Ultra-processed foods need tobacco-style warnings, says scientist

Ultra-processed foods (UPFs) are displacing healthy diets “all over the world” despite growing evidence of the risks they pose and should be sold with tobacco-style warnings, according to the nutritional scientist who first coined the term.

Prof Carlos Monteiro of the University of São Paulo will highlight the increasing danger UPFs present to children and adults at the International Congress on Obesity this week.

“UPFs are increasing their share in and domination of global diets, despite the risk they represent to health in terms of increasing the risk of multiple chronic diseases,” Monteiro told the Guardian ahead of the conference in São Paulo.

“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.”

The stark warning comes amid rapidly rising global consumption of UPFs such as cereals, protein bars, fizzy drinks, ready meals and fast food.

In the UK and US, more than half the average diet now consists of ultra-processed food. For some, especially people who are younger, poorer or from disadvantaged areas, a diet comprising as much as 80% UPF is typical.

In February, the world’s largest review of its kind found UPFs were directly linked to 32 harmful effects to health, including a higher risk of heart disease, cancer, type 2 diabetes, adverse mental health and early death.

Monteiro and his colleagues first used the phrase UPF 15 years ago when designing the food classification system “Nova”. This assesses not only nutritional content but also the processes food undergoes before it is consumed.

The system places food and drink into four groups: minimally processed food, processed culinary ingredients, processed food and ultra-processed food.

Monteiro told the Guardian he was now so concerned about the impact UPF was having on human health that studies and reviews were no longer sufficient to warn the public of the health hazards.

“Public health campaigns are needed like those against tobacco to curb the dangers of UPFs,” he told the Guardian in an email. “Such campaigns would include the health dangers of consumption of UPFs.

“Advertisements for UPFs should also be banned or heavily restricted, and front-of-pack warnings should be introduced similar to those used for cigarette packs.”

He will tell delegates: “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.”

Monteiro will tell the conference that food giants marketing UPFs know that, in order to be competitive, their products must be more convenient, more affordable and tastier than freshly prepared meals. “To maximise profits, these UPFs must have lower cost of production and be overconsumed,” he said.

He will also draw parallels between UPF and tobacco companies. “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.”

However, Dr Hilda Mulrooney, a reader in nutrition and health at London Metropolitan University, said comparing UPF to tobacco was “very simplistic”.

“There is no such thing as a safe cigarette, even second-hand, so banning them is relatively straightforward in that the health case is very clear.

“However, we need a range of nutrients including fat, sugar and salt, and they have multiple functions in foods – structural, shelf-life – not just taste and flavour and hedonic properties.

“It is not as easy to reformulate some classes of foods to reduce them and they are not the same as tobacco because we need food – just not in the quantities most of us are consuming.”