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Two researchers from Inserm and one researcher from INRAE contributed to a series of three articles published on 19 November in The Lancet on the health consequences of consuming ultra-processed foods. The 43 international scientists who signed this series of articles propose the implementation of public health measures to limit the use of ultra-processed foods and improve nutrition worldwide. The scientific literature shows that this improvement requires the implementation of coordinated public policies aimed at reducing the production, marketing and consumption of ultra-processed foods, alongside measures to limit sugar, salt and saturated fat intake and improve access to healthy food.
Ultra-processed foods (UPFs) account for around 35% of our calorie intake in France (and up to 60% in the United States). Studies from around the world show that consumption of these products is associated with an increase in certain chronic diseases such as cardiovascular disease and type 2 diabetes. Limiting consumption of these products is a public health challenge that requires coordinated policies and action at the international level, according to this new series of three articles written by 43 global experts and published in The Lancet. The authors present a roadmap for moving towards effective regulation and healthier, more accessible and affordable diets.
Evidence of the harmful effects of ultra-processed foods is mounting
Ultra-processed foods, according to the NOVA classification, are products that have undergone significant processing (chemical, physical, biological), which are generally formulated from industrial ingredients such as hydrogenated oils, protein isolates or glucose/fructose syrup, and “cosmetic” food additives ‘ food additives (colourings, artificial sweeteners, emulsifiers, etc.).
The data examined in the first article in the series show that diets rich in ultra-processed foods are associated with overall overeating, poor nutritional quality (too much sugar and unhealthy fats, too little fibre and protein) and higher exposure to chemicals and additives that may be harmful to health. In addition, a systematic review of the scientific literature, covering 104 long-term studies, found that 92 of them reported a higher incidence of one or more chronic diseases associated with the consumption of ultra-processed foods, with meta-analyses showing significant associations for 12 health problems, including obesity, type 2 diabetes, cardiovascular disease, depression and premature mortality from all causes. The French NutriNet-Santé cohort, led by the Cress-Eren team (Inserm/INRAE/Cnam/Université Sorbonne Paris Nord/Université Paris Cité), has made it possible to publish some of these pioneering studies. The cohort now makes it possible to go further by providing information on the potential factors at play (food additives, contaminants linked to processing and packaging, etc.).
According to Mathilde Touvier, Inserm research director and coordinator of the NutriNet-Santé cohort, and her colleague Bernard Srour, INRAE researcher, who contributed to the first article in the series: “More and more studies show that a diet rich in ultra-processed foods is harmful to health. While a debate on ultra-processed foods within the scientific community is welcome in order to strengthen the level of available evidence, particularly on the mechanisms and factors involved, it should be distinguished from attempts by special interest groups to discredit current scientific evidence and slow down public health policies.”
Policies to combat ultra-processed foods while improving access to healthy alternatives
The second article in the series presents solutions aimed at regulating and reducing the production, marketing and consumption of UFPs, in order to make manufacturers accountable for their role in promoting ultra-processed foods.
The article explains how improving nutrition globally requires specific policies to complement existing legislation to reduce the saturated fat, salt and added sugar content of foods. Although measures need to be put in place at the consumer level (labelling, education, recommendations), the main focus is on fundamentally transforming the ultra-processed food system. In terms of labelling, for example, this would involve indicating the ultra-processed nature of products so that consumers can easily identify them, as has been proposed and tested with an advanced version of the Nutri-Score that incorporates the dimension of ultra-processing.
The authors also propose stricter trade restrictions, particularly for advertising aimed at children, in digital media and at brand level, as well as a ban on ultra-processed foods in public instiatutions such as schools and hospitals, and restrictions on their sale and shelf space in supermarkets, as is already the case in several countries.
A coordinated global response to combat the lobbying strategies of the ultra-processed food industry
The authors of the third and final article in the series – to which Melissa Mialon, researcher and holder of the Inserm Research Chair in Health Services, contributed – explain the relationship between the strategies of the agri-food industry and the rise of ultra-processed food products: the use of cheap ingredients, industrial methods to reduce costs, intensive marketing and attractive designs to stimulate consumption. With annual global sales of $1.9 trillion, ultra-processed foods are the most profitable food sector.
The series examines the mechanisms that contribute to avoiding regulation, steering scientific research and influencing public opinion despite knowledge of the health impacts.
The authors call for a coordinated global public health response and argue that ‘there is now a need for a bold and coordinated global response to establish food systems that prioritise the health and well-being of populations.’
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