The increase of ultra-processed foods in diets worldwide presents an “urgent challenge” to health that demands “co-ordinated policies and advocacy action”, a new three-paper series authored by 43 global experts, including the UK’s Dr Chris van Tulleken, has warned.
Following on from the publication of the damning Eat-Lancet report last month – which called for a significant shift in global diets away from meat and dairy – the papers, published in The Lancet on Wednesday, called for a “co-ordinated global response” to protect policymaking from industry interference.
With global annual sales of $1.9 trillion, UPFs were the “most profitable food sector” and were “displacing fresh and minimally processed foods and meals, worsening diet quality, and associated with an increased risk of multiple chronic diseases”, the authors of the three reports, titled Ultra-Processed Foods and Human Health, claimed.
Additional studies on the impact of UPFs on human health would be “valuable”, given the uncertainty over the definition of the foods. However, “further research should not delay immediate and decisive public health action to tackle UPFs and improve diets globally”, the papers urged.
Improving diets “cannot rely on consumer behaviour change alone”, they added, and instead required policies to reduce UPF production, marketing, and consumption, alongside tackling high fat, sugar and salt (HFSS) products and improving access to healthy food.
And in a media briefing accompanying the launch of the report, van Tulleken pointed to the many “financial conflicts of interest between the ultra-processed food industry and policy makers”, citing “tobacco industry [lobbying] tactics”, with several examples where UPF companies either directly funded or were otherwise involved in industry bodies, such as the Food Strategy Advisory Board.
“Our biggest food charity, the British Nutrition Foundation, is majority funded by companies like and including Nestle, McDonald’s and Coca-Cola,” he added. “Their purpose is for profit.”
Read more: The real problem with UPFs isn’t the ingredients, it’s the incentives
Several national surveys had indicated the share of UPFs in diets was on the rise globally, one of the papers pointed out.
The estimated energy contribution of UPFs to total household food purchases or daily food intake had tripled in Spain (11% to 32%) and China (4% to 10%) over the past three decades.
They had also increased (10% to 23%) in Mexico and Brazil over the previous four decades. Levels in the US and UK had “increased slightly” over the past two decades, maintaining even higher levels, at above 50%.
Evidence reviewed in the series showed diets high in UPFs were linked to overeating, poor nutritional quality (such as too much sugar and unhealthy fats, and too little fibre and protein), plus higher exposure to harmful chemicals and additives.
A systematic review conducted for the papers, encompassing 104 long-term studies, also found 92 had “reported greater associated risks of one or more chronic diseases”. Meta-analyses showed significant associations for 12 health conditions, including obesity, type 2 diabetes, cardiovascular disease, depression, and early death from all causes.
A key tool in tackling the global rise in UPFs should include front-of-package labels to denote the content of colours, flavours, sweeteners and excessive saturated fat, sugar, and salt, “to prevent unhealthy ingredient substitutions, and enable more effective regulation”, said one of the report’s authors, Professor Barry Popkin, of the University of North Carolina.
Authors also proposed “stronger marketing restrictions – especially for adverts directed at children, on digital media, and at the brand level – as well as banning UPFs in public institutions such as schools and hospitals and placing limits on UPFs sales and shelf space in supermarkets.
The UK government is yet to outline its own strategy to tackle UPFs, despite calls in a House of Lords inquiry in October 2024 for a swathe of new taxes on the food industry, and for it to be “held to account” for causing the obesity crisis.
Eat-Lancet calls for major reduction in meat consumption
A pre-watershed TV advertising and total online ban on HFSS food and drink, is however, due to come into force in the new year. A delayed introduction on HFSS multibuy deals came into force last month.
The papers revealed how UPF companies employ “sophisticated political tactics to protect profits, blocking regulations, shaping scientific debates, and influencing public opinion”. UPFs accounted for over half of $2.9 trillion in shareholder payouts by all publicly listed food companies since 1962.
Companies also co-ordinated “hundreds of interest groups worldwide, lobby politicians, make political donations and engage in litigation to delay policies”, authors added.
“Powerful corporations – not individuals’ choices – are behind the global rise of ultra-processed foods,” said author Professor Simón Barquera, of the National Institute of Public Health of Mexico.
“Through interest groups, these corporations often position themselves as part of the solution, but their actions tell a different story – one focused on protecting profits and resisting effective regulation,” he added.
“Just as we confronted the tobacco industry decades ago, we need a bold, co-ordinated global response now to curb the overproportionate power of UPF corporations and build food systems that prioritise people’s health and wellbeing,” urged professor Karen Hofman, of the University of the Witwatersrand, South Africa.
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Responding to the study papers, Kate Halliwell, chief scientific officer for the Food And Drink Federation, said companies “have been making a series of changes over many years to make the food and drink we all buy healthier, in line with government guidelines”.
As result, FDF-member products on sale across shops and supermarkets ”now contain a third less salt and sugar and a quarter fewer calories than they did in 2015”, she added.
“For everyone to be confident that food and drink policies and regulations work in the real world, we believe that consultation and collaboration between government and industry is critical , and we support this being done in as transparent a way as possible,” Halliwell said.
“The UK’s current dietary advice to eat more fruits, vegetables and fibre and less sugars and salt, is based on decades of scientific evidence,” she pointed out.
“As highlighted by scientists commenting on this report, we agree that we need more, better quality research to be able to understand if there’s an additional link between food processing and health. This aligns with the view of the government’s independent Scientific Advisory Committee on Nutrition.”
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