Certain ultraprocessed foods, or UPFs, are contributing to worldwide obesity, chronic health conditions and premature death, yet the food industry continues to aggressively market new and existing products in this category for massive profits, according to an unprecedented three-part series authored by 43 global experts in nutrition and supported by the United Nations Children’s Fund, or UNICEF, and the World Health Organization.
More than 50% of the $2.9 trillion paid to shareholders by food corporations between 1962 and 2021 “was distributed by UPF manufacturers alone,” according to research published Tuesday in the leading medical journal The Lancet.
“We found evidence that UPF consumption is increasing everywhere around the world, fueled by powerful global corporations,” said coauthor Carlos Augusto Monteiro, professor emeritus of nutrition and public health in the School of Public Health at Brazil’s University of São Paulo.
“To keep this business model, which is highly profitable, the industry cannot afford to make minimally processed foods as they did in the past, so they use extensive political lobbying to stop effective public health policies that support healthy eating,” said Monteiro, who coined the term “ultraprocessed food” in 2009 when he developed the NOVA classification system, which categorizes foods into four groups by their level of industrial processing.
Companies can “double or triple their profits” by turning corn, wheat, beans and other whole foods “into a colorless and flavorless sawdust which is then reconstructed with artificial flavorings and additives,” said Barry Popkin, the W.R. Kenan Jr. Distinguished Professor at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health.
Countries like Mexico, Norway, the UK, South Korea and Ireland have implemented laws against the marketing of ultraprocessed foods, especially to children. - Karen M. Romanko/Photodisc/Getty Images/File
“The food industry doesn’t want to lose their cash cow, so they’re willing to put millions into fighting government restrictions on ultraprocessed food as well as funding nutritionists who’ll say there’s no evidence of harm,” said Popkin, who coauthored two of the articles.
The series presents research on the known health harms of ultraprocessed food and calls for a global effort to regulate the industry, with methods such as food warning labels, taxation, and laws to restrict marketing and advertising, especially to children.
However, the International Food & Beverage Alliance, founded in 2008 by leading food and nonalcoholic beverage companies, told CNN that health authorities worldwide have rejected the concept of ultraprocessed food due to its lack of scientific consensus.
“The policy and advocacy recommendations of this series go far beyond the available evidence — proposing new regulatory action based on ‘processing’ or additive ‘markers’ and calling for the exclusion of industry from policymaking,” said IFBA Secretary-General Rocco Renaldi in an email.
“If adopted as proposed, these policy recommendations would risk limiting access to nutrient-dense processed foods and reducing the availability of safe, affordable, shelf-stable options globally,” Renaldi said.
A coordinated global effort by industry
Food industry actions to battle regulations and discredit science are coordinated through a global network of “front groups, multi-stakeholder initiatives, and research partners,” one of the Lancet articles said. This network could include advertising firms, fast-food chains, grocery retailers, ingredient suppliers, lobbyists, plastic producers and research partners, the authors wrote.
Even dietitian influencers have been hired to promote anti-stigma messaging, the article said. Social media messaging by agents in the network may try to blame overeating and obesity on consumer willpower and lifestyle, or portray opponents of ultraprocessed food as “elitist, misinformed, or ideologically motivated.” State, local or federal attempts to restrict manufacturing, marketing or sales of ultraprocessed foods are portrayed by some influencers as an overreach of authority, the article stated.
Actions taken by this network include “direct lobbying, infiltrating government agencies, and litigation,” the authors wrote, as well as “framing debates and manufacturing scientific doubt.”
Those efforts also extend to industry-funded research, the article said. One review reported in the paper, for example, found studies paid for by the food industry were five times more likely to show no association between obesity and consumption of ultraprocessed foods.
Using Big Tobacco’s playbook
To extend their markets, food and beverage corporations — gobbled up by major tobacco companies between the 1960s and ’80s — have used the tobacco industry’s playbook to create products designed to be hyperpalatable and addictive, said Marion Nestle, the Paulette Goddard Professor Emerita of Nutrition, Food Studies and Public Health at New York University. She has written numerous books on food industry politics.
“By the ’80s, ultraprocessed food was everywhere, in large portions, heavily processed, utterly delicious, irresistible and acceptable to be eaten all day long, any place, under any circumstances,” said Nestle, who coauthored two of the articles in the series.
Experts say corporations are using marketing and sales techniques, similar to those that enticed 45% of American adults to smoke by 1954, to create an exploding global market for ultraprocessed foods. Those marketing techniques are often directed at children, an area which needs swift and rigid regulation, Nestle said.
Today, some 70% of the food on grocery store shelves in the United States are ultraprocessed, making it difficult to avoid UPFs that are often cheap and convenient, experts say. A recent report by the US Centers for Disease Control and Prevention found American children get an average of 62% of their daily calories from ultraprocessed foods — and it’s about 53% a day for adults.
With the US, United Kingdom and European Union markets heavily saturated with ultraprocessed foods, the food industry has been pushing heavily into South America, Africia and Eastern Europe, as well as China and India, said Maria Laura da Costa Louzada, a professor and vice-coordinator of the Center for Epidemiological Research in Nutrition and Health at the University of São Paulo, Brazil.
“Ultraprocessed foods are taking more and more space in what people eat. Their share has doubled in countries like Brazil, Canada and Mexico, and tripled in just a few years in China, South Korea and Spain,” Louzada said in a taped video. “This means that traditional, freshly prepared meals are losing ground fast. Without strong public policies, the consumption of ultraprocessed foods will keep rising.”
That increased consumption will be a disaster for health, according to a new, systematic review published in the Lancet series. Out of 104 studies, 92 showed an association between ultraprocessed foods and a higher risk of one or more chronic diseases, according to the review. An additional meta-analysis found statistically significant associations between UPFs and a dozen chronic illnesses, said Montiero, who was first author on both studies.
“We believe the displacement of traditional diets by ultraprocessed foods is the most convincing explanation for the global pandemic of chronic diseases related to diet, such as obesity, type 2 diabetes and heart disease,” Montiero said.
Recent randomized clinical trials, considered the gold standard of research, have shown ultraprocessed foods lead to eating an additional 500 to 1,000 calories a day compared with a diet of minimally processed whole foods — even though both diets contained the same number of total calories, sugars, fiber, fat, salt and carbohydrates.
And an August study found that even when ultraprocessed foods are “healthier,” eating minimally processed foods — such as whole foods cooked at home — doubled weight loss.
“There’s something about UPFs that cause overeating, perhaps because they are not foods, they are formulations designed to hit our ‘bliss point,’” Monteiro said. “When you subject traditional, modified whole foods to these formulations, the food industry can manipulate sugar, salt and fat with the use of flavors, textures and additives until they become irresistible.”
Critics point out that most studies on ultraprocessed foods are observational and therefore cannot prove a direct impact on health.
“It seems to me likely that at least some UPFs could cause increases in the risk of some chronic diseases,” said Kevin McConway, professor emeritus of applied statistics at The Open University in the UK, in a statement.
But the Lancet series of papers “certainly doesn’t establish that all UPFs increase disease risk. There’s still room for doubt and for clarification from further research,” said McConway, who has been an adviser to the BBC and other journalistic organizations.
A global call for action
The second paper in the Lancet series examines the success of a number of regulatory actions by US states and international countries to quell the spread of ultraprocessed foods.
Imposing taxes on sugary sodas, for example, has successfully reduced consumption of ultraprocessed drinks. State or government restrictions against the use of trans fats, food dyes and some additives have changed how industry formulates their products.
“Reducing specific ingredients to mere markers of ultra-processing is an overgeneralized response to a far more nuanced issue,” said Carla Saunders, president of the Calorie Control Council, which represents manufacturers of foods and beverages with non-nutritive sweeteners.
“Safe, rigorously tested ingredients, like no- and low-calorie sweeteners, are scientifically validated by the world’s leading health authorities and play a critical role in managing chronic conditions such as diabetes and obesity, which supports better health.”
Countries like Chile, Mexico, Norway, the UK, South Korea and Ireland have implemented laws against the marketing of UPFs, especially to children. A growing number of countries require front-of-package labels that alert consumers to problematic ingredients. Such efforts are starting to improve diets to some extent, experts say.
However, many of the front-of-package labels have only alerted the public to the health harms of foods high in fat, sugar and salt, called HFSS foods. Limiting the message to HFSS foods, however, fails to limit chemical-laden ultraprocessed foods reformulated by food manufacturers to fall below sugar, salt and saturated fat levels established by regulators, Montiero said.
“But, if we add the presence of artificial flavorings, colorings and non-nutritive sweeteners to the warning labels, we cover nearly 100% of ultraprocessed foods,” he said. “This also addresses the criticism that NOVA has received for not addressing the issue of nutrients such as sugar and salt.”
While all of these efforts have been partially successful, according to the Lancet series, true change is going to come from a coordinated global effort. Authors call for a worldwide network of government leaders, UN agencies, scientists, academicians and the public, all designed to combat the spread of ultraprocessed foods, prioritizing children. Two powerful agencies have already joined the effort, announcing their involvement in statements published in The Lancet.
The World Health Organization, which in May put out a global call for scientists to join in its work on ultraprocessed foods, described the escalating consumption of UPFs as “a systemic threat to public health, equity, and environmental sustainability.”
The Lancet series, the WHO said, makes “a compelling argument for urgent action on UPFs.”
In its own published statement, UNICEF offered its full support to the proposed global network in order to develop an international policy framework to “protect children, families, and societies from UPFs.”
“Effective protection of children from UPFs demands confronting the economic and political power that enables the UPF industry to weaken, delay, or obstruct government action,” wrote Joan Matji, global director for child nutrition and development, and Mauro Brero, senior nutrition adviser for food systems for children at UNICEF.
“Governments must lead a whole-of-society approach that ensures this generation is the first in which children’s rights to nutrition, food, and health are prioritised over corporate profit.”
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