Ultra-processed food linked to premature deaths

A global study analysing dietary surveys and mortality data from eight countries shows that premature deaths attributable to consumption of ultra-processed foods (UPFs) increase significantly according to their share in individuals’ total energy intake.

The new paper, appearing in the American Journal of Preventive Medicine, 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.

Dr Eduardo Augusto Fernandes Nilson of the Oswaldo Cruz Foundation (Fiocruz), Brazil, said processing and the addition of artificial ingredients has become more common.. ‘UPFs affect health beyond the individual impact of high content of critical nutrients (sodium, trans fats, and sugar),’ he said. ‘Assessing deaths from all-causes associated with UPF consumption allows an overall estimate of the effect of industrial food processing on health,’ he said.

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, United Kingdom, and United States) to link dietary patterns, considering the extent and purpose of industrial food processing, to deaths from all causes.

‘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%,’ Dr Nilson said. ‘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.

‘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,’ Dr Nislon said. ‘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.’