Short Takes: Alarm bells over the food we eat, and the food we give
Ultra-processed foods may contribute to thousands of preventable early deaths each year; and many leading baby food pouches are low in vital nutrients, and high in misleading claims, shows research.
Ultra-processed foods linked to early deaths
High consumption of ultra-processed foods (UPFs) may be contributing to tens of thousands of premature deaths annually, particularly in high-income countries such as the UK and the US, reveals a large global modelling study published in the American Journal of Preventive Medicine.
Eduardo A.F. Nilson, DSc, of the Oswaldo Cruz Foundation (Fiocruz) in Brasília, Brazil, led a team that analysed dietary intake data and mortality statistics from eight countries: Australia, Brazil, Canada, Chile, Colombia, Mexico, the UK and the US.
Using a dose–response meta-analysis of seven studies covering nearly 240,000 participants, Nilson and colleagues estimated that, for every 10% increase in UPFs as a proportion of daily energy intake, the risk of death from any cause rose by 2.7%. The researchers then used national survey data to estimate how much this increased risk translated to real-world mortality.
In the UK, where UPFs make up an estimated 53.4% of daily energy intake, the authors calculated that around 18,000 premature deaths per year (13.8% of deaths among adults aged 30–69 years) may be attributable to UPF consumption. That number rises to over 124,000 per year in the US, where UPFs account for more than 54% of energy intake.
Nilson said the findings underscore the broad public health burden of the foods: “UPFs affect health beyond the individual impact of high content of critical nutrients (sodium, trans fats and sugar) because of the changes in the foods during industrial processing and the use of artificial ingredients, including colorants, artificial flavors and sweeteners, emulsifiers, and many other additives and processing aids.”
He added: “Policies that disincentivize the consumption of UPFs are urgently needed globally, promoting traditional dietary patterns based on local fresh and minimally processed foods.”
The study’s strength lies in its use of nationally representative dietary surveys and mortality data, but its authors acknowledge there are limitations. All the underlying studies were observational, so causality cannot be confirmed—something emphasised by experts not involved in the study.
Nerys Astbury, MMedSc, PhD, Associate Professor of Diet and Obesity at the University of Oxford, commented: “This study adds to the body of evidence on the association between UPF and ill health and disease [but] it is important to note this does not mean that these deaths were caused by UPF consumption.”
She added: “Studies to date have been unable to determine with certainty whether the effects of UPF are independent of the already established effects of diets high in foods which are energy dense and contain large amounts of fat and sugar.”
“It is possible that the true causal risk factor is not ultraprocessed foods, but a related risk factor such as better physical fitness,” and UPFs are “simply an innocent bystander,” noted Stephen Burgess, MMATH, PhD, a statistician at the MRC Biostatistics Unit, University of Cambridge. “But, when we see these associations replicated across many countries and cultures, it raises suspicion that [they] may be more than a bystander.”
Nonetheless, Nilson and his team argue that reducing UPF consumption should be prioritised in dietary guidelines and regulatory policy, noting that intake is rising in many middle-income countries as UPFs displace traditional diets.
Some baby food pouches low in iron, high in sugar
An investigation by the TV programme BBC Panorama has found that popular baby food pouches from leading brands in the UK may fall short on nutritional quality, raising concerns about their use as everyday food for infants and toddlers.
The BBC commissioned independent UKAS-accredited laboratory testing of 18 pouches—fruit, yoghurt and savoury—from six brands: Ella’s Kitchen, Heinz, Piccolo, Little Freddie, Aldi and Lidl.
Results showed that several savoury pouches, marketed as suitable for babies as young as four months, contained less than 5% of an infant’s recommended daily iron intake. Some pouches with meat—the most reliable dietary source of iron—contained as little as 0.3 mg of iron per serving.
“That doesn’t meet even 5% of a baby’s daily iron needs,” said Bahee Van de Bor, a paediatric dietitian with the British Dietetic Association. “The iron-rich food content is a very tiny amount.”
One fruit pouch had virtually no vitamin C left, due to degradation during manufacturing. And pouches labelled “no added sugar” sometimes contained up to 19.6g of sugar, or more than four teaspoons, largely from blended fruit.
Alison Tedstone, RNutr, former chief nutritionist at Public Health England, told the programme: “You think as a parent it is a healthy product, and it just isn't.”
“All babies and children have a right to grow up healthy, but overwhelmingly the commercial baby and toddler food industry is misleading parents about the nutritional benefits of their products,” commented Barbara Crowther, Children's Food Campaign Manager at Sustain, an alliance of organisations campaigning for better food and farming.
“Why is it that the cheapest and most convenient food options are often the unhealthiest,” asked Children’s Food Ambassador at Sustain, and parent of a toddler Jaynaide Powis. “It is clear that the health and wellbeing of our children has not been a priority. Instead, commercial companies have put their profits first, and successive governments has allowed them to do this.”
Public health experts have called for tighter regulation, including bans on marketing to parents of infants under six months and clear front-of-pack warnings against feeding babies directly from the pouch.
Kremlin Wickramasinghe, PhD, World Health Organization Europe’s programme manager for nutrition, commented that marketing these foods to four-month-olds is “against the best interest of babies.”
In response to the investigation, some brands—Ella’s Kitchen, Piccolo, and Aldi—have announced they will raise the minimum age recommendation to six months. But campaigners say that voluntary changes are not enough, and the government must act.
“We should put our babies' health ahead of commercial incentives to sell more product,” said Dr Tedstone, adding: “I would hope that ministers, when they think about the baby food industry, recognise that we need to protect our babies,” as business are not going to change “unless they are forced to.”
Nilson’s study was supported by the National Council for Scientific and Technological Development—CNPq and Fundação de Amparo à Pesquisa do Estado de São Paulo.
No relevant financial relationships declared.
Liam Andrew Davenport is a medical reporter with more than 20 years’ experience covering a wide range of specialties and topics in the field.