By Wendy Tuohy
Almost half of what Australians eat is ultra-processed food, which is increasing exposure to cocktails of harmful chemicals, including PFAS, and raising people’s risk of chronic disease.
Mass-produced bread, protein bars, processed meats, fast food, ready meals, soft drinks, instant noodles and breakfast cereals are increasing the risk of illness and death, and consumers have no way of knowing what the combinations of chemicals in them could be doing to their health.
Forty-three global experts, including Australians, published the series Ultra-Processed Foods and Human Health in The Lancet on Wednesday, warning that diets are worsening as dietary patterns move away from fresh and minimally processed foods.
This is having a similar impact on health – but “in reverse” – to the protective effects of the widely recommended Mediterranean diet.
Soft drink companies are no longer competing for market share but instead with people’s consumption of tap water, raising many disease risks beyond obesity.
The research included a systematic review encompassing 104 long-term studies, 92 of which reported greater associated risks of one or more chronic diseases.
It found links between ultra-processed dietary patterns and cancer-related, cardiovascular-related, and cerebrovascular (brain vessel) related illness and death, and kidney, liver, gall bladder, joint, metabolic and mental illnesses.
Ultra-processed foods were also associated with 12 health conditions including obesity, type 2 diabetes, cardiovascular disease, high blood pressure, depression, chronic kidney disease and Crohn’s disease.
Co-author Dr Priscila Machado, a public health nutrition researcher at Deakin University, said the health risks are not limited to the foods having too much sugar or fat.
“Diets high in ultra-processed foods are nutritionally poor,” she said. “They have less fibre, key vitamins and minerals. They also displace whole foods and all of their health-protective benefits.”
If it’s wrapped in plastic and contains ingredients you wouldn’t find in a normal kitchen, it’s ultra-processed food.Credit: James Brickwood
The first in the three-paper series notes that ultra-processed foods also lead to increased intakes of “xenobiotics (substances foreign to a biological system)” and toxic compounds that are “often generated during their manufacture”.
“Noxious chemicals ... which are known endocrine disruptors, can leach from packaging commonly used for UPFs (ultra-processed foods) with long shelf lives, or from UPFs consumed directly from packaging,” the paper states.
Exposure to PFAS chemicals is linked to increased risk of certain cancers, immune system effects, reproductive and developmental issues and impacts on cholesterol, liver and thyroid function, according to New South Wales Health.
“Nationally representative studies from the USA found higher urinary concentrations of PFAS in people with increased UPF intake. During pregnancy, an increased UPF intake was associated with greater maternal concentrations of phthalates and umbilical cord PFAS,” the research stated.
Diets high in ultra-processed foods contain more classes or mixtures of additives that are harmful to health, such as emulsifiers, flavour enhancers and non-sugar sweeteners and colourings, but there was not enough known about the short and long-term effects of them together in the body.
Mark Lawrence, Public Health professor at Deakin University, said: “More and more of these novel ingredients are entering the food supply, including cosmetic additives … that haven’t been used before.”
Traditionally, the risks of each class had been examined individually. “But we need to be more sophisticated in how we use toxicology studies, so … the cocktail of these novel ingredients are assessed,” he added.
“We need to look at not just the immediate or acute impacts of these novel ingredients, but the cumulative effect over time … the impact of these novel ingredients on longer-term diet-related diseases, the heart diseases, cancers and so on.”
Lawrence and his co-authors, who spoke at press conferences in Australia and Europe before the series’ release, said food standards had to be reformed to improve front-of-package labelling on products, and consumer health information, such as Australia’s health star ratings system, should be compiled without the influence of or partnership with manufacturers.
The use of processing aids – substances used to improve texture, shelf-life or stability – should be mandated, Lawrence said. “At the moment, we have no way of knowing if a product has been manufactured using novel enzymes that change the whole structure of the food matrix [chemical structure] itself,” he said.
Gyorgy Scrinis, a professor of Food and Nutrition Politics and Policy at the University of Melbourne, said while policies exist to promote reformulation of existing high fat, sugar and salt foods, policies influencing dietary patterns are needed.
“That really means a new suite of policies required, and stronger policies to ... drive down ultra-processed food consumption,” he said.
Existing marketing restrictions should be extended to a wider range of ultra-processed products, possibly including new taxes and restrictions on availability, including in schools.
Dr Phillip Baker, of Sydney School of Public Health, said the influence of manufacturers over consumers and governments must be challenged.
Multinationals use their resources for political influence to ensure that governments are not regulating the industry and self-regulation was not working for consumers, he said.
“We describe how just three manufacturers – Coca-Cola, Pepsi and [snack maker] Mondelez – spend $13.5 billion on advertising every year, which is four times more than the entire operating budget of the World Health Organisation,” Baker said.
Australia’s health-star rating system, a public-private partnership, had “been co-opted as a marketing tool” and was ineffective: “After 10 years [it] has only been implemented on a third of packaged food products in Australia … and many of those products have favourable health star ratings.
“I think this is something that the Australian public, and policymakers need to take a very serious look at,” he said.
The researchers described the increase in ultra-processed food consumption as an urgent challenge to health, and called for a strong global public health response similar to the co-ordinated efforts to challenge the tobacco industry.
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