Lancet warns of human health dangers of ultra-processed foods

Of 104 studies reviewed, 92 showed a link between ultra-processed dietary patterns and increased chronic disease risk.

Ultra-processed foods are directly linked to increased health risks for 12 diseases, including type 2 diabetes, obesity, depression and heart, kidney and gastrointestinal conditions, according to a major series published Tuesday in The Lancet, that also found that diets are now full of such foods, replacing fresh and minimally processed, traditional home-cooked meals globally.

Representational image. (Unsplash)

These industrially manufactured products—packaged snacks, instant noodles, sugary cereals, carbonated soft drinks, ready-to-eat meals and processed meats—have become ubiquitous in supermarkets, corner shops and increasingly in rural markets worldwide.

Of 104 studies reviewed, 92 showed a link between ultra-processed dietary patterns and increased chronic disease risk. High consumption resulted in a 25% risk increase for type 2 diabetes, 23% for depression, and 21% for both obesity and cardiovascular diseases.

“These findings support the thesis that ultra-processed dietary patterns are a major driver of the escalating chronic disease burden,” the authors said.

The papers, authored by 43 global food experts including professor Carlos Monteiro at the University of Sao Paulo—who coined the term UPFs in 2009—documented dramatic consumption increases worldwide. UPF energy contribution to total household food purchases, or daily intake, more than doubled in Canada over eight decades, from 24% to 55%. Over three decades, it tripled in Spain from 11% to 32%, South Korea from 13% to 33%, and China from 4% to 10%. In Mexico and Brazil, consumption increased from 10% to 23% over four decades.

In India, food sales data indicates rising UPF intake, especially in major metropolitan cities, with consumption slowly picking up in rural areas, according to Arun Gupta, one of the authors and convenor of Nutrition Advocacy in Public Interest (NAPi). The dietary shift towards “packaged and ultra-processed foods” is accelerating faster in India than the global average, he said.

Mass-produced biscuits, chips, breakfast cereals, flavoured yoghurts, chicken nuggets, reconstituted meat products, energy bars and sweetened beverages increasingly replace traditional meals of freshly cooked grains, vegetables, pulses and seasonal produce. These products, designed for convenience and long shelf life, now dominate food environments from urban shopping centres to village provision stores.

The papers warned that UPFs and other products with high sugar and fat content are rapidly replacing traditional culinary diets even in middle- and low-income countries in Africa and Asia, threatening increased health burden. Studies show disease burden is rising even in younger populations, including children, due to higher intake of easily available UPFs.

Based on national dietary surveys, large cohort studies and randomised controlled trials, the papers indicated that diets high in UPFs result in major nutrient imbalances, overeating, gains in body weight and fat mass, reduced intake of health-protective phytochemicals, and intake of toxic compounds and potentially harmful food additives.

The series argues that although additional studies will be valuable, further research should not delay immediate and decisive public health action to tackle UPFs and improve diets globally.

The authors emphasised that improving diets cannot rely on consumer behaviour change alone but requires coordinated policies to reduce UPF production, marketing and consumption, alongside tackling high fat, sugar and salt levels and improving access to healthy food.

The series highlighted how UPFs are products of a food economy driven by corporate profit rather than nutrition or sustainability. Of 2.9 trillion US dollars paid to food industry shareholders between 1962 and 2021, more than 50% was distributed by UPF manufacturers. The high profits provided surplus for strong market strategies and to influence policymakers globally. Only a coordinated global response can combat UPF companies’ political playbook—the largest barrier to implementing effective policies to reduce UPF share in people’s diets, the series stated.

Indian retail data showed UPF sales increased from USD 0.9 billion in 2006 to nearly USD 38 billion in 2019. During this period, obesity doubled in both men and women. A 2023 Indian Council of Medical Research (ICMR) study found obesity affecting one in every four Indians, abnormal obesity in one in every three, and diabetes in one in every 10.

Dr Gupta said India is witnessing the same dietary shift the Lancet series warns about, with traditional meals being replaced by “hyper-palatable industrial UPF products”, even though India lacks exact UPF consumption data. The Lancet provides the scientific basis for India to act before the burden becomes irreversible, he added.

The papers urged governments to take “decisive” public health action to control UPF adverse health impact, similar to action taken for toxic substances such as cigarettes.

Professor Srinath Reddy, chancellor of PUFI University of Public Health Services, said the series highlighted the danger posed by denaturing production processes and worldwide marketing of ultra-processed foods. “While global regulation of such products is needed, India needs to adopt strong regulatory measures directed at their production, marketing and public disclosure of their constituents. Front-of-pack warning labels must clearly communicate the harmful levels of salt, sugar and fat to consumers,” he said.