by PAULO SERODIO
In a new three-paper Series published in The Lancet, my colleagues and I tackle a deceptively simple question: what will it take to move humanity away from ultra-processed diets, and towards food systems that support health and equity rather than undermine them?
The stakes could not be higher. Ultra-processed foods (UPFs) now provide more than half of all calories in some high-income countries, and their consumption is rising rapidly across the rest of the world. A growing body of cohort studies and meta-analyses links high UPF intake to higher risks of obesity, type 2 diabetes, cardiovascular disease, depression and premature mortality. This is no longer a story about occasional “junk food”, it is about a structural shift in what people eat, and the health consequences that follow.
The Lancet Series, Ultra-processed foods and human health, brings these strands together. The first paper synthesises evidence on health impacts and mechanisms; the second sets out a menu of policies to halt and reverse the ultra-processed dietary pattern; and the third, which I co-authored, examines corporate power and global governance, asking what kind of coordinated response might realistically change the trajectory we are on.
Why ultra-processed foods are a global health issue
The Series uses the NOVA classification, which distinguishes between minimally processed foods, culinary ingredients, processed foods and ultra-processed foods. UPFs are not just “foods in packets”; they are industrial formulations of ingredients assembled through multiple processing steps and containing additives such as flavourings, colours, emulsifiers and sweeteners that are rarely used in home kitchens.
Across diverse countries, higher dietary shares of UPFs are consistently associated with poorer overall diet quality (more free sugars, unhealthy fats and sodium), and with increased risks of a wide range of chronic conditions and all-cause mortality. These associations remain even when controlling for energy intake or more traditional nutrient indicators, suggesting that how foods are formulated, structured and promoted matters over and above what nutrients they contain.
The Series reviews plausible mechanisms: UPFs tend to be hyper-palatable, energy-dense, aggressively marketed, easy to consume quickly and often stripped of their original food matrix. They displace minimally processed foods and home-cooked meals from the diet and may expose consumers to concerning levels of certain additives and processing-related contaminants.
Importantly, these are not marginal effects. Recent estimates suggest that in several high-income countries, ultra-processed diets may already account for between roughly 4% and 14% of premature deaths. That makes UPFs a population-level risk factor on a par with many of the classical hazards that have long been the focus of public health research.
Ultra-processed diets are built into today’s food systems
One of the most important messages of the Series is that ultra-processed diets are not an unfortunate by-product of individual poor choices, they are a structural outcome of how contemporary food systems are organised.
Over recent decades, global UPF sales have grown to nearly US$2 trillion, with the fastest growth in low and middle-income countries. A small group of transnational manufacturers (household names like Nestlé, PepsiCo, Unilever, Coca-Cola, Danone, Mondelez and Kraft Heinz), now control a large share of the sector’s assets, brands and distribution infrastructure and have a presence in almost every world market.
The Series frames this as a story about profitability and corporate strategy. UPFs are highly profitable: they rely on cheap commodity inputs and processing technologies to minimise production costs and on intensive marketing and product design to maximise consumption. We argue this profitability advantage drives capital towards the ultra-processed sector and, over time, pushes entire food systems in the direction of ultra-processed diets. What looks like a set of individual choices at the checkout is in fact the visible expression of deeper economic and political dynamics.
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