It's official: Ultra-processed foods are harmful and these are the next steps we must take
In one of the research reviews, Dr Carlos Monteiro identified over 100 studies linking ultra-processed foods to diseases such as type 2 diabetes, obesity, heart disease, kidney, and inflammatory bowel disease.
This week in a series of three review papers published in , public health experts across the globe have called on governments to take on the challenge of ultra-processed food consumption that is underpinning a global epidemic of obesity and chronic diseases.
The papers gather the evidence on the links between ultra-processed foods and poor health, while outlining the policy changes that are needed to reverse a growing reliance on these foods that now comprise up to half of the national diet and even more in both the US and Britain.
The impact on health is no longer up for debate, according to Carlos Monteiro, nutritional epidemiologist and emeritus professor at the University of São Paulo in Brazil. In one of the research reviews, Dr Monteiro identified over 100 studies linking ultra-processed foods to diseases such as type 2 diabetes, obesity, heart disease, kidney, and inflammatory bowel disease.
Recommendations for policy change include: taxes on sugary drinks; warning labels for certain ultra-processed foods; especially those with poor nutritional profiles — high levels of fat, sugar and salt; and restrictions on marketing.
While food companies predictably push back, there is hard evidence behind this approach. In countries where some of these measures have been introduced they are beginning to see positive results.
The bottom line is that if we are to reduce health harms from food, the industry needs to operate to mandatory health standards and if that is not possible, they need to pay for the externalities their products cause in terms of health harms.
How could this work?
The first step is to introduce mandatory reformulation of ultra-processed foods. This would require all companies to reformulate their products with restrictions on calorie density.
In , human nutrition and metabolism expert, Kevin Hall suggests that mandatory reformulation would gradually reset the national palate to move away from the oversweet, salty and fatty foods we have become so used to and now crave at the mega doses the industry has set. Hall suggests that governments should introduce mandatory targets for reductions in salt, sugar, refined grains and saturated fat content in ultra-processed foods. He suggests that “all we need is the political will to start acting.” Mandatory reformulation would ensure healthier versions of prominent unhealthy foods.
The next step is to target price so that the cost of healthy foods can compete with the less healthy options. Hall suggests that we can start by taxing foods that can easily be reduced or even eliminated from the diet with no downsides for health (fizzy drinks, sweets, biscuits, crisps).
This is already happening with a tax on sugary drinks, introduced in Ireland in 2018, to great effect, reducing consumption and forcing the industry to reformulate so that sugary drinks no long fall into the tax band. This measure has now been introduced in nearly 120 countries. Colombia has taken this one step further by introducing a new tax on all ultra-processed foods with poor nutritional profiles.
Warning labels on foods high in saturated fats, added sugars, salt and calories add to the impact of taxation. In 2016, Chile began requiring food manufacturers to do exactly that. Within a year, the number of products that needed warning labels had dropped from over half of products (51%) to 44%. As with the sugary drinks tax, manufacturers had tweaked recipes to ensure products did not fall into the tax band. In other words, manufacturers were following the money.
“To make sure the taxes don’t just increase food prices in general,” Hall states, “we also need to use some of the tax revenue to promote healthy replacements so that they’re more affordable, more prominent, and more convenient.”
This is where we need to think of ways to move the burden of improving dietary patterns up the food supply chain — by changing the food environment.
There are several ways to do this. Supermarkets could be held to high standards regarding the scope of the products they offer. Walk into any supermarket today and you will have to climb over Christmas offerings of towers of selections boxes, biscuits, cakes and puddings. This is because manufacturers of the most profitable ultra-processed foods pay a premium for access to prime shelf space.
One away to change this is to ban the promotion of unhealthy foods at store entrances, end-of-aisles and at checkout tills. Another option is to tax the income of food manufacturers to promote improvements in quality.
Another is to support food businesses that make affordable, healthy prepared food more available to people. Nourish Scotland are piloting the introduction of public diners in Nottingham and Dundee in 2026, where healthy freshly cooked meals are provided in communities at a fraction of the price they would be served in restaurants.
New York Mayor-elect Zohran Mamdani made food affordability a lynchpin of his campaign, proposing the introduction of municipal grocery stores across five boroughs in New York. Mamdani is suggesting that the government step in and fix what a profit-driven market has failed to do — make healthy food affordable. These food stores could be subsidised by revenue from a tax on unhealthy foods.
Hall suggests there is so much more we can do.
Getting there means changing our food culture. To do that we can learn from anti-tobacco campaigns that shifted the norms around smoking making it first illegal and then undesirable to smoke in public. Hall suggests that some of this might involve regulation — like ads that promote fruit and vegetable consumption or education mandates related to food and nutrition. Japan has been doing this for over two decades and is the only rich country across the globe with low levels of obesity.
The food industry shifted norms around eating — normalising eating on the go, replacing cooking with ultra-processed foods, snacking and massive portion sizes; in ways that reflect how the tobacco industry normalised smoking.
“We need to fight back to reverse unhealthy norms,” concludes Hall.
What is needed is a paradigmatic shift in the food culture ensuring that healthy food reverts to being a cultural norm — affordable and available to everyone.
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