Dr. Hayes Columns — The Life Expectancy Gap, Part 1: The Table

American life expectancy reached 79.0 years in 2024. That is the highest figure in the country’s recorded history. Even so, the United States still trails other wealthy nations with comparable incomes. The average life expectancy across those comparable countries was 82.7 years. The difference is 3.7 years, and one of the clearest places to start looking for an explanation is ultra-processed food.

That gap can look small. But it is not one person’s story. It is the average for an entire country. When a national average sits 3.7 years lower, it means a great many lives end that much sooner.

The United States spends more on health care than any other nation. Spending runs to roughly $14,885 per person each year, about twice the OECD average. Yet the results do not follow the money. When a country spends more and does not live longer, the question moves naturally to what is different.

There is no single answer. A life expectancy gap is built from many factors layered on top of one another. This series takes those factors apart one at a time. Part 1 starts in the first place worth looking: the daily table.

There is a reason to start with food. What Americans eat is measurably different from what people in other wealthy countries eat, and the data showing that difference was recently confirmed by the U.S. government’s own survey. I have spent a long time looking at the table, and I think of this data not as something meant to frighten anyone, but as a way to see the choices we make every day a little more clearly.

Ultra-Processed Food Is 53% of the Average American Adult’s Calories

In August 2025, the U.S. Centers for Disease Control and Prevention released official data on how much ultra-processed food Americans eat. The figures come from the National Health and Nutrition Examination Survey (NHANES) collected between 2021 and 2023, with foods sorted using the NOVA classification system.

According to that survey, adults age 19 and older get an average of 53.0% of their total calories from ultra-processed food. Across everyone age 1 and older, the figure is 55.0%. For children and teenagers age 18 and under, it rises to 61.9%. In other words, American kids get close to three-fifths of their daily calories from ultra-processed sources.

The term ultra-processed food may need a short explanation. It does not simply mean food that has been processed. Baking bread, canning vegetables, or fermenting milk are light forms of processing, and they belong in a healthy diet. Ultra-processed food goes a step further. It is made with industrial methods and ingredients you would not keep in a home kitchen, such as high-fructose corn syrup, hydrogenated oils, preservatives, artificial flavors, and emulsifiers. These foods sit in the highest tier, Group 4, of the NOVA system. Soda, chips, candy, hot dogs, crackers, boxed cereal, and ready-to-eat meals all belong here.

The CDC survey named the largest calorie sources within this group: sandwiches including burgers, sweet bakery products, savory snacks, pizza, and sweetened drinks. Reading that list makes one thing plain. Ultra-processed food is not some unusual category. For many Americans, it is the ordinary shape of a day’s meals.

One more point belongs here. This number has come down slightly over the past decade. For adults, it fell from about 56% in 2013 to 2014 to 53% in 2021 to 2023, a drop of roughly 3 percentage points. The direction is right. The size of the change is small.

How Other Countries Measure on the Same Scale

An important point comes first. Countries survey eating habits in slightly different ways, so any fair comparison of ultra-processed food has to use numbers measured by the same method. Here the comparison holds up well. The NOVA system the CDC used is the most widely applied standard in the world, and several countries have measured their own diets the same way. Every figure below uses NOVA, and wherever possible it comes from each country’s national nutrition survey.

France comes first. When the French national nutrition survey (ENNS) is analyzed with the NOVA system, adults get about 31.1% of their total calories from ultra-processed food. That is roughly three-fifths of the American adult figure of 53%. France is a wealthy country like the United States, measured by the same kind of government survey using the same classification, and the difference is still this large.

Korea runs a national survey of the same character as the American NHANES, called KNHANES. A 2025 study that analyzed that data with the NOVA system found that Korean adults drew about 26.7% of their calories from ultra-processed food in 2016 to 2019, and about 25.3% in 2020 to 2022. Twenty-five years earlier, in 1998 to 2005, the figure was about 17.4%, so the share has clearly risen in Korea too. Even so, the current level is around half of the American figure.

Japan does not have a single government survey of this kind, but several nationwide academic studies do exist. Depending on the method, the numbers range from about 28% to 38%, and researchers generally place Japanese adults at no less than a third of total calories from ultra-processed food. That is still clearly lower than the United States.

Spain is reported at about 32%. Spain has one of the highest life expectancies in Europe and sits among the OECD leaders alongside Japan and Switzerland. Its food culture is built on fresh, seasonal ingredients, cooking at home, and long shared meals. This is the Mediterranean diet, centered on olive oil, vegetables, legumes, whole grains, nuts, and fish, with little red meat. It is the most studied dietary pattern in nutrition science, and clinical trials have linked it to lower LDL cholesterol, lower body weight, lower body mass index, and lower systolic blood pressure.

One trend is worth noting. Ultra-processed food has risen across all these countries over recent decades. This is a global change, not an American one. What sets the United States apart is that it started higher and remains higher. The United Kingdom, which shares a language and much of its food culture with the United States, measures around 54% to 57% by the NOVA standard, as high as or higher than America. That tells us ultra-processed food is a question of food culture, not of any one continent.

What the Research Links to Ultra-Processed Food

The tables differ. The next question is whether that difference is linked to how long people live. This part calls for care. The studies do not say this food kills people. They show an association, meaning that certain health problems are seen more often in groups that eat more of it. The distinction matters, and reading the data honestly means holding onto it.

An updated meta-analysis published in 2025 pooled 18 studies covering more than 1.15 million people. It found that the group eating the most ultra-processed food was associated with a 15% higher risk of death from any cause compared with the group eating the least. You can read the full meta-analysis in Systematic Reviews. A separate dose-response meta-analysis covering more than 200,000 adults reported a similar pattern for the heart, with cardiovascular death about 50% higher and heart-related death about 66% higher in the highest-intake group. That analysis is available in the journal Nutrients.

Another study, published in early 2025, analyzed data from eight countries including the United States. It reported that each 10-percentage-point rise in the share of daily calories from ultra-processed food was associated with about a 3% higher risk of early death between the ages of 30 and 69. Around the same time, a study in The Lancet Regional Health Europe, covering about 428,000 people across nine European countries, reported that ultra-processed food intake was positively associated with deaths from circulatory disease, cerebrovascular disease, ischemic heart disease, and digestive disease. A separate umbrella review in The BMJ found direct links between ultra-processed food exposure and 32 health outcomes, including cancer, major heart and lung conditions, and type 2 diabetes.

Researchers offer several explanations for why these associations appear. Ultra-processed foods carry fewer nutrients for the same calories, along with more sugar, salt, saturated fat, and additives. One finding stands out. The U.S. National Institutes of Health ran a study in which hospitalized patients ate diets matched for calories and nutrient content. The people on the ultra-processed diet ate about 500 more calories a day and gained weight. That suggests the way a food is processed can drive people to eat more, and that this may not be a simple matter of willpower.

This is where the idea behind my book, Reading the Table, comes in. The table we sit down to every day is not just a meal. It is information to be read. Learning what is in our food and how it was made lets us make a different choice in front of the same table. I have written more about that starting point in this earlier piece on the American table.

Where the Table Stops Explaining

The data so far makes one thing clear. The table is an important piece of the life expectancy gap. The United States sits near the top for ultra-processed food, and its life expectancy is shorter than its peers. Yet the table alone cannot account for all 3.7 years.

The same data shows the limit. France draws about 31% of its calories from ultra-processed food, and Korea about 25% to 27%. Both are lower than the United States, and both have longer life expectancy. But there are also differences between France and Korea, in their tables and in their life expectancy. If food were the only factor, the order of these countries by life expectancy would line up exactly with the order of their tables. Reality is not that tidy.

Food is a strong factor, then, but not the whole story. At the same level of ultra-processed food, some countries still live longer. So where does the rest of the difference come from?

The next two parts of this series take up that remainder. Part 2, The Body, looks at daily physical activity and how much people move. Part 3, The Test, looks at who finds a disease earlier when it strikes, which means looking at screening systems. The table is only the first piece.

Plain-Language Reference

If you want to ask “where am I” before reading the next two parts, a few of the tools on this site line up with what this article covered.

· Heart Age Calculator (estimate how old your heart is, given that ultra-processed food is most strongly linked to cardiovascular risk)
· Life Expectancy Calculator (see how everyday factors add up across a lifetime)
· Body Truth Calculator (a clear read on body composition, which diet shapes over time)

The Bottom Line

If you ask why American life expectancy is shorter, the table is the first place to look. American adults get 53% of their calories from ultra-processed food, and other wealthy countries measured on the same NOVA scale come in much lower: France at about 31%, Korea at about 25% to 27%, and Japan at no less than a third. And in country after country, the groups that eat the most ultra-processed food show a higher risk of death.

This data does not tell anyone what to do. It only shows that the daily table is not just one meal. It is a choice that accumulates over a long stretch of time. What to do with that choice is yours to decide.

This article is for general educational purposes and does not constitute medical advice. Country figures use the NOVA classification but were collected in different survey years, so they should be read as broad comparisons rather than exact rankings. Talk with your own physician about your individual health.

Take care of yourself. Nobody else will do it for you.