. BMJ Open, 6(3), e009892. https://doi.org/10.1136/bmjopen-2015-009892
Twenge, J. M. (2000). The age of anxiety? The birth cohort change in anxiety and neuroticism, 1952–1993. Journal of Personality and Social Psychology, 79(6), 1007–1021. https://doi.org/10.1037/0022-3514.79.6.1007
USDA. (2022, December 15). Food Availability (Per Capita) Data System | Economic Research Service. https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system
USDA. (2025, September 4). Sugar and Sweeteners Yearbook Tables | Economic Research Service. https://www.ers.usda.gov/data-products/sugar-and-sweeteners-yearbook-tables
Younossi, Z. M., Koenig, A. B., Abdelatif, D., Fazel, Y., Henry, L., & Wymer, M. (2015). Global epidemiology of nonalcoholic fatty liver disease—Meta‐analytic assessment of prevalence, incidence, and outcomes. Hepatology, 64(1), 73–84. https://doi.org/10.1002/hep.28431