Journal Article

The need to reshape global food processing: a call to the United Nations Food Systems Summit

Millett, Christopher, Nestle, Marion, Popkin, Barry M, Swinburn, Boyd, Lawrence, Mark, Scrinis, Gyorgy, Monteiro, Carlos Augusto

2021

Overview

By contrast, ultra-processed foods are mostly enabled, produced and sold by a small number of transnational corporations, some of whose turnovers exceed the revenues of many countries and make annual profits of US$ billions.3 These corporations use their power to formulate, mass manufacture, distribute and aggressively market their products worldwide.4 These corporations shape scientific findings by funding in-house and university-based research, so as to defend and promote ultra-processed foods.5 They also exercise political power by intensive lobbying, donations and sponsorships, and until now have dissuaded most governments from adequately regulating their products and practices.6 Time-series food sales data indicate the explosive growth in manufacturing and consumption of ultra-processed foods worldwide.7 National dietary surveys show that ultra-processed foods already make up 50% or more of total dietary energy intake8 in high-income countries, with even higher consumption among children and adolescents.9 In middle-income countries, they now represent between 15% and 30% of total energy intake8 but sales of ultra-processed foods are increasing fastest in these countries.10 The pandemic of obesity and related diseases and its link with ultra-processing According to WHO, worldwide prevalence of obesity has nearly tripled since the mid-1970s, and now over 650 million adults are obese, and 1.9 billion adults and over 370 million children and adolescents are overweight or obese (https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight). Three meta-analyses of findings from epidemiological studies, including large, long-duration, carefully conducted cohort studies, show dose-response associations between consumption of ultra-processed foods and obesity, abdominal obesity, type 2 diabetes, dyslipidaemias, metabolic syndrome, depression, cardio and cerebrovascular diseases and all-cause mortality.12–14 Analysis of national dietary or food purchase surveys in middle-income or high-income countries shows that the higher the dietary share of ultra-processed foods, the higher the obesogenic dietary nutrient profiles. Participants gained 0.9 kg at the end of the 2 weeks with the ultra-processed diet and lost 0.9 kg at the end of the non ultra-processed diet, mostly of body fat.15 A longitudinal ecological study of 80 countries from 2002 to 2016 shows a direct association between changes in annual per capita volume sales of ultra-processed foods and corresponding changes in population adult body mass index.16 Taken together, the totality of evidence summarised here shows beyond reasonable doubt that increased consumption of ultra-processed foods is a major contributor to the pandemic of obesity and related diseases. There is also mounting evidence of the harmful effects of the ultra-processed food industry on the planet, through its global demand for cheap ingredients that destroy forests and savannah, its displacement of sustainable farming, and its resource-intensive manufacturing and packaging.17 Policy responses To begin with, the UN Food Systems Summit should urge international and national health and food and nutrition authorities to review their dietary guidelines to emphasise preference for fresh or minimally processed foods and avoidance of ultra-processed foods, in line with guidelines developed, for example, by the WHO/Pan American Health Organization,18 and issued in several Latino-American countries, and now also in France, Belgium, and Israel.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adolescents / Coronaviruses / COVID-19 / Diabetes / Diet / Ecological studies / Energy / Food / Food systems / Income / Manufacturing / Meals / Metabolic disorders / Nutrition / Obesity / Overweight / Pandemics / Political power / Processed foods / Public health / Sustainable agriculture