Without exception, obesity rates have risen in every country around the world. Between 2016 and 1975, worldwide obesity tripled. But what can account for this dramatic increase? One key reason: Societies have moved from traditional diets towards diets high in ultra-processed products or “junk foods,” such as sugary drinks, snack foods, frozen meals, packaged breads and frozen desserts. The evidence is robust: diets high in ultra-processed products are significantly associated with obesity, high blood pressure and diabetes worldwide. Despite being widely available, the harmful effects of ultra-processed products are not always known by consumers, and often underplayed by government authorities due to industry involvement. Even during this year’s UN Food System’s Summit, ultra-processed food was noticeably missing from the agenda.
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With more than one-third of the world’s population overweight or obese, and the COVID-19 pandemic revealing deep structural inequities in food environments, the push to combat unhealthy diets and ultra-processed products has become more urgent than ever. To learn more about ultra-processed products, how consumers can be more informed about their harms, and what governments can do to better regulate these health harming products, we sat down with Trish Cotter, Senior Advisor and Global Lead of the Food Policy Program at Vital Strategies.
What are ultra-processed products?
Ultra-processed products are foods you can’t make at home because you wouldn’t find the ingredients or the tools for the industrial processing in your kitchen. You’ll find supermarket shelves packed full of them, items such as soft drinks, ice creams or prepared frozen dishes. They are not simply modified foods, but formulations—pseudo-food made to look fabulous. These products go through many manufacturing steps which alter the food from its natural state. They are quite literally torn apart and put back together again with the addition of a cocktail of preservatives, emulsifiers, flavors and colors. The result is products that are packaged, ready-to-eat, hyperpalatable, potentially addictive and have long-lasting consequences on a person’s health.
Why should we be concerned about ultra-processed foods?
There are three major areas of concern about ultra-processed foods.
The first is the prevalence of these products in our food system and the way they have displaced traditional diets. In fact, over 50% of calories consumed in the United States are from ultra-processed products. Low- and middle-income countries are also experiencing rapid rises in ultra-processed food consumption. While sales are highest in Australia, the United States and Canada, they are increasing rapidly in middle-income countries including China, South Africa and Brazil. And worryingly, children and people with lower incomes in communities with fewer healthy food choices, are often the primary targets of ultra-processed product marketing.
The second area of concern is the strong association between high ultra-processed product consumption and many elevated health risks including increased overweight and obesity, type 2 diabetes, depression, heart disease and stroke and mortality.
A third, and equally important concern, is the effect discretionary foods, such as ultra-processed products, have on the environment. One study from Australia suggests that ultra-processed products generate more than a third of the world’s diet related environmental impact. The food production chain which includes the production, distribution and preparation of ultra-processed products is responsible for 20-30% of greenhouse gas emissions and 80% of the consumption of water resources and groundwater contamination. The largest plastic generators worldwide are familiar food and beverage brands most of us know and recognize—Coca Cola, Danone, Mars, Mondelez, Nestle and Pepsi.
Discretionary foods: Foods and drinks not necessary to provide the nutrients the body needs, but that may add variety. Many of these are high in saturated fats, sugars, salt and/or alcohol. (Australian Dietary Guidelines)
Can you explain why consumers are often unaware of the risks of ultra-processed products? What role does marketing and advertising play?
Ultra-processed products have creeped into our lives under the guise of convenience backed up by some extremely clever and consistent marketing by the food and beverage industry. In a research study conducted in Brazil and Colombia amongst focus groups of adult men and women ages 25 to 55 years, we found that marketing is so persuasive and pervasive that people associate these harmful, ultra-processed products with family, social gatherings, children, ease, joy, cravings and even breakfast and physical activity. Worldwide, palates (and brains) have been trained to crave these foods all the while the food industry continues to invest millions in marketing them to be highly desirable. The food and beverage industry has infiltrated the mind of the consumer. As a global public health community, we have a responsibility to warn consumers about the harms of ultra-processed products and, at the same time, ensure that this is not an individual problem but a systematic issue.
What steps can public health practitioners and policymakers take to raise awareness on the harms of ultra-processed products?
For public health efforts to be successful in reducing harm, it is crucial that the term “ultra-processed products” is clearly and consistently understood by consumers and the public. One thing in the public health community’s favor is that the term “ultra-processed food” sounds really unfriendly. People can conceive of these products as being unhealthy, and most recognize them to be harmful. We can use this to our advantage and fight against industry marketing efforts. Like the marketing industry builds a brand, public health needs to build meaning around the term “ultra-processed” to alert consumers about its harms.
We can also look at past movements—like tobacco control—to see where the public health community has achieved huge policy wins and strong public understanding of the consequences of consuming a dangerous product.
Public health practitioners are not alone. Ministries of health and governments must also play their part. Government regulations are important for reducing the consumption of ultra-processed foods. For example, governments can implement proven policy approaches like clear front-of-package warning labels which help consumers identify unhealthy products and taxing sugary drinks and junk food which can reduce consumption and also increase government revenue that can be used for other public health efforts. Just like tobacco control efforts–warning labels, marketing restrictions, taxes and investment in strong media campaigns–would put us on the right path to a healthier future.
To truly stop the devastation to our food system and our health, governments and the global public health community need to urgently build the image of ultra-processed products—those glossy packaged, alluringly marketed, ready-to-eat, convenient and tasty products—for what they really are: the vector for obesity and a risk factor for serious disease.
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