What’s really inside that tater tot?

Plus: why teenagers' brains are actually pretty cool [View this email online]( [NPR Health]( May 28, 2023 by Andrea Muraskin This week: It’s not just the fat, sugar and salt – something about ultra-processed foods makes them [worse for us than less-processed, nutritionally similar alternatives](. Plus: a [defense of the teenage brain]( a very [pricey appendectomy]( and why the [body may reject a life-saving organ](. --------------------------------------------------------------- [What we know about the health risks of ultra-processed foods]( [Foods classified as ultra-processed are those that have many added ingredients such as artificial coloring, added sugars, emulsifiers and preservatives. An apple may undergo minimal processing when it gets made into applesauce. But when it gets made into a shelf-stable apple pie or candy gummies with added sugars, colorings and flavorings, these foods are considered ultra-processed.]( Meredith Rizzo for NPR We all know a freshly baked potato is a healthier choice than a serving of packaged tater tots from the freezer. Why? Because, conventional wisdom says, the frozen tater tots come with additional calories: fat (from vegetable oil), salt, and even sugar. And that’s true. But a recent study suggests there may be another factor at play, something to do with ingredients like emulsifiers, stabilizers and dyes used in so-called “ultra-processed foods.” For the study, 20 healthy adult volunteers stayed at an NIH facility for four weeks. For two weeks, volunteers were fed a diet of ultra-processed foods: meals like canned beef ravioli, chicken salad made with canned chicken, tater tots and hot dogs. Then for the next two weeks, they ate minimally processed foods: mainly fruits, vegetables and unprocessed meat. Each diet had essentially the same total amount of fat, sugar, salt, fiber, carbohydrates and protein, and the volunteers could eat as much or as little as they wanted. The results: people took in about 500 more calories per day on the ultra-processed diet, and they gained weight and body fat. On the minimally processed diet, they ended up eating less and losing weight. Researchers aren’t exactly sure what it is about ultra-processed foods that makes people want to overeat. But they say we shouldn’t wait to take action: these foods make up about 60% of the average American diet, and they’re linked to chronic conditions like diabetes and heart disease. [Find out what exactly is ultra-processed food and how you can cut down.]( [Also: Cheap, legal and everywhere: How food companies get us 'Hooked' on junk]( --------------------------------------------------------------- Newsletter continues after sponsor message --------------------------------------------------------------- [Farewell, my kidney: Why the body may reject a lifesaving organ]( [Leila Mirhaydari, shown shortly after her kidney transplant surgery in 2014. Eight years later, Leila learned her body was rejecting the donated organ.]( Courtesy of Leila Mirhaydari Your immune system protects your body from intruders. But it doesn’t necessarily distinguish between things that do you harm – like viruses or bacterial infections – and a donated organ that you depend on for survival. That’s why when a person gets an organ transplant, they must take immuno-suppressant drugs to prevent immune cells from attacking or “rejecting” the organ. Leila Mirhaydari experienced kidney failure at age 27, and spent three years on nightly dialysis. A transplant in 2014 gave her the freedom to live a normal life. But after eight years, her immune system is attacking the organ. Mirhaydari suspects her body is rejecting the kidney as a result of trying to stretch out her immunosuppressant medication after she lost her job in 2020. [Now, it’s time to say goodbye.]( [Also, listen: Reforming the country’s organ transplant system]( [Behold the marvel of the teenage brain]( ["When you're younger, your mind is more open, and you're more creative," says 13-year-old Leo De Leon. Adolescence is a time of rapid brain development that scientists call "breathtaking."]( Jon Hamilton/NPR We’ve reported recently on how teenagers’ brains make them especially vulnerable to [social media-driven mental health problems]( including how some of them are even [asking their parents to help them get off the apps](. But pediatric psychiatrist Beatriz Luna says we should also pay more attention to the upsides of this time of life. "I want people to understand that adolescence is not a disease, that adolescence is an amazing time of development," she says. During adolescence, the wiring of the brain is changing. Some synaptic connections are eliminated, while others are reinforced, or myelinated. This “use-it-or-lose it” process may be why adolescents tend to be interested in new experiences and taking risks. Research shows sex differences in cognition emerge during adolescence too. So get to know the teenage brain – [it just might help you understand the adolescent(s) in your life](. [Plus: An overlooked brain system helps you grab a coffee — and plan your next cup]( [Bill of the Month: He visited the U.S. for his daughter's wedding — and left with a $42,000 medical bill]( [fter emergency surgery, an American expatriate with Swiss insurance now carries the baggage of a five-figure bill.]( Photographer/Source Jay Comfort, a retired American expat who lives in Switzerland, had an emergency appendectomy on a visit to the U.S. last summer. His Swiss insurance company says it will pay about one fifth of Comfort’s bill – which is twice what the procedure would have cost in Switzerland. But $42,000 is steep, even by American standards. The reason may have to do with the trend of hospital consolidation in this country. KFF Health News [and NPR investigate what’s behind the charges.]( Do you have a medical bill that is exorbitant, baffling, infuriating or all of the above? [Send it to us and tell us about your experience.]( You may be featured in a future edition of [Bill of the Month](. We hope you enjoyed these stories. Find more of [NPR's health journalism]( on Shots. All the best and happy Memorial Day, Andrea Muraskin and your Shots editors --------------------------------------------------------------- Listen to your local NPR station. Visit NPR.org to find your local station stream. [Listen Live]( [Facebook]( [Instagram]( [Twitter]( What do you think of today's email? We'd love to hear your thoughts, questions and feedback: [shots@npr.org](mailto:shots@npr.org?subject=Newsletter%20Feedback) Enjoying this newsletter? Forward to a friend! [They can sign up here.]( Looking for more great content? [Check out all of our newsletter offerings]( — including Goats & Soda, Daily News, Best of NPR and more! You received this message because you're subscribed to Health emails. 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