The Americanisation of our diets is destroying our health – and it’s not just about size

Nothing is better evidence of America’s devotion to junk food than Donald Trump’s go-to lunch order. According to insiders he regularly eats a Big Mac, Filet-o-Fish, french fries and a vanilla milkshake in one sitting, a meal that comes in at well over 2000 calories.

Junk food is part of America’s DNA. The first American fast food joint opened in 1921 in the mid western state of Kansas, as the US experienced the post-WW1 boom that shaped it into the nation we know now. These days burger giant McDonald’s – surely the country’s most famous export – contributes as much to America’s GDP as the entire state of Rhode Island. The chain is ubiquitous from coast to coast: it’s not Texas or Florida but the supposedly clean-eating state of California that’s home to the most McDonald’s restaurants.

Enormous stacks of pancakes heaped with bacon and maple syrup, burger buns stuffed with eight cheese-wrapped patties, pizzas the width of a doorframe – all reflect the “general American affinity for the idea that bigger is always better,” says Dr Will Bulsiewicz, US medical director for the nutrition company Zoe.

Meanwhile the rest of the world has adopted America’s love of fast food, and nutritionists in Britain are now blaming the Americanisation of our diets for rising rates of obesity, bowel cancer and type 2 diabetes. But are people in the States really eating in a way that’s uniquely unhealthy? We asked the experts.

Portion size

“It’s absolutely true that portion sizes tend to be larger in America,” says Prof Rebecca Earle, a food historian at the University of Warwick. Earle was born in America, and when she first moved to the UK in the 1980s, she was “astonished that the yogurts I’d buy from British supermarkets came in such tiny pots, because individual servings at home were pretty much double the size”.

The differences are most stark at fast food restaurants. McDonald’s chicken nuggets are offered in 40-nugget boxes in the United States, while in Britain, it’s only possible to buy a serving of 20 in one box – a large serving of fries, meanwhile, is around 30 per cent bigger in America than it is in the UK.

More than just upping the number of calories we might eat in one sitting, “regularly being served such large amounts of food makes people numb to smaller portions,” says nutritionist Jenna Hope. “When we’re given big portions, we overeat by default and lose the chance to be satisfied with a smaller amount of calories. In the case of American fast food, this also means that people are consuming more saturated fat, sugar and salt.” The consequences are obvious: weight gain, higher risk of diabetes and raised cholesterol.

Contrary to popular belief, a Big Mac in America is about the same size as one you’d find here in Britain – both weigh around 200g, and measure about 10cm across. Burger trends across both countries, however, tell the real story about how Americans eat.

Here in Britain, we like thick beef burgers served with cheddar cheese, chunky chips and lots of veg, as evidenced by the proliferation of gourmet burger joints in recent years. In America, meanwhile, burgers have trended larger and crazier. Just take Wendy’s, a chain that to us in Britain is synonymous with American diner culture: their Dave’s Triple burger comes with three beef patties and three slices of cheese, and it isn’t even the most calorific option on the menu.

Some of the contrast here might be put down to American competitive spirit, says Dr Bulciewicz. “Americans eat out a lot, so there’s competition to provide value for money as part of that experience,” he explains.

Hope, meanwhile, thinks that America’s large portions have more to do with social media trends, which encourage people to eat in ways that are increasingly over-the-top and calorific, and the size of American supermarkets, which contain millions of products. “I still remember going into a supermarket in America years ago and finding hot dogs wrapped in blueberry pancakes,” she recalls. “It takes a truly enormous supermarket to be able to stock items as niche and outlandish as this.”

Add to this the problems with processed meat in America – for example, many manufacturers still add harmful trans fats to patties, a practice that has been reduced through market incentives in Britain – and US portion sizes become a health nightmare.

Wendy’s Dave’s Triple Burger vs GBK The Classic, single

Additives

Even a Greek-style yogurt sold in an American supermarket may not be made equal to a British offering. Aside from being larger, a pot of yogurt might also contain carrageenan, a food thickener that’s also used to make toothpaste, air freshener and makeup.

“In the US, food companies don’t always need to seek approval before they start putting different additives into our foods [if the additives are considered safe],” says Dr Bulsiewicz. “We know that some of the additives in our food are causing health issues, but once they’re in our food supply, it’s really difficult to isolate them and show which ones are causing the problem.”

For American health experts, the issue of additives in food demands attention on one product in particular: bread. Soft, white slices of Wonder Bread, America’s most-bought loaf, contains over 30 different ingredients, most of which are chemicals that would never be found in our kitchen cupboards next to flour and yeast. Some other kinds of bread sold in America even contain potassium bromate, an ingredient illegal in Britain and the EU as it is a proven carcinogen.

Why is bread in America so excessively tampered with? People in this country “have always been concerned about what’s in their loaves,” says Prof Earle. The first British laws against the adulteration of bread were introduced 800 years ago, in 1202. The same legal history is not present in America, says Dr Bulciewicz. “The USDA [United States Department of Agriculture] was only created after the Second World War to govern our food supply, and to this day the regulations are more relaxed than they are in Europe,” he explains.

Dietitians in modern Britain still rail against the health risks of shop-bought white bread. Our most-loved loaf is Warburtons Toastie White, which itself has over 10 ingredients, and the ultra-processing of bread to make it stay fresh and mould-free for longer “strips it of most of its fibre,” says Rhian Stephenson, nutritionist and founder of the supplement brand ARTAH.

“Not only are you getting rid of many of the beneficial compounds in the grain, you’re removing the element that makes people feel full. You can sit and eat white bread all day, but a good-quality brown sourdough will have you feeling full after one good, thick, slice,” says Stephenson. In the US, that additive-free wholemeal sourdough can come in at $6.50 (over £5) per supermarket loaf, if it can be found – 23.5 million Americans live in food deserts, defined as areas with no fresh food available within a mile in urban areas, or 20 miles in rural ones.

By now we are used to hearing about the deleterious effects of additives, but as a reminder, “you’re asking your body to break down chemicals that it never evolved to encounter whenever you’re eating them,” says Hope. “This disrupts your gut microbiome, which has massive knock-on effects on your overall health, and causes inflammation. While additives are included at safe levels in individual foods, that doesn’t account for the amount we’re consuming in our daily diets.”

Wonder Bread vs Warburtons medium white sliced loaf

Sugar

American foods are known for being sugary to the point of sickly-sweetness – and “generally Americans tend to have a taste for sweeter foods,” says Prof Earle. Both American and British intakes are far too high at around 80-100g of sugar consumed per person per day, but sugar seems to be wreaking havoc in America especially, where 49 per cent of the country is either prediabetic or diabetic.

American breakfasts have a characteristic sweetness. While this is far from what our bodies naturally crave – “we need protein in the mornings, but we’re conditioned to want sugar instead,” says Stephenson – sugar does give us a boost of energy in the mornings, and can tempt us out of bed at even our groggiest. Add to that the fact that corn is so abundant in America, and can be easily turned into corn syrup, it’s easy to see why Americans are known for eating Poptarts, pancakes and cereals that resemble cookies and ‘candies’ first thing in the morning.

American cereals such as Lucky Charms, Froot Loops and Cinnamon Toast Crunch are packed with high fructose corn syrup, “which is actually sweeter than sugar, and is terrible for your body because it’s more likely to be stored as fat and cause health issues like insulin resistance,” says Hope. Though fructose is also present in fruit, fruit also contains fibre and glucose which make fruit healthy, she points out. Over time “even cereals that are good for you have had more and more sugar added to them, which makes it normal to sit down and eat something that’s basically cookies with milk”.

By contrast, the most-bought breakfast cereal in Britain is Weetabix (though we eat our fair share of over-sweetened cereals here too). Although Weetabix does contain ingredients that nutritionists like Hope describe as ultra-processed, the cereal “has more fibre and protein as well as added vitamins,” making it much safer to eat on a regular basis.

Lucky Charms (36g) vs Weetabix (2 biscuits)

Salt

Visitors to America often remark on the saltiness of the foods that they find there. “In America, 60 percent of the calories we eat every day come from ultra-processed food, and ultra-processing essentially involves combining salt, fat and sugar to make food taste food,” says Dr Bulsiewicz. “We’re hardwired to pursue salt – it’s part of our biology,” he adds. “Most Americans who cook with salt have no problem with seasoning their food healthily, but manufacturers add salt to their products to keep people buying and eating them.”

Some salt is essential to our health, “but too much can negatively affect the gut microbiome, as well as kidney and immune system function, and may contribute to the risk of autoimmune disease, ” Dr Bulsiewicz says. Salt is also a preservative, making it essential in a country “where so many people drive long distances and on the road, there’s limited options for what to eat outside of ultra-processed food,” Hope adds.

We can see this most plainly when we contrast the classic neon-orange American sliced cheese with old-fashioned British cheddar (or Wensleydale, stilton or red Leicester, or any other British-origin cheese). Kraft Singles, a popular brand of American cheese, actually contain less than 51 per cent “cheddar cheese”, meaning that the product can’t be legally marketed as a kind of cheese. The rest of each slice is made up of milk, whey, preservatives and emulsifiers, and comes in at 230mg of sodium per slice.

Cathedral City mature cheddar meanwhile contains less sodium gram-for-gram, and its only listed ingredient is cheddar. While most cheeses are considered high in saturated fat, “cheddar contains calcium and protein, making it relatively nutritious,” Hope says. No wonder we call it “plastic cheese” in this country by contrast.

Kraft singles (21g slice) vs Cathedral City mature cheddar (25g slice)

Calories

All of this means that the same foods are simply more calorific in America. Hidden calories account for a large part of the fact that the average American eats over 3,500 calories every day, more than the average for any other country in the world – and more what we eat in the UK, with the average man getting through 3,000 calories per day and women 2,500.

Competition between fast food companies has led to hidden fat, salt and sugar in all sorts of foods, which come in far larger serving sizes. Even the gherkins found in an American burger can come with added corn syrup. “It’s much harder for Americans to keep track of what they’re eating,” Hope explains. This is a fact that Dr Bulsiewicz says makes him “really quite angry,” given the costs of fresh produce in many parts of the United States.

Same foods, different calories