Findings published in the American Journal of Preventive Medicine support a call for revised dietary guidelines and public policies to lessen the disease burden across nations
A study analyzing data from nationally representative dietary surveys and mortality data from eight countries (Australia, Brazil, Canada, Chile, Colombia, Mexico, United Kingdom, and United States) shows that premature deaths attributable to consumption of ultra-processed foods (UPFs) increase significantly according to its share in individuals’ total energy intake. The new study opens in new tab/window, appearing in the American Journal of Preventive Medicine opens in new tab/window, published by Elsevier, reinforces the call for global action to reduce UPF consumption, supported by regulatory and fiscal policies that foster healthier environments.
UPFs are ready-to-eat-or-heat industrial formulations that are made with ingredients extracted from foods or synthesized in laboratories, with little or no whole foods in their composition. These have gradually been replacing traditional foods and meals made from fresh and minimally processed ingredients.
Lead investigator of the study Eduardo Augusto Fernandes Nilson, DSc, Oswaldo Cruz Foundation, Brazil, says, "UPFs affect health beyond the individual impact of high content of critical nutrients (sodium, trans fats, and sugar) because of the changes in the foods during industrial processing and the use of artificial ingredients, including colorants, artificial flavors and sweeteners, emulsifiers, and many other additives and processing aids, so assessing deaths from all-causes associated with UPF consumption allows an overall estimate of the effect of industrial food processing on health."
While previous studies focused on specific dietary risk factors instead of food patterns, the current study modeled data from nationally representative dietary surveys and mortality data from eight countries (Australia, Brazil, Canada, Chile, Colombia, Mexico, the United Kingdom, and the United States) to link dietary patterns, considering the extent and purpose of industrial food processing, to deaths from all causes.
Dr. Nilson explains, "We first estimated a linear association between the dietary share of UPFs and all-cause mortality, so that each 10% increase in the participation of UPFs in the diet increases the risk of death from all causes by 3%. Then, using the relative risks and the food consumption data for all countries (ranging from 15% of the total energy intake in Colombia, to over 50% of the calories in the United States), we built a model that estimated that the percentage of all-cause premature preventable deaths due to the consumption of UPFs can vary from 4% in countries with lower UPF consumption to almost 14% in countries with the highest UPF consumption. For example, in 2018, 124,000 premature deaths were attributable to the consumption of UPFs in the United States."
High consumption of UPFs has been associated with 32 different diseases, including cardiovascular disease, obesity, diabetes, some types of cancer, and depression. For the first time, this study has estimated the burden of UPF intake on premature deaths from all-causes in different countries, showing that the attributable mortality is significant in all settings and that addressing UPF consumption should be a global public nutrition priority.
Dr. Nilson notes, "It is concerning that, while in high-income countries UPF consumption is already high but relatively stable for over a decade, in low- and middle-income countries the consumption has continuously increased, meaning that while the attributable burden in high-income countries is currently higher, it is growing in the other countries. This shows that policies that disincentivize the consumption of UPFs are urgently needed globally, promoting traditional dietary patterns based on local fresh and minimally processed foods."
Notes for editors
The article is “Premature Mortality Attributable to the Ultra-Processed Dietary Pattern in the Eight Countries” by Eduardo A. F. Nilson, Felipe Mendes Delpino, Carolina Batis, Priscila Pereira Machado, Jean-Claude Moubarac, Gustavo Cediel, Camila Corvalan, Gerson Ferrari, Fernanda Rauber, Euridice Martinez-Steele, Maria Laura da Costa Louzada, Renata Bertazzi Levy, Carlos A. Monteiro, and Leandro F.M. Rezende (https://doi.org/10.1016/j.amepre.2025.02.018 opens in new tab/window). It appears online in the American Journal of Preventive Medicine, published by Elsevier.
The article is openly available for 30 days at https://www.ajpmonline.org/article/S0749-3797(25)00072-8/fulltext opens in new tab/window.
Full text of this article is also available to credentialed journalists upon request; contact Astrid Engelen at +31 6 14395474 or ajpmmedia@elsevier.com opens in new tab/window. Journalists wishing to interview the authors should contact Eduardo Nilson, Oswaldo Cruz Foundation (Fiocruz), Brazil at eduardo.nilson@fiocruz.br opens in new tab/window, Carlos Monteiro, University of Sao Paulo, Brazil at carlosam@usp.br opens in new tab/window or Leandro Rezende, Federal University of Sao Paulo at leandro.rezende@unifesp.br opens in new tab/window.
Parts of this study were supported by the National Council for Scientific and Technological Development (CNPq) and the Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp), in Brazil.
About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine opens in new tab/window is the official journal of the American College of Preventive Medicine opens in new tab/window and the Association for Prevention Teaching and Research opens in new tab/window. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials. www.ajpmonline.org opens in new tab/window
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