Noted open-access medical journal The BMJ  just published an article revealing that exposure to ultra-processed foods is associated with an increased risk of 32 damaging health outcomes, including cancer, major heart and lung conditions, mental health disorders, and early death.

“Ultra-processed foods, including packaged baked goods and snacks, fizzy drinks, sugary cereals, and ready-to-eat or heat products, undergo multiple industrial processes and often contain colours, emulsifiers, flavours, and other additives,” the articles says. “These products also tend to be high in added sugar, fat, and/or salt, but are low in vitamins and fibre.”

Urgent measures required

“Ultra-processed foods are not merely modified foods. … They are formulations of often chemically manipulated cheap ingredients such as modified starches, sugars, oils, fats, and protein isolates,” say the researchers. They suggest urgent measures that target and aim to reduce dietary exposure to these products—which can account for up to 58% of total daily energy intake in some high-income countries, and have rapidly increased in many low and middle income nations in recent decades.

To bridge this gap, researchers carried out an umbrella review (a high-level evidence summary) of 45 distinct pooled meta-analyses from 14 review articles associating ultra-processed foods with adverse health outcomes. The review articles were all published in the past three years and involved almost 10 million participants. None were funded by companies involved in the production of ultra-processed foods.

Risk of cardiovascular disease, mental disease diabetes, and death

Convincing evidence showed that higher ultra-processed food intake was associated with around a 50% increased risk of cardiovascular-disease-related death, a 48-53% higher risk of anxiety and common mental disorders, and a 12% greater risk of type 2 diabetes.

Highly suggestive evidence also indicated that higher ultra-processed food intake was associated with a 21% greater risk of death from any cause, a 40-66% increased risk of heart disease related death, obesity, type 2 diabetes, and sleep problems, and a 22% increased risk of depression. Evidence for the associations of ultra-processed food exposure with asthma, gastrointestinal health, some cancers and cardiometabolic risk factors, such as high blood fats and low levels of “good” cholesterol, remains limited.

Public policies and health actions essential

“These findings support urgent mechanistic research and public health actions that seek to target and minimize ultra-processed food consumption for improved population health,” say the researchers.

They point out that reformulation does not eliminate harm, and profitability discourages manufacturers from switching to make nutritious foods, so public policies and action on ultra-processed foods are essential. These include front-of-pack labels, restricting advertising and prohibiting sales in or near schools and hospitals, and fiscal and other measures that make unprocessed or minimally processed foods and freshly prepared meals as accessible and available as, and cheaper than, ultra-processed foods.  

“It is now time for United Nations agencies, with member states, to develop and implement a framework convention on ultra-processed foods similar to the framework on tobacco, and promote examples of best practice,” they advise.

Citation: Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. 28 February 2024. BMJ. 384. https://www.bmj.com/content/384/bmj.q439 (open access)

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