Eating large amounts of ultra-processed food increases risk of early death, study finds
Consuming large amounts of ultra-processed food (UPF) increases the risk of an early death, according to a international study that has reignited calls for a crackdown.
Each 10% extra intake of UPF, such as bread, cakes and ready meals, increases someone's risk of dying before they reach 75 by 3%, according to research.
UPF is so damaging to health it is implicated in as many as one in seven of all premature deaths that occur in some countries, according to a paper in the American Journal of Preventive Medicine.
They are associated with 124,107 early deaths in the US a year and 17,781 deaths every year in England, the review of dietary and mortality data from eight countries found.
Eduardo Augusto Fernandes Nilson, the lead investigator of the study, from the Oswaldo Cruz Foundation in Brazil, said additives such as sweeteners and flavourings harm health, not just UPFs' high levels of fat, salt and sugar.
The authors found 'a linear dose-response association between the ultra-processed food consumption and all-cause mortality' when they examined official surveys previously undertaken in the UK and US, as well as Australia, Brazil, Canada, Colombia, Chile and Mexico.
While 4%, 5% and 6% of premature deaths in Colombia, Brazil, and Chile respectively are 'attributable to UPF consumption', the equivalent percentage is 10.9% in Canada, 13.7% in the US and 13.8% in England — the highest proportion among the eight countries.
Premature deaths attributable to consumptions of ultra-processed foods increase significantly according to their share in individuals' total energy intake.
A high amount of UPF intake can significantly affect health,' the study concluded.
Death rates are highest in the countries where the population gets the largest amounts of total energy from eating UPF.
'We first estimated a linear association between the dietary share of UPFs and all-cause mortality, so that each 10% increase in the participation of UPFs in the diet increases the risk of death from all causes by 3%,' said Mr Nilson.
'UPFs affect health beyond the individual impact of high content of critical nutrients — sodium, trans fats and sugar — because of the changes in the foods during industrial processing and the use of artificial ingredients, including colourants, artificial flavours and sweeteners, emulsifiers and many other additives and processing aids, so assessing deaths from all causes associated with UPF consumption allows an overall estimate of the effect of industrial food processing on health.'
The study's authors urged governments worldwide to introduce bold measures to tackle UPF, including tighter regulation of food marketing and the sale of food in schools and workplaces, and also taxes on UPF products.
The findings add to the growing body of evidence linking UPF to a higher risk of both specific illnesses, such as cancer and heart disease, and a increased risk overall of dying before 75. However, they found an association between UPF and early death, not that one definitely causes the other.
US research published last year in the British Medical Journal found people who consume the most UPF have a 4% higher risk of death overall, and a 9% greater risk of dying from something other than cancer or heart disease.
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Irish Daily Star
30-04-2025
- Irish Daily Star
Four ultra-processed foods that may be harming your health without you realizing
When asked to identify ultra-processed foods, many people would likely point to high fat or sugar snacks and meals. Biscuits, crisps, sausages, and pastries are all obvious examples - but there are some less well-known ones. The health warning offers similar advice to an expert who said a diet switch could lead to a 17 percent reduction of your death risk. The British Heart Foundation explains that the term 'ultra-processed foods', which has been linked to increased chances of contracting serious health issues , originates from the NOVA food classification system developed by researchers at the University of São Paulo, Brazil. This system categorises food into four groups based on the extent of processing during production: Unprocessed or minimally processed foods : This includes produce such as fruit, vegetables, milk, fish, pulses, eggs, nuts and seeds that have no added ingredients and have been little altered from their natural state. Read More Related Articles FDA says bread sold in six states has been recalled over 'glass fragments' Read More Related Articles Four jobs linked to highest heart disease risk including one with 'extreme' effects Processed ingredients : This includes foods that are added to other foods rather than eaten by themselves, such as salt , sugar and oils Dr Chris Van Tulleken, author of Ultra Processed People, says many of us are consuming ultra-processed foods without even realising it (Image: Getty Images) Processed foods : These are foods that are made by combining foods from groups 1 and 2, which are altered in a way that home cooks could do themselves. They include foods such as jam, pickles, tinned fruit and vegetables, homemade breads and cheeses Ultra-processed foods : Ultra-processed foods typically have more than 1 ingredient that you never or rarely find in a kitchen. They also tend to include many additives and ingredients that are not typically used in home cooking, such as preservatives, emulsifiers, sweeteners, and artificial colours and flavours. These foods generally have a long shelf life. Many items in the UPF category are tasty choices or quick and easy to grab, making them a popular choice in our hectic lives. However, researchers have just released findings from a significant study which revealed that nearly 18,000 people potentially died as a result of consuming UPFs. The research, published in the American Journal of Preventive Medicine, found that in 2018/19, approximately 17,781 premature deaths in the UK could have been associated with UPFs, , reports Surrey Live . Lead investigator Eduardo Nilson, hailing from Brazil's notable Oswaldo Cruz Foundation, outlined: "UPFs affect health beyond the individual impact of high content of critical nutrients (sodium, trans fats, and sugar) because of the changes in the foods during industrial processing and the use of artificial ingredients, including colourants, artificial flavours and sweeteners, emulsifiers, and many other additives and processing aids, so assessing deaths from all causes associated with UPF consumption allows an overall estimate of the effect of industrial food processing on health." Dr Nilson highlighted the stark findings of the study: "Each 10% increase in the participation of UPFs in the diet increases the risk of death from all causes by 3%." The British Heart Foundation (BHF) cautions: "More than half of the energy (calories) an average person in the UK eats and drinks comes from ultra-processed foods. That's perhaps not surprising as they can be convenient and appealing and are heavily marketed to us. But researchers have shown that ultra-processed foods can impact our health." However, it's not always straightforward to dodge UPFs, some are more elusive than you think. It's clear they go beyond sausage ice cream, crisps, and biscuits - striking some as seemingly healthy or just unexpected. Ultra-processed foods that might catch us off guard. Many people might not realize that their 'healthy' breakfast cereal or a ham salad sandwich could be packed with UPFs. The BHF remarks: "When you think of ultra-processed foods, you might think of chips, sweets, and colourful sugary drinks, but there are some less obvious examples." It's highlighted a few items that may fly under your UPF radar. Breakfast cereals and bread. Common goods like breakfast cereals and mass-produced or packaged bread are often tagged as ultra-processed foods. They typically contain added extras during their making, such as emulsifiers, sweeteners, and artificial colours and flavours. The BHF notes: "One of the criticisms of the NOVA method of categorising foods is that foods like these, which can be part of a healthy diet, sit alongside less nutritious ultra-processed foods. Less nutritious ultra-processed foods can include pre-prepared meals, sausages and nuggets, as well as sweets, biscuits, pastries, buns, cakes and pre-prepared chips." Vegetarian and vegan foods. Even plant-based meat and cheese alternatives fall into the ultra-processed category, so they might not be as wholesome as their marketing suggests. Cheese. Most fresh dairy cheeses such as Cheddar, Brie, mozzarella, and Edam are classified as processed foods because they're made using methods like pasteurisation, fermentation, or ageing, according to the BHF. However, some cheeses are considered UPFs. The BHF advises: "Cheeses that are ultra-processed include cheese slices, spreads, some shredded cheeses, and flavoured cheeses. They have been industrially processed and can typically contain added fats, sugars and salt, as well as ingredients we do not have at home, such as preservatives, sweeteners, emulsifiers, and artificial colourings. "Vegetarian and vegan cheeses can also be ultra-processed because of the ingredients and additives used to make them taste and feel like dairy cheese. Cheese is a good source of calcium and protein and, in moderation, can be a healthy part of your diet. "To avoid ultra-processed foods, stick to traditional cheeses. For example, buying Cheddar in a large block and slicing it yourself is cheaper and healthier than buying pre-sliced options. "But keep in mind that cheese can be high in salt and saturated fat, so aim for a matchbox-sized portion (around 30g) per day to keep your intake in check." Beverages. Ultra-processed foods aren't limited to brightly colored options. According to the BHF, "carbonated drinks and some alcoholic beverages, including whisky, gin, and rum," all fall under this category. Is it necessary to completely eliminate UPFs from my diet? The BHF advises that even though evidence is piling up against ultra-processed foods in relation to heart and circulatory health, the current research isn't strong enough to mandate completely ditching them. They suggest: "Instead of trying to completely cut out these foods, think about the balance in your diet. For all the latest news straight to your inbox, sign up for our FREE newsletters here . "Make sure that there are minimally processed foods in there too – eat fruit and vegetables with your meals and drink water instead of sugary drinks – and try to fit in time over the week for home cooking. It's also important to remember that not all ultra-processed foods are equal. "When you do include ultra-processed foods in your diet, choose those with more nutritional benefit – wholegrain bread and cereals or baked beans for example, instead of crisps, sweets or pizzas. Get in the habit of reading food labels so you can easily identify and cut back on foods that are high in sugar, salt, or saturated fat." For the latest local news and features on Irish America, visit our homepage here .
Irish Examiner
28-04-2025
- Irish Examiner
Eating large amounts of ultra-processed food increases risk of early death, study finds
Consuming large amounts of ultra-processed food (UPF) increases the risk of an early death, according to a international study that has reignited calls for a crackdown. Each 10% extra intake of UPF, such as bread, cakes and ready meals, increases someone's risk of dying before they reach 75 by 3%, according to research. UPF is so damaging to health it is implicated in as many as one in seven of all premature deaths that occur in some countries, according to a paper in the American Journal of Preventive Medicine. They are associated with 124,107 early deaths in the US a year and 17,781 deaths every year in England, the review of dietary and mortality data from eight countries found. Eduardo Augusto Fernandes Nilson, the lead investigator of the study, from the Oswaldo Cruz Foundation in Brazil, said additives such as sweeteners and flavourings harm health, not just UPFs' high levels of fat, salt and sugar. The authors found 'a linear dose-response association between the ultra-processed food consumption and all-cause mortality' when they examined official surveys previously undertaken in the UK and US, as well as Australia, Brazil, Canada, Colombia, Chile and Mexico. While 4%, 5% and 6% of premature deaths in Colombia, Brazil, and Chile respectively are 'attributable to UPF consumption', the equivalent percentage is 10.9% in Canada, 13.7% in the US and 13.8% in England — the highest proportion among the eight countries. Premature deaths attributable to consumptions of ultra-processed foods increase significantly according to their share in individuals' total energy intake. A high amount of UPF intake can significantly affect health,' the study concluded. Death rates are highest in the countries where the population gets the largest amounts of total energy from eating UPF. 'We first estimated a linear association between the dietary share of UPFs and all-cause mortality, so that each 10% increase in the participation of UPFs in the diet increases the risk of death from all causes by 3%,' said Mr Nilson. 'UPFs affect health beyond the individual impact of high content of critical nutrients — sodium, trans fats and sugar — because of the changes in the foods during industrial processing and the use of artificial ingredients, including colourants, artificial flavours and sweeteners, emulsifiers and many other additives and processing aids, so assessing deaths from all causes associated with UPF consumption allows an overall estimate of the effect of industrial food processing on health.' The study's authors urged governments worldwide to introduce bold measures to tackle UPF, including tighter regulation of food marketing and the sale of food in schools and workplaces, and also taxes on UPF products. The findings add to the growing body of evidence linking UPF to a higher risk of both specific illnesses, such as cancer and heart disease, and a increased risk overall of dying before 75. However, they found an association between UPF and early death, not that one definitely causes the other. US research published last year in the British Medical Journal found people who consume the most UPF have a 4% higher risk of death overall, and a 9% greater risk of dying from something other than cancer or heart disease.
Irish Examiner
26-04-2025
- Irish Examiner
I tried to give up ultra-processed foods — here's what happened (and what the experts had to say)
I am staring at the ingredients list of a chicken wrap. It has more than 40, half of which I can't identify. Additives, emulsifiers, E numbers, and acidity regulators are all listed before I get to what I would have assumed was the main ingredient — chicken. And, as you'll know if you studied home economics in secondary school, ingredients on food labels must be listed in descending order of weight. It's one of the major shocks I endure during my seven days of attempting to eat no ultra-processed foods (UPFs). There are many. From stock cubes to tins of coconut milk, 'healthy' Nutella alternatives and packs of quick-oats, the week is full of moments where I wonder: how much of my diet is actually made up of the food I think I am buying, and not, as the man heading the growing movement shunning UPFs terms it, 'food-like substances'? Dr Chris van Tulleken has become the face of a movement decreeing ultra-processed foods. Picture: Claire Witkin That man is infectious disease physician Chris van Tulleken, whose book Ultra-Processed People: Why Do We All Eat Stuff That Isn't Food…and Why Can't We Stop? has become one of those science books that transcends the health and wellbeing space. Released in 2023, the book has since been the focus of a prime-time TV show, podcasts, and been embraced by a slew of online influencers who have taken to spreading its gospel. With just 2% of nutrition-related videos analysed on TikTok being shown to be accurate, according to recent research from Dublin City University and MyFitnessPal, it's safe to say we should all be wary of taking nutrition advice from those who lack the appropriate qualifications. That said, those advocating the avoidance of UPFs can point to a growing body of research that looks like it could support at least some of their claims. A recent study suggested those following a diet consisting wholly of UPFs are likely to consume more calories compared to those eating whole foods, which could be linked to rising obesity levels. A large review of studies published last year also drew links between UPFs and 32 health problems, including higher risk of heart disease, cancer, type 2 diabetes, and adverse mental health. Nicole Glennon discovered many of her kitchen staples were considered UPFs. Picture: Nina Val What is an ultra-processed food? The NOVA food classification system, devised by Carlos Monteiro, professor of nutrition and public health at the University of São Paulo, Brazil, is the most widely used method of identifying UPFs. It categorises foods into four categories: unprocessed, minimally processed, processed, and ultra-processed foods. The latter are defined as 'industrial formulations made entirely or mostly from substances extracted from foods (oils, fats, sugar, starch, and proteins), derived from food constituents (hydrogenated fats and modified starch), or synthesised in laboratories from food substrates or other organic sources (flavour enhancers, colours, and several food additives).' Dietitian Orla Walsh has another way of thinking about it: 'If you're making processed food, you're putting on an apron; if it's ultra-processed, you're putting on a lab coat.' We typically picture UPFs as a calorific pizza, a pack of luminous sweets, a certain brand of potato snack that promises 'once you pop, you can't stop'. But what soon becomes apparent when I start reading the food labels of products in my own cupboard and fridge is just how much of my kitchen is made up of these foods. A study published in 2018 found that almost half of the average Irish diet is made up of UPFs, but after rifling through my kitchen before my UPF-free grocery shop, I'd be surprised if that isn't an underestimation. From my humble loaf of bread to breakfast cereals, ketchup, and soy sauce, curry pastes and high-end chocolate bars, most contain a lengthy list of ingredients I don't recognise. Even the tinned tomatoes, coconut milk, and stock cubes, which contain chemical preservatives, are considered UPFs. I quickly realise meals I make from scratch: stews, curries, pasta dishes with homemade sauce, are all considered UPFs under this definition. It'll be a long week. A look at some of the food Nicole enjoyed during her UPF-free week. Picture: Nina Val A week without ultra-processed foods Grocery shopping the weekend before my challenge is one of the most time-consuming and stressful experiences I've ever had in a supermarket — and I did the household's pandemic shopping. I spend over an hour in my local Lidl and Tesco, reading the labels of everything that goes in my trolley. I stock up on fresh fruit, vegetables and meats, opting for organic varieties where available. I find UPF-free versions of some of the 'handy' products I was concerned about — such as boil-in-the-bag rice — as well as UPF-free tinned tomatoes and tomato puree. I manage to find alternative ketchup, mayonnaise, peanut butter, and stock cube products that pass the UPF-free test, but a suitable tin of coconut milk proves elusive. It's a sign of how deranged this challenge is already making me that I almost cry with relief when I realise all of Ballymaloe's pasta sauces are UPF free. Monday: I am working from home, so making everything from scratch is easy to stick to. Porridge with fruit, seeds, and a dollop of 100% peanut butter. Scrambled eggs on a fresh sourdough loaf with butter. Smoked salmon with a homemade pasta sauce made with cream and butter. The only slight annoyance today is having to trade my usual pre-workout protein bar for an oat bar from plant-based brand Deliciously Ella. It's tasty, but not as filling, and I notice the difference in my performance in the gym. Tuesday: Things start getting trickier. I am in the office today and realise the quick oats variety of porridge I have at my desk isn't UPF friendly. It only has four ingredients, but one — sulphur dioxide — means it's off limits. I am eating out with a colleague for lunch and spend an unreasonable amount of time trying to find a local eatery that lists the ingredients on their lunch plates. None do. I reckon my best option is a salad-chain, but when I reach the top of the queue, I see there's an allergen listed for every bowl — sulphur dioxide. Now starving, and conscious of my uber-patient colleague waiting to order, I accept defeat and order the bowl anyway. Dinner is a stew, sans some of the UPF ingredients I'd usually use, like Worcestershire sauce. My cravings for a sweet treat are satisfied by M&S' Dominican Republic 46% milk chocolate, which appears to be the only high-street brand offering chocolate I can eat. It's a highlight of the week. M&S' UPF-free Milk Chocolate was a saving grace during Nicole's week Wednesday: With two work events to attend, both of which involve food, I am really starting to feel the restriction. Sitting in the middle of a table of 20-plus people, my cheeks are bright red as I ask the waitress if I can check which items on the set menu are free of additives, emulsifiers and preservatives. 'Allergies?' she asks. I say no, I am just trying to avoid them, and immediately sense her internal eye roll. Sweating at this point, and with my fellow dinner guests all eavesdropping, I ask if she can check if any options are free of sulphites – these are a common allergy, at least. After a couple of minutes, the server returns and assures me all options are fine, which honestly, seems unlikely given how prevalent I now realise sulphites are... I order a salad without the dressing or accompanying focaccia, the roast chicken and skip dessert. Later that day, I attend the second event and eat nothing. I arrive home late and starving, rustling up a salad with sweet potato and halloumi. I text my friend to rearrange our lunch date for this weekend — I can't face having to eat out again. Nicole ate a lot of salads during her UPF-free week Thursday: I take a stroll to my local coffee shop for breakfast. I want the ground to swallow me whole when I ask the barista if he knows what's in the 'bliss balls' on the counter. Thankfully, I am the only one there at the time, so he's happy to dig out a big folder with all the information on what they stock, including ingredients and allergens. They turn out to be UPF free... hooray! Despite the flat white, I have a lingering headache, and I am chalking this down to the fact that I am probably consuming a lot less sugar than I usually would. It's one of the first proper sunshiny days of the year, and later, as I go for a walk with my partner, I feel a bit sorry for myself when I see everyone with their first 99s of the season. We check our local Mace to see if there's any ice cream I can have. I can't find one. A croissant from Bread 41 Bakery, Pearse St Friday: Back in the office, I've come prepared. UPF-free quick oats with porridge and fruit for breakfast, a make-shift salad bowl for lunch, and a croissant from local bakery Bread 41 after confirming the ingredients used. When I clock off for the evening, I can't face another salad, or cooking a meal from scratch after a week of it, so I head to M&S to see if I can find anything ready-made that passes the test. To my delight, I do. A steak pie, roasted potatoes, and beef gravy. I can't express how glorious it feels to just throw something in the oven that evening with minimal effort and clean up. I've managed to nab all three items for under €12 too, as all are reduced to clear at the end of the day. A Friday takeout for two in Dublin now costs almost three times that, so it's a rare win for my wallet this week too. Saturday: For breakfast, I try M&S' one-ingredient cornflakes, a new product you have to imagine has come on stream as a direct result of the rise in awareness around UPFs. I wonder how something made only of corn can taste good. It doesn't. I am on the move most of today, with no access to a kitchen to refrigerate or heat up pre-prepared foods. For lunch, I go to one of Dall'Italia's pasta bars, where the chef prepares the dish right in front of you with ingredients of your choosing. A traditional carbonara seems like a safe and delicious choice. Later that day, I bring my own UPF-free flatbreads, crisps, and hummus to a pal's wine and cheese night. Technically, I should not have had a few glasses of wine, given it contains sulphites. However, they are naturally occurring sulphites, so I convince myself they can't count as ultra-processed. It's been a long week. Nicole managed to find a UPF-free lunch at Heuston Station Sunday: I am on the move again and lunch at Heuston Station proves challenging. After examining ingredients in a range of pre-packaged foods, I am starting to think fresh chips from Supermacs might be my best option. I eventually find a pesto pasta I can eat. Dinner that night is out of my hands again, as we are in a restaurant for a birthday. After my dressing-less salad and what I feel is the relatively safe choice of fish and chips (at this stage, I am not asking what's in the batter) I am feeling very deserving of breaking out and indulging in a dessert. I order the most luscious chocolate dessert to celebrate the end of my UPF week. When it arrives, with a glistening ganache top and dark, rich mousse, I am thrilled, but about an hour after eating it, I feel rotten. The rest of the night, I am conscious of my stomach gurgling away as I rub its distended, bloated surface. It's probably just the high sugar content after a week of nothing but some good quality chocolate, but it makes me question whether, now that I'm free of my UPF challenge, I really should return to my previous way of eating... Should we cut out ultraprocessed foods? Here's what the experts say 'For a lot of people, UPFs make up the bulk of their diet,' dietitian Orla Walsh says. 'One reason for this is UPFs tend to taste great, so it's understandable why people would want to eat them, but the other thing is, cooking skills have reduced. It's commonplace that someone would come into my clinic and not know how to boil an egg or make an omelette.' She notes that UPFs, particularly those that are fortified with vitamins and minerals, are in some cases helping to 'fill nutrient gaps' in many Irish people's diets. 'Highlighting UPFs can be helpful,' she says, but feels the conversation, particularly in online spaces, 'is too black and white'. Orla Walsh: 'If a name sounds chemical, it might still be safe — and not only safe, but beneficial for you' 'Just because you can't pronounce something or you don't know what it is, doesn't mean it's bad. If a name sounds chemical, it might still be safe — and not only safe, but beneficial for you.' For dietitian Evan Lynch, the Nova UPF classification is flawed because it doesn't take into account the potential benefit or nutritional value of different foods. 'A protein yoghurt and a frozen pizza are both ultra-processed foods,' he points out. While some research suggests UPFs might be linked to overconsumption, his own experience working with clients is that some UPFs can play a role in managing hunger. 'If you're on a weight loss journey, and struggling with satiety, protein bars and yoghurts can really help with satiety, which is associated with better weight loss outcomes.' 'There's no compelling research or evidence that I can see that including foods like this in a balanced manner will raise your likelihood of having a disease,' Lynch says. For every person, the decision to use a UPF should boil down to, what's your personal situation, what's your food environment, what are your skills, how much time do you have, and does the UPF either add to the nutrient value or the nutritional value of your diet, or subtract from it? Even nutritionist Rob Hobson, the author of two books, Unprocess Your Life and Unprocess Your Family Life, recommends a balanced approach. 'The negative impact UPFs have on health is often due to a combination of factors, including their nutrient-poor composition, additives, altered food structure, and the broader dietary context in which they are consumed,' he says. For Hobson, it's not about demonising a whole slew of foods, but about helping consumers understand 'more about our food system', including that modern day ultra-processing may play a role in why many of us struggle to eat within our recommended calorie allowances. That said, Hobson is aware that the convenience of UPFs is something that can't be easily replaced. The cost of buying whole, organic foods, also can't be understated. Rob Hobson takes a balanced approach to reducing UPFs in our diet. Picture: Ola Smit 'People need to do the best they can with the time and the money that they've got. If you can't afford to buy sourdough, or your kids don't like it, and you have to buy white sliced bread, it's not the end of the world. 'You're not poisoning your kids by giving them some UPF foods,' he stresses. How worried the average person or parent should be about UPFs largely depends on how reliant we are on them throughout our diet, he says. 'You're not going to sacrifice your health dramatically if you're eating some ultra-processed food,' he says. 'We have to be realistic,' Hobson says. 'I get attacked a lot by people who say 'don't eat anything UPF, the food industry is killing you'. It's a very nuanced topic. It's not that simple for most people.' Nicole Glennon says her experience has changed her grocery shop — but she won't be changing her diet massively. Picture: Nina Val My final takeaway In the days after I finish my week of eating no UPFs, and sharing parts of my journey on my Instagram page, I keep getting asked the same question: 'Will you keep it up?' I will continue to read food labels and be more aware of what goes in my shopping trolley. Where possible, I'll buy foods that don't contain additives or emulsifiers. At best, they aren't adding much to my diet, at worst, they may be linked to negative health outcomes — I'd rather avoid them. Aside from that, I don't plan on changing my diet too much. UPFs are so ingrained in modern-day life, avoiding them is not possible without significant lifestyle changes, some of which have their own consequences. For example, I went to the gym less during my challenge because I was spending more evenings cooking food and prepping tomorrow's lunch. My grocery bill skyrocketed as I had to replace so many of my fridge and cupboard staples. I developed anxiety around food and eating out. I took myself out of social situations because I didn't want to inconvenience friends or service staff. Reflecting on the week, something Orla Walsh said really resonates. 'It might be mad as a dietitian to say this, but I don't want someone's number one priority to be nutrition. That's not healthy.' So, I am off to get that 99 — and I won't feel bad about it.
