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August 20, 2026
Quarterly Article
Ashley N. Gearhardt
Kelly D. Brownell
Allan M. Brandt
Back to The Milbank Quarterly
We appreciate the thoughtful response to our article and strongly agree that improving diet quality should remain a central public health goal. Diets rich in minimally processed, fiber-containing, and diverse foods are associated with better health outcomes and may support healthier gut microbial ecosystems.1 Public health should continue promoting nourishing dietary patterns and improving access to real food.
However, we are concerned that the response frames these goals as somehow separate from, or even incompatible with, addressing the addictive engineering of ultra-processed foods (UPFs). In our view, this creates a false dichotomy.
This is a commentaries on From Tobacco to Ultraprocessed Food: How Industry Engineering Fuels the Epidemic of Preventable Disease By Ashley N. Gearhardt, Kelly D. Brownell, Allan M. Brandt.
