California passes law to ban ultra-processed foods from school lunches

> Ok, so we already have your standard

Who is "we"?

I don't know what you are going on about. Empirical evidence is one thing, mechanism is another source of knowledge by which we can shape public health policy. While empirical evidence is valid only for the situation in which it was obtained, mechanism is universal.

For example, we mandate wearing seatbelts in cars in the name of public health. It is however not necessary to do seatbelt on/off RCTs with actual people. How we know that this is beneficial: Because physics, verification through crash tests (with dummies), and because we know that seatbelt mandates increase the frequency of people wearing them.

Going back to the original question, it was clearly shown in observational studies that giving children sweetened food is bad: Childhood dietary habits shape lifelong food preferences, and preference for sweet food leads to worse outcomes regarding chronic diseases later in life. This has been shown in lots of research, both in humans and in animal models:

https://doi.org/10.1126/science.adn5421

https://doi.org/10.3390/nu16030428

https://doi.org/10.1093/chemse/bjr050

With randomly adding or substituting sugar with artificial sweeteners there is however no empirical evidence nor known mechanism which supports a public health benefit. In fact the mechanisms we know from animal farming suggest a detrimental effect.

I'm open to being wrong but if it's not the oil or the frying, what is it that makes potato chips junk food?

A finding that most kindergartens and youth centers finds out is that cutting apples into pieces will have a significant difference in consumption compared to providing them as whole. It could be the aroma or the lower investment to start eating (just one slice, and then a second one...). It also work on adults in places like wellness centers, and hotels (watch what happens if they place a plate with cut fruit vs a bowl with whole fruits).

School food generally has the problem that they made to be cheap, low labor, and lowest common denominator terms of taste, spices and salt. To take Sweden as an example, the cost per serving sit just between $0.6 to $1.2 per student in term of ingredients cost. Even providing an apple per student would cut into that budget.

Thanks - I'd not seen DASH-sodium but only the DASH study whose samples it's based on.

Having read the study now: DASH-sodium barely indicates anything about sodium independently. It looks at three biomarkers which _correlate_ with cardiovascular disease, and finds that reducing sodium from high to low levels for four weeks reduced one of those biomarkers by 19%, _increased_ another biomarker by 9%, and didn't change the third. You could say that this suggests higher sodium increases cardiovascular disease risk but that seems like a stretch when if you'd picked a slightly different set of CVD-correlated biomarkers you would have got exactly the opposite result.

Even if the results had been more convincing, the methods are not - it's an extremely short term study and looks only at correlative biomarkers and not at actual health outcomes. There's no meaningful way to quantify the impact based on this.

The potassium study is indeed interesting. It shows among people who already have CVD, a reduced risk of death of 12%. I think it's pretty well known that modern diets have a significant electrolyte imbalance, i.e. not enough potassium per sodium. I do supplement potassium for this reason sometimes and recommend it, though I'd prefer to just have a ton of natural nutrient dense food available and not feel like I need to. So we're in agreement on that one. That said I don't take that study to strongly show that sodium is a primary driver of CVD - it could just as easily be interpreted that the lack of potassium due to lack of real natural food is a cause of CVD (potassium being mostly in nutrient dense greens, and grass fed meat (i.e. animals that ate more natural diets i.e. greens)).

So, thank you - this helps my understanding of the whole topic - not that I know the answers, but it does make me more curious about sodium/potassium electrolyte imbalance being a factor in CVD. Ideally this would be fixed with a healthier diet but it can be hard/expensive to get enough nutrient dense foods.

Edit: oops - I missed the TOHP study - but that's one where they don't isolate sodium: > The active intervention, described in detail elsewhere,22 involved dietary and behavioural counselling on how to identify sodium in the diet, self monitor intake, and select or prepare lower sodium foods and condiments suited to personal preferences. Individual and weekly group counselling sessions were provided during the first three months, with additional counselling and support less frequently for the remainder of follow-up.

Woah woah woah.

Potato chips are junk food. The important thing is that they aren't ultra-processed in a meaningful sense. What people want to mean when they say "ultra-processed" is actually "junk food." This is why people end up bending over backwards to find a reason to label ice cream and potato chips as "ultra-processed" so it can be a cure-all solution when reality isn't so simple.