By Dr Dolly van Tulleken
12th February 2024
On a cold, dark Monday evening at the end of January, more than 200 people fought train strikes and Monday blues to gather together and hear from leading experts about ultra-processed food (UPF). The event, co-hosted by the Food, Farming & Countryside Commission (FFCC) and The Conduit Club, reflected the enormous public interest in food and health. Aided by an explosion of academic research made accessible by popular books, podcasts, social media and TV shows, we are fast waking up to the ubiquity of UPF in our lives. I have been following the UPF evidence base closely for about three years, but the statistics still knock me sideways.
In the UK, 60% of the average adult’s diet is UPF - more for children and even more for people living in the most deprived areas. Families, squeezed by soaring food prices, often face no other option but to buy cheap, highly processed foods. UPF forms the majority of what our largest food companies make, sell and market. It has become our national diet and the consequences for our health and the environment are devastating. Poor diets high in UPF are now the leading cause of early death and increase our risk of almost every major health problem you can name. While for the environment, UPF production relies on intensive extraction from the land and excessive use of pesticides and plastic packaging, resulting in 36-45% total diet-related biodiversity loss as well as land degradation and “eutrophication”, the excess nutrient run-off from agricultural land which devastates water bodies and their ecosystems.
Citizens are worried. Research by FFCC shows that across all demographics, ages and political groups, people don’t want this food system. They want the government to act. Parliament has taken a first step by launching a new House of Lords inquiry into UPF to understand the issue and identify solutions for government. The Times newspaper also published its Health Commission report, drawing attention to UPF and calling for government to double down on the aggressive marketing often targeted at children.
As pressure on policymakers grows and with an election on the way, is UPF the tipping point we need to move towards a greener, fairer and healthier food system? This was the question explored at FFCC’s event by Sue Pritchard, Professor Tim Benton, Dr Chris van Tulleken, Eddie Abbew, Rob Percival, Baroness Rosie Boycott, and chair Rachel Sylvester, which you can watch in full here.
The panel explained how traditional diets globally are being displaced by a highly industrialised, “Americanised” diet. Some countries, like the UK, have experienced a slow, insidious displacement over many decades making it hard to spot exactly when things tipped over. Whereas other countries, like in Latin America, have experienced a displacement of traditional diets akin to wildfire: rapid, scary and flagrant. It also explains why the UPF concept was born in Brazil. A team of academics, led by Professor Carlos Monteiro, noticed that despite purchasing of sugar, salt and oil decreasing, the purchasing of UPF products was drastically increasing, hand-in-hand with skyrocketing rates of obesity and Type-2 diabetes.
This focus on the industrialised nature of our food system and the excessive processing behind UPF is what the panel agreed has helped unlock people’s understanding of the food system and the harm it is causing. Eddie Abbew, a health advocate and gym-owner, shared his experience as a social media influencer: just by posting social media videos calling out UPF and advocating buying and cooking “real food”, Eddie’s Instagram following has grown from 500,000 to 1.9 million since September 2023. His message is clearly resonating.
People see how UPFs are symptomatic of a dysfunctional food system in which the incentives benefit only a few and harm is caused en masse. “While the food system is broken for most of us, it works incredibly well for a small group of financial beneficiaries making eye-watering profits”, said FFCC Chief Executive Sue Pritchard, referring to the small number of transnational food companies that dominate our food system.
At what cost to us and planet? Chatham House’s Professor Tim Benton referenced a recent UN FAO report which costed the global food system at $12.75 trillion, of which $9.3 trillion were healthcare costs from poor diets (mostly from high and higher middle-income countries).
Rob Percival, Head of Food Policy at the Soil Association, pointed out that while it can be easy to get caught up in debating which UPF products are worse than others, it was important to think beyond individual products and instead focus on the wider food system, which is oriented towards ultra-processing: “If you’re ill, if you have a fever, you might be sweating. Our food system is sweating ultra-processed food. But they are symptomatic of an underlying illness and it's the underlying illness we need to treat.”
Quoting Finnish scientist and former politician Professor Pekka Puska, Rachel Sylvester said it was a case of “everything, everywhere, all at once”.
For medical doctor and author Dr Chris van Tulleken, an urgent priority is to remove conflicts of interest from policymaking, academia and advocacy. He suggested that no one making decisions, advising or advocating on nutrition policy should be taking money from an industry causing diet-related health problems. Chris also emphasised the need for government to acknowledge the effect of processing on our health and how much we eat, rather than solely focusing on reducing levels of fat, salt and sugar in food.
Rob pointed to the pioneering work of the Brazilian government in 2014 to integrate ultra-processing into its dietary guidelines alongside traditional nutrition science. Not only do Brazil’s guidelines warn against high UPF consumption but they also interweave a political analysis that advocates for a healthy and sustainable diet based around whole foods, mostly plants, with animal products eaten sparingly and sourced from agroecological systems. This, Rob thinks, should be the template for what we have in the UK.
Attention turned to policies adopted across Latin America to reduce UPF consumption, including black octagon warning labels, bans on UPF in key settings like schools, and taxes. While these may be suitable later down the line, Chris cautioned that stronger measures like taxation should only be introduced once there are viable alternatives for people, as currently UPF is often the only food many people can afford. Government should focus first and foremost on increasing choice, freedom and opportunity so everyone can eat well.
The critical importance of citizen pressure from the bottom up was something all panellists agreed on. Rachel said that polling from The Times Health Commission found that people overwhelmingly favoured - three to one - government doing more on food, not less. She reflected that the public has a sense they are being exploited by big companies. The businesses Rachel spoke to also wanted government intervention to the level the playing field and create conditions where good food is good business. This mirrors early insights from FFCC’s The Food Conversation, which found that 74% want a target to reduce UPF in shops and on the high street.
There was a strong sense in the room that change is on the horizon, and that the political mandate for action, from businesses and citizens alike, is coalescing. With politicians vying for public support on key issues such as the economy and the NHS, Rachel suggested that meaningful action on food could host the electoral power they’re looking for. Baroness Rosie Boycott drew parallels to the smoking ban in 2007, comparing the unprecedented and immediate popularity of the policymakers who had taken the hard decisions needed. “Overnight he became the most popular man in England”, referring to former Chief Medical Officer Liam Donaldson.
Baroness Boycott emphasised that citizens are ready for serious politics and they are looking to government to be the adult in the room. "I want a parent state. I don't want a nanny. I want a parent who looks out for me and who says actually, what you eat is of great concern to me. And you know, when we set up the welfare state, we did education, we did health, we did welfare... but we’ve always left [food] to the market."
FFCC will be rolling out The Food Conversation across all four UK nations in 2024 and 2025. It will continue to explore what people really think about food, including on issues like UPF, and feeding this back to politicians, policymakers and businesses.