Consumer

The silent epidemic: ultra-processed foods

March 13, 2025

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The modern food landscape is dominated by an insidious force: ultra-processed foods (UPFs), often high in fats, sugars, and sodium (HFSS). While their hyper-palatability and convenience are undeniable, their meticulously engineered nature belies a complex web of health risks. This article moves beyond simply outlining these risks. It presents a holistic, policy-driven approach, advocating for a fundamental restructuring of our food systems.

Expect concrete recommendations, from mandatory front-of-pack labeling (FOPNL) to fiscal measures and marketing restrictions, all grounded in existing frameworks like the WHO’s global action plan. This is not just another warning about UPFs and HFSS; it’s a call for systemic change, backed by detailed scientific evidence and forward-looking research, exemplified by the inclusion of the forthcoming Liang et al. (2025) review, to address the escalating crisis.

Table of Contents

1. The rise of ultra-processed foods in modern diets

1.1. What are ultra-processed foods?

UPFs are defined by the NOVA classification system, which categorises foods based on their level of processing. Unlike minimally processed foods or processed culinary ingredients, UPFs are industrial formulations made from multiple ingredients, often with little to no whole food content. Examples include sugary snacks, ready-to-eat meals, soft drinks, and packaged baked goods.

1.2. Global consumption trends

The consumption of UPFs has surged globally, particularly in high-income countries. In the United States and the United Kingdom, UPFs account for over 50% of dietary energy intake.

Even in low- and middle-income countries like Colombia and Mexico, UPF consumption ranges from 16% to 30% of total dietary energy.

This trend is driven by the convenience, affordability, and aggressive marketing of these products (WHO, 2022).

2. Health impacts of ultra-processed foods

2.1. Increased risk of all-cause mortality, genetic changes and aging

The systematic review by Liang et al. (2025) synthesised data from 18 prospective cohort studies involving over 1.1 million participants. The findings revealed that:

individuals with the highest UPF consumption had a 15% increased risk of all-cause mortality compared to those with the lowest consumption;
each 10% increment in UPF intake was associated with a 10% higher risk of mortality.

Processed and ultra-processed foods high in sugar and saturated fat, as well as alcohol, are also associated with increased oxidative stress, inflammation, and shorter telomeres, accelerating the aging process (Marti, 2019).

2.2. Mechanisms linking UPFs to adverse health outcomes

Several pathways explain the detrimental effects of UPFs on health:

poor nutritional quality. UPFs are typically high in saturated fats, sugars, and salt, which contribute to obesity, cardiovascular diseases, and other chronic conditions;
food additives. Emulsifiers, sweeteners, and other additives in UPFs can disrupt gut microbiota, leading to reduced microbial diversity and increased inflammation;
unhealthy lifestyles. High UPF consumption is often associated with other unhealthy behaviours, such as smoking, excessive alcohol consumption, and physical inactivity;
overconsumption. The organoleptic properties of UPFs, such as their hyper-palatability, can lead to faster (rather than mindful) eating and delayed satiety signals, and food addiction (Filgueiras et al., 2019).

3. Evidence from recent studies

3.1. Study design and scope

The review by Liang et al. (2025) included 18 prospective cohort studies conducted across various regions, including the United States, Europe, and Asia.

These studies assessed UPF consumption using the NOVA classification and examined its association with all-cause mortality.

The large sample size (over 1.1 million participants) and long follow-up durations (ranging from 7.1 to 34 years) provide robust evidence for the harmful effects of UPFs.

3.2. Major outcomes

Dose-response relationship. The review found a linear dose-response relationship between UPF consumption and mortality risk. Even small increases in UPF intake were associated with higher mortality rates.
Subgroup analyses. The risk of mortality was consistently higher across various subgroups, including different age groups, sexes, and regions. Notably, males exhibited a higher risk than females, possibly due to differences in diet and lifestyle factors.

4. Interim conclusions: a call for action

The evidence is clear: reducing UPF and HFSS consumption is crucial for improving public health and reducing the burden of non-communicable diseases (NCDs). To achieve this, comprehensive nutrition policies must be implemented at national and global levels, as recommended in WHO’s Global action plan for the prevention and control of noncommunicable diseases (2013).

These policies must start from the definition of scientifically sound nutrient profiles, as also recommended by WHO (2023). A good example is offered by the nutrient profiles developed by the Food Standards Agency (FSA, UK) and University of Oxford, as further developed and updated by the Nutri-Score Scientific Committee.

4.1. Front-of-pack nutrition labelling

Front-of-pack nutrition labelling (FOPNL) systems, such as Nutri-Score, can help consumers make informed and healthier choices (Deschasaux-Tanguy et al., 2024), by providing clear information about the nutritional quality of foods.

These labels should be mandatory for all packaged foods, and those offered by food service chains (i.e. fast-food), as recommended by WHO (2019, 2023). Also with a focus on highlighting UPFs as Nutri-Score inventor Professor Serge Hercberg proposed in 2021.

4.2. Fiscal measures

Taxation on UPFs, particularly those high in sugar, salt, and saturated fats, can discourage consumption. And it should be introduced thoroughly, as recommended by WHO (Fiscal policies to promote healthy diets, 2024).

Simultaneously, VAT reductions and subsidies for fresh produce and minimally processed foods ought to be implemented to make healthier options more affordable and accessible.

4.3. Restrictions on marketing and sales

Marketing of UPFs, especially to children, should be strictly regulated. The European legislator ought to reform the Audiovisual Media Services Directive (AVMS) – which failure has been recognized by the Commission and highlighted by EPHA (European Public Health Association) to protect minors from predatory marketing of junk food.

Sales of UPFs in schools, hospitals, and other public spaces should be restricted, following the examples of India and Mexico. Vending machines in these settings should offer healthier alternatives, to increase awareness about the role of nutrition and reduce the negative outcomes of UPF intakes (Volpe et al., 2023).

4.4. Global collaboration: The imperative for inclusivity

Policies should align with World Health Organization (WHO) strategies, political declarations, and guidelines to ensure a coordinated global response. However, the fight against the UPF epidemic cannot be won without the active participation of China and India, the world’s most populous nations. These countries, with their rapidly growing middle classes and shifting dietary patterns, are increasingly vulnerable to the health impacts of UPFs. Their involvement is critical not only for their own populations but also for setting a precedent for other low- and middle-income countries.

China and India must be integral partners in global efforts to regulate UPFs. This includes adopting and adapting WHO-recommended policies such as FOPNL, fiscal measures, and marketing restrictions. Moreover, these nations should leverage their unique cultural and economic contexts to develop innovative solutions that can be scaled globally. For instance, China’s advancements in digital technology could be harnessed to create real-time nutritional tracking apps, while India’s vast network of local food producers could be mobilized to promote traditional, minimally processed foods.

Low- and middle-income countries, where UPF consumption is rising rapidly, should also receive targeted support to implement these measures. This support should include financial aid, technical expertise, and capacity-building initiatives to ensure that no country is left behind in the global fight against UPFs.

5. Final thoughts

The confluence of undernutrition, micronutrient deficiencies, and the burgeoning epidemic of obesity – the triple burden of malnutrition – demands a radical departure from conventional solutions. Dismantling the pervasive influence of ultra-processed foods is not merely a dietary adjustment; it is a fundamental restructuring of our food systems.

We must move beyond incremental policies to embrace a holistic, preventative strategy that empowers individuals, regulates industry, and prioritizes public health over profit. Only through such transformative action, with the active participation of all nations, especially China and India, can we forge a future where food nourishes, rather than erodes, the well-being of humanity.

Dario Dongo

References

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EPHA (2021). Call to protect children from the marketing of nutritionally poor food https://tinyurl.com/y35b49dj. Proposal for a ‘Directive XX/XXXX of the European Parliament and of the Council XXX on the protection of children from the marketing of nutritionally poor food’. https://tinyurl.com/mr34xxt7
Filgueiras AR, Pires de Almeida VB, Koch Nogueira PC et al. (2019). Exploring the consumption of ultra-processed foods and its association with food addiction in overweight children. Appetite. https://doi.org/10.1016/j.appet.2018.11.005
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