As a foodie growing up in Sweden, Filippa Juul could be counted on to "think about food, dream about food, love cooking and remember events and experiences through food memories." Connecting food to its benefits for health, she had a lightbulb moment to combine studying both topics, and earned a bachelor’s degree in nutrition and dietetics at the Universidad Autónoma de Madrid. At first Filippa's goal was to become a dietitian, helping her patients eat better, but she concluded that working one-on-one would not have the impact she desired. "I realized that so much of our poor dietary habits, and the chronic diseases that are related to them, are driven by systemic and structural factors," she explained.
Wanting to tackle the root causes of diet-related problems, and recalling her affinity for an undergrad course in nutritional epidemiology, Filippa returned home to pursue a master's degree in public health nutrition at the Karolinska Institute, where she also worked as a research assistant at its obesity center. As Filippa delved into the nutrition research, she felt something was missing. "It was frustrating; most of the literature seemed like "diet wars" between different researchers. Was the problem fat or sugar? Should you eat low-carb or high-carb? The focus was on the macronutrient composition; no one talked about the actual foods."
When she came upon a commentary in 2009 by a University of Sao Paulo epidemiologist, Dr. Carlos Monteiro, his thesis resonated with Filippa. Monteiro suggested the epidemic of diet-related disease around the world isn’t related to fat or carbs per se; it’s the change from traditional, minimally processed food to diets of highly processed food. His idea to classify foods according to processing level, which introduced the concept of ultra-processed foods (UPFs), made perfect sense to Filippa; it was the missing piece.
As she explained, "Compare the fat in fried foods to the fat in an avocado, or the sugar in fruit to the sugar in soda. We live in a food environment that clearly did not exist 100 or even 50 years ago. Our shift toward food that has undergone heavy industrial processing and contains multiple additives has displaced nutritious, minimally processed foods from our diet." With an interest in prevention and now a clear focus, Filippa knew immediately that she wanted to conduct research on the topic—and earn her PhD.
In considering where to pursue her doctorate, Filippa noted the scholarship coming from the U.S., including renowned studies such as the Framingham Heart Study and the Nurses’ Health Study. She zeroed in on multiple schools on the east coast, but meeting at GPH with faculty member Dr. Niyati Parekh was the clincher. "We both have a whole-foods diet approach," recalled Filippa. "It quickly became clear that we were aligned in terms of looking at dietary patterns holistically, not just at certain components or micronutrients. After that NYU was a shoo-in; here was someone I shared research interests with, who would be a fantastic mentor."
Her studies progressed as she explored UPFs, culminating in dissertation research finding a positive association between the proportion of UPFs in diets and the risk of cardiovascular disease. She also became a post-doctoral fellow and adjunct professor at NYU, and now is a tenure-track assistant professor at SUNY Downstate.
Filippa recently published, in conjunction with Drs. Parekh and Monteiro, a review on UPFs and is also working on a project investigating the biological pathways that UPFs affect. She loves doing research, but her aspiration is to make sure her work informs policy and has a real impact on reducing rates of diet-related diseases.
"I want to understand the different pathways that link UPFs to cardiovascular disease, and to assess the public health benefits of policies targeting UPFs specifically. We have enough evidence at the moment to issue recommendations to avoid these foods, but we need more data to understand which components are harmful. My end goal is that the work I’m doing will transform policies and drive change."