Junk food diet

| July 8, 2024

Ultra-processed foods (UPFs) are increasing their share in and domination of global diets despite to the risk they represent to health in terms of increasing the risk of multiple chronic diseases. In a presentation at this year’s International Congress on Obesity, held in Sao Paulo from the 26th to the 29th of June, Professor Carlos Monteiro of the University of Sao Paulo will highlight the dangers UPFs represent to global health, and recommend that they be regulated in similar way to tobacco with warning labels and advertising restrictions.

Professor Monteiro and colleagues were responsible for developing the Nova food classification, a system for grouping edible foodstuffs based on the extent and purpose of food processing applied to them, with a rating from 1 (least processed) to 4 (UPF). He will discuss the concept and business model that drives UPFs – namely that to be competitive, substitutes must be more convenient, tasteful, and affordable than whole foods and freshly prepared meals. Prof Monteiro explains: “To maximise profits, these ultra processed foods must have lower cost of production and be overconsumed.”

UPFs are ready-to-consume, long-duration, hyper-palatable formulations of cheap food-derived substances and additives with little if any whole food and liable to displace all other Nova groups to maximise industry profits.

Professor Monteiro will discuss how UPFs are displacing healthier, less processed foods all over the world, and also causing a deterioration in diet quality due to their several harmful attributes. Together, these foods are driving the pandemic of obesity and other diet-related chronic diseases, such as diabetes.

UPFs now provide near or more than half of the calories in diets in developed countries such as Canada (47%) the USA (60%) and the UK (57%), with lower but increasing proportions in middle-income countries such as Brazil 20%. Explaining the possible reasons behind the wide variations in % dietary calories from UPF among countries, Prof Monteiro says: “The high levels of close to half or more of total calories coming from ultra-processed foods are seen only in the US, UK, Canada and Australia.

One explanation is the lower resilience of traditional dietary patterns in these countries and the fact that the UPF industry was born mostly in the US and then moved to other Anglo-saxon countries. Levels in Brazil are similar to levels in Colombia and lower than in Chile and Mexico, around 35%. But increases are being seen in all these countries. European countries, with strong food cultures, also have levels lower than in the US.”

Exposure to high-UPF diets increases total fat, saturated fat and added sugar, and decreases fibre, protein and potassium consumption. Prof Monteiro will also discuss the clinical trial from Kevin Hall (USA) and colleagues showing that UPFs cause huge increases in calorie intake and weight gain. Other side effects of a high UPF diet include lower consumption of healthy phytochemicals that boost health (such as flavonoids), and an increased consumption of harmful chemicals such as acrylamide (created during processing), bisphenols that can leach into foods from packaging, and additives such as emulsifiers and artificial sweeteners.

In terms of disease risk, UPF diets have been shown to be associated with at least 25 chronic diseases including obesity, type 2 diabetes, hypertension, dyslipidaemias, hyperuricemia, heart attack, cerebrovascular disease, Crohn’s disease, peptic ulcer, chronic kidney disease, chronic pulmonary obstructive disease, colorectal adenoma, colorectal cancer, breast cancer, oesophagus adenocarcinoma, head and neck cancer, ‘frailty’, depression, anxiety, and dementia. And overall, direct associations were found between exposure to UPFs and 32 health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes.

Prof Monteiro will conclude by looking at the similarities between the UPF and tobacco industries. “Both tobacco and UPFs cause numerous serious illnesses and premature mortality; both are produced by transnational corporations that invest the enormous profits they obtain with their attractive/addictive products in aggressive marketing strategies, and in lobbying against regulation; and both are pathogenic (dangerous) by design, so reformulation is not a solution.”

He suggests that public health campaigns may be needed similar to those against tobacco to curb the dangers of UPFs. Such campaigns would include the health dangers of consumption of UPFs. Prof Monteiro also says advertisements for UPFs should be prohibited or heavily restricted, and front-of-pack warnings should be introduced similar to those used for tobacco (although he acknowledges warning labels of various forms such as black octagons in products high in energy, sugar, salt, or saturated fat, present in some countries, already include a great proportion of UPFs). He adds: “Sales of UPFs in schools and health facilities should be banned, and there should be heavy taxation of UPFs with the revenue generated used to subsidise fresh foods.”

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