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UPF policies stall amid confusing science

As a new WHO report puts processed foods in the same harmful category as tobacco, confusion behind ultra-processed food (UPF) science remains, stalling policy and regulatory creation.

In a recent report, the World Health Organization (WHO) has placed processed foods in the same harmful category as tobacco, alcohol, fossil fuels, and certain occupational practices. These categories combined are linked to nearly 7,500 deaths per day in Europe.

The World Obesity Federation points out the growing dominance of UPFs in diets globally, despite the significant criticism they receive. So much so, that these are ‘pushing aside’ all other food groups.

With growing research and awareness around UPFs and industry-leading organisations emphasising their dangers, one question remains: Why are we not moving towards implementing policies and regulations on a broad global scale?

In its review of current evidence, the UK government’s expert scientific committee, the Scientific Advisory Committee on Nutrition (SACN), has said that more research is needed before it can draw any firm conclusions about whether UPFs cause poor health. SACN is undertaking additional work on this subject and is expected to issue an update in November 2024.

“It is unclear to what extent observed well-established nutritional relationships between nutritional factors and health outcomes explain associations between UPF and adverse health outcomes,” said Andrew Curtis, director general scientific and regulatory affairs at Snack, Nut and Crisp Manufacturers Association (SNACMA).

There is a call for urgent and collaborative action to address this issue and overcome the confusion around this prominent food group.

The bumpy road to regulation

Several key issues are impacting global leaders' and legislatures’ ability to restrict the prevalence of UPFs and introduce labelling requirements and advertising bans.

1. No standard definition

The answer to why we are not moving towards implementing policies and regulations on a broad global scale lies partly in the need for harmonisation. Where contradictions exist in the food science community, confusion follows. Thus, any progress on clamping down on UPFs is stalled due to concerns over the science behind them and the effective route forward to protect consumer health.

“There is also the elephant in the room, which is the term UPF,” Curtis noted. The term appears in various WHO documents, and it is also starting to appear in European Union (EU) documents. “The current definition of UPF is somewhat subjective,” a spokesperson for WHO said.

“While the media, some scientists, and some NGOs have been happy to promote the term and use it to denigrate industry, the actual definition remains very nebulous and is open to a very large degree of interpretation by all who use it,” Curtis added.

There is also confusion among consumers as to what constitutes a UPF. Recent research shows that many US consumers cannot correctly identify UPF products and vastly underestimate their consumption of these foods.

2. Contradictions in scientific studies

To illustrate the point of conflicting scientific studies on UPFs, let’s look at two recent studies on the food group. On 30th June 2024, the American Society for Nutrition published the results of research on limiting UPFs. This calls into question the level of processing as a proxy for diet quality. The researchers stated that limiting UPFs does not necessarily make for a healthy diet.

The United States Department of Agriculture (USDA) presented its most recent UPF study and findings at the American Society for Nutrition meeting in 2024. The research suggests that largely consuming minimally processed foods, as classified by the NOVA system, does not guarantee a healthy diet. This implies that the specific types of foods we consume significantly impact our health more than the degree of processing involved in their production.

In this study, the USDA created two menus with similar diet quality and nutrient content but different levels of processing. One menu was comprised mostly of UPFs, as defined by NOVA criteria, and the other primarily of less-processed foods. “We found that the less-processed menu was more costly and had a shorter shelf life than the more-processed menu while providing similar nutrition,” Dr Julie Hess, research nutritionist at USDA, said.

Another study, however, published by the American Society for Nutrition on the same day, 30 June 2024, linked the intake of UPFs with an increased risk of death. It states that processed meats and soft drinks show the strongest association with increased mortality.

After tracking over half a million US adults for nearly three decades, the study’s results revealed that older adults who ate more UPFs, as defined by the NOVA classification system, had a roughly 10% higher likelihood of dying over a 23-year follow-up period compared to those who consumed less processed food.

Today, researchers are conducting longitudinal cohort studies like this to gain a large-scale understanding of the effects of UPFs over the longer term. These studies aim to observe the direct and indirect effects of UPF consumption over this expanse of time. In France, the NutriNet-Santé study is an ongoing web-based cohort study examining the impact of nutrition on health, including the role of UPFs on consumer health.

3. Lack of comprehensive research methods

The problem may also lie in how research on UPFs is carried out. Evidence to date is almost exclusively of the association variety, such as observational studies, prospective cohort, and cross-sectional studies, WHO said. “A clear path of causality cannot be made between consumption of UPF and most if not all observed health outcomes,” added WHO’s spokesperson.

The WHO says some randomised controlled trials (RCTs) have been conducted, which enable researchers to examine the immediate and short-term health effects of UPF consumption compared to minimally processed diets. However, these tend to support what is observed in observational studies. RCT studies can provide insights by exploring how UPF consumption changes metabolic markers, inflammation, and gut microbiota compared to whole foods.