Overhauling public policy could be key to improving long-term health outcomes says Brazil investigation of eight national dietary surveys.
What you need to know
A Brazil-led study has found a link showing premature deaths increase as ultraprocessed food consumption rises.
Stronger food cultures tend to have lower rates of death attributed to these products.
The US is encouraging food manufacturers to switch from artificial to natural additives.
An investigation by one of Brazil's leading health research institutes has linked high intakes of ultra processed foods to greater rates of premature death.
For some countries like the US and United Kingdom, as many as 1 in 7 deaths could be attributed to ultraprocessed food consumption
The study led by researchers from the Oswaldo Cruz Foundation, based in Rio de Janeiro, analyzed data from eight countries, including nationally representative dietary surveys and mortality data.
They discovered what they call a "linear dose-response association," which means that as the amount of dietary energy derived from ultraprocessed foods increases, so too does the risk of mortality from any cause.
While many studies have found ultraprocessed foods may be bad for health due to deficiencies in key nutrients, this study investigated the impact of dietary patterns, or how having a diet higher in these food products, on mortality risk.
Eduardo Nilson, a nutritional epidemiologist at the Oswald Cruz Foundation, who led the study, said the focus on single nutrients is "reductionist," and that a whole-of-diet assessment was necessary to understand the impact of ultraprocessed food.
"We should look at the pattern of the diet," Nilson told DW. He points to Brazil's adoption of "food system" dietary guidelines and other interventions to promote healthier food systems as a way forward to reducing mortality.
The bitter truth about sugar
To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video
What are ultraprocessed foods?
The University of Sao Paulo, Brazil, developed a classification system to group foods based on the amount of processing a product undergoes before being sold to consumers.
The four groups used by this Nova classification system are:
Unprocessed or minimally processed foods, which can include whole foods, fruits and vegetables, fresh meat, eggs and milk.
Processed culinary ingredients, which can include certain condiments, oils, salts and sugars.
Processed foods, which can include preserved and tinned fruits and vegetables, preserved meat products, breads, fresh cheese and
Ultraprocessed foods are those that undergo industrial processing and modification using food derived substances such as fats, starches and proteins, and may include coloring, flavor enhancing chemicals and preservatives. These include chocolates, soda and energy drinks, pre-packaged meals, baked products and pastries, certain breakfast cereals, sweetened yogurts and juices.
Ultraprocessed foods — sometimes abbreviated to UPFs — are often referred to as "junk foods," which should be consumed sparingly.
They have been associated with 32 health impacts and disease, including obesity diabetes , heart diseases, cancer , and cognitive health , gastrointestinal, metabolic and respiratory problems.
How do different countries compare?
Of the eight countries studied, those in Latin America had the lowest share of UPFs in their diet and the lowest number of premature deaths that could be attributed to their consumption.
That contrasts to four major Anglosphere economies — Australia, Canada, the UK and US — with particularly high premature mortality, and larger proportions of UPFs in the average diet.
Nilson attributes durable food cultures that have resisted infiltration by UPFs as crucial in keeping premature death rates low.
"It's not surprising that the countries that have the stronger food culture, that have been less changed by ultraprocessed foods have maintained healthy patterns," said Nilson. "We're talking Japan, Italy, France, the Mediterranean countries in general."
"With the Brazilian food pattern, with rice, beans, salad, fruits and some kind of protein, it also leads to a cardioprotective outcome."
System improvements are important
Simply eating well is not an easy task, as access to affordable, high-quality food products is not always possible.
Nilson's group, which included scientists from several South and Central American research institutions, supports food system improvements that enable better dietary patterns.
These improvements would connect the place and method of food production to nutrition-promoting policies including things like sugar taxes.
"We have zero taxes for fresh and minimally processed foods as part of [Brazil's] food reform," Nilson said.
There are also incentives for farmers to diversify food production and to procure organic agricultural products for use in public programs, such as school meals.
"Policy has to think of the food system as a whole," Nilson said. "All countries should take action because the evidence is very compelling."
That's more challenging for some countries over others, especially those with high UPF consumption.
Nilson's group recommends a mix of economic measures, including taxes to penalize unhealthy foods , labelling systems and affordability initiatives for unprocessed products.
US asks for voluntary phaseouts
Some countries are beginning moves to end some additives in their food supplies, among them the US. Its National Institutes of Health has been undertaking studies into the impacts of diets high in UPFs, while manufacturers are beginning to remove synthetic dyes and other additives from their products.
Last week, a US Food and Drug Administration commissioner confirmed it was pursuing policies to bring an end to artificial colors being used in food production, though this would be through manufacturers electing to do so, rather than being forced by a ban.
Such a move would align the US to a standard currently held by Canada and the European Union.
Our sweet, sweet world
To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video
These moves are consistent with an oft-stated policy priority from US Health Secretary Robert F. Kennedy Jr. to overhaul how food in America is made.
"The FDA is asking food companies to substitute petrochemical dyes with natural ingredients for American children as they already do in Europe and Canada," said FDA Commissioner Marty Makary.
Some US companies such as General Mills had previously attempted switches to natural colors, however customer backlash prompted a reversal to their decision to take artificial dyes out of its Trix cereal brand.
On Monday, the Associated Press reported major food makers PepsiCo and WK Kellogg had begun making the switch from artificial to natural dyes.
Edited by: Uwe Hessler
Sources
Premature Mortality Attributable to Ultraprocessed Food Consumption in 8 Countries
Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses
Products with additives like sweeteners, artificial coloring and preservatives are considered bad for health Image: Jonathan Brady/empics/picture alliance Many popular breakfast cereals are examples of ultraprocessed foods, due to the addition of artificial colors, flavorings and preservatives
Matthew Ward Agius