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It may seem to you like there is ongoing controversy about whether ultra-processed food (UPF) is really harmful. After all, a press conference last autumn produced headlines reporting that the effects of UPF had been exaggerated and that many UPF products were healthy.
In fact the debate is polarised by conflicts of interest. An investigation by the British Medical Journal revealed that four of the five scientists who spoke at the conference had links to UPF companies and the conference itself was hosted by the Science Media Centre, an organisation partly funded by UPF companies including Nestlé and Procter & Gamble.
The press conference is just one example. This is standard stuff. The food industry, like the tobacco industry, uses credible sounding paid intermediaries to sow doubt and confusion.
In the meantime, there is a vast and growing body of evidence linking UPF to poor health — as discussed by Dr Rhonda Patrick on the latest episode of The Standard’s Brave New World podcast. But what is UPF? The formal definition, used by scientists around the world, is long but if you want to check then look at the ingredients and if you find something not found in a typical kitchen — emulsifiers, stabilisers, flavourings — then the product you’re holding is probably UPF.
This is the only affordable food for many Britons — people living in poverty are forced to eat a harmful diet
UPF is very different to processed food. Humans have been processing food for hundreds of millennia; we have to process our food. But UPF is about using the cheapest possible ingredients to make the most irresistible formulations with the purpose of generating financial growth, mainly for large companies owned by institutional investors.
It seems plausible that such products could be harmful, but what is the evidence? There are now more than 80 of the type of studies used to link cigarettes to cancer. These show UPF is associated with a range of what we euphemistically call “negative health outcomes”, including obesity, type 2 diabetes, cancer, cardiovascular disease, liver disease, kidney disease, dementia, anxiety, depression and early death from all causes. So really quite negative.
These studies are conducted on different populations at world class research centres including UCL where I work and the results are very consistent. We know that UPF is eaten by people who live with other disadvantages — poverty, increased tobacco and alcohol intake and so on. Epidemiologists are good at controlling for these but it’s not easy to prove something just using population studies.
Luckily, we also have hundreds of papers of experimental evidence about properties and additives unique to UPF. There are studies on how soft, energy dense food (like UPF) drives excess consumption. There are studies on additives like emulsifiers, non-nutritive sweeteners and the plastic molecules that leech into the food from the packaging. These show effects on the microbiome and our metabolic and endocrine systems. There are also studies on the marketing which show it causes excess consumption and drives weight gain.
Most importantly UPF is very high in salt, saturated fat and sugar. Modelling conducted by my research group at UCL and colleagues in South America shows that about 95 per cent of UPF is higher in salt, saturated fat and sugar than UK guidelines recommend. This creates a double jeopardy — UPF is engineered to drive excess consumption, so you end up consuming even more fat salt and sugar than if you made salty, fatty sugary food at home.
The evidence around UPF has reached the threshold for saying that it does cause harm. UPF makes up about 60 per cent of our calories in the UK and is the primary cause of our obesity problem and the reason that poor diet has overtaken tobacco as the leading cause of early death globally.
But what should we do about it? This is the only affordable, available food for many people in this country. People living in poverty are essentially forced to eat a harmful diet. Any policy must ensure that real healthy diets become cheaper, but we must use the lessons from tobacco control to regulate the companies that profit from causing so much suffering.
First, we need to apply mandatory warning labels to food high in saturated fat, sugar and salt using existing UK dietary recommendations. This would label more than 90 per cent of UPF and lots of non-UPF food which is also driving obesity and other disease. This can’t be done overnight but it must happen. Evidence from South America, where this has been widely implemented, shows that it will encourage food companies to reformulate, that it shifts consumers to real food. The most effective labels are large black octagonal STOP signs. All the other necessary policies — marketing restrictions, bans on cartoon characters and misleading health claims, possible taxes on the worst products — will then apply to foods with octagons.
Second, we need to end the financial relationships between the food industry and those who influence food policy. About half the members of the Government’s Scientific Advisory Committee on Nutrition (SACN) have conflicts with companies such as and including Coca-Cola.
To some these proposals feel extreme, but we are in a health crisis which is morally, scientifically and economically unjustifiable.
