The rise of ultra-processed foods (UPFs) in human diets is damaging public health, fuelling chronic diseases worldwide, and deepening health inequalities.
Addressing this challenge requires a unified global response that confronts corporate power and transforms food systems to promote healthier, more sustainable diets, according to a new Lancet Series on UPFs and human health, that was published in November.
UPFs are the most processed group of foods in the Nova classification system, which categorises foods by the extent and purpose of processing. UPFs are identified by the presence of sensory-related additives that enhance the texture, flavour, or appearance of foods.
High UPF intake is associated with an increased risk of obesity and cardiovascular disease. However the value of the UPF concept is not universally accepted. Some critics argue that grouping foods that might have nutritional value into the UPF category, including fortified breakfast cereals and flavoured yoghurts, together with products such as reconstituted meats or sugary drinks, is unhelpful.
But UPFs are rarely consumed in isolation. It is the overall UPF dietary pattern, whereby whole and minimally processed foods are replaced by processed alternatives, and the interaction between multiple harmful additives, that drives adverse health effects.
At the core of the UPF industry is the large-scale processing of cheap commodities, such as maize, wheat, soy, and palm oil, into a wide array of food-derived substances and additives, controlled by a small number of transnational corporations. UPFs are aggressively marketed and engineered to be hyperpalatable, driving repeated consumption and often displacing traditional, nutrient-rich foods.
In many high-income countries, UPFs comprise about 50% of household food intake, and consumption is rising quickly in low-income and middle-income countries. Industrial production, processing, and transport of agri-commodities are fossil-fuel intensive systems, and plastic packaging is ubiquitous in UPFs.
The UPF industry generates enormous revenues that support continued growth and fund corporate political activities to counter attempts at UPF regulation.
A handful of manufacturers dominate the market, including Nestlé, PepsiCo, Unilever, and Coca-Cola. A Government-led approach is needed to reverse the rise in UPF consumption.
Priority actions include adding ultra-processed markers, such as colours, flavours, and non-sugar sweeteners, to nutrient profiling models used to identify unhealthy foods; mandatory front-of-pack warning labels; bans on marketing aimed at children; restrictions on these types of foods in public institutions; and higher taxes.
The market dominance and political power of the UPF industry must also be addressed by stronger competition policy, replacing self-regulation with mandatory regulation, and combating corporate interference.
Civil society can also help to accelerate change, as epitomised by Bloomberg Philanthropies’ Food Policy Programme, which has facilitated policy wins throughout Latin America and sub-Saharan Africa by building coalitions to promote industry regulation, evaluating policies once implemented, and providing support when countries face corporate interference when adopting and implementing policies to curb UPF consumption.
Consumption tends to be higher among people facing economic hardship. Efforts to transition away from diets that are high in UPFs must not deepen gender inequities in cooking or food insecurity among populations who are dependent on cheap UPF options.
Echoing the recommendations of the EAT–Lancet Commission, transforming food systems will require redirecting agricultural subsidies away from large, transnational corporations. Instead, a diverse range of food producers should be supported in creating locally sourced, affordable, minimally processed foods and meals that are convenient and appealing to consumers.
Taxation on UPFs could help to fund cash transfers for whole foods and other minimally processed foods protecting low-income households.