Ultra-processed foods should be treated more like cigarettes than food – study | Global development

Ultra-processed foods (UPF) have more in common with cigarettes than fruits or vegetables, and require much stricter regulation, according to a new report.

UPFs and cigarettes are designed to encourage addiction and consumption, researchers from three US universities said, highlighting parallels in widespread health harm that link the two.

UPFs, widely available worldwide, are industrially manufactured food products, often using emulsifiers or artificial colors and flavors. This category includes soft drinks and packaged snacks such as chips and cookies.

There are similarities in the production processes of UPFs and cigarettes, as well as manufacturers’ efforts to optimize the products’ “doses” and how quickly they act on reward pathways in the body, according to the paper by researchers from Harvard, the University of Michigan and Duke University.

They draw on data from the fields of addiction science, nutrition and public health history to make their comparisons, published February 3 in the health journal The Milbank Quarterly.

The authors suggest that marketing claims on products, such as “low fat” or “sugar free,” constitute “health washing” that can block regulation, similar to the advertising of cigarette filters in the 1950s as protective innovations that “in practice offered few significant benefits.”

“Many UPFs share more characteristics with cigarettes than with minimally processed fruits or vegetables and therefore warrant regulation commensurate with the significant public health risks they pose,” they concluded.

One of the authors, Professor Ashley Gearhardt of the University of Michigan, a clinical psychologist who specializes in addiction, said her patients made the same connections: “They would say, ‘I feel addicted to this stuff, I crave it – I used to smoke cigarettes.’ [and] now I have the same habit but it’s with sodas and donuts. I know it kills me; I want to stop, but I can’t.

The debate around UPFs fits a well-known pattern in the addiction field, according to Gearhardt. She said: “We put the blame on the individual for a while and say ‘oh, you know, smoke in moderation, drink in moderation’ – and eventually we get to a point where we understand the levers that the industry can pull to create products that can really hook people.

Although food, unlike tobacco, is essential for survival, the authors argue that this distinction makes action doubly necessary because it is difficult to opt out of the modern food environment.

Gearhardt said it should be possible to differentiate between harmful UPFs and other food products in the same way that alcoholic beverages are differentiated from other beverages.

UPFs meet “established criteria” for whether a substance should be considered addictive, the document claims, with design features that “may lead to compulsive use” – although “the harms of UPFs are clear, regardless of their addictive nature”.

The authors suggested that lessons learned from tobacco regulation, “including litigation, marketing restrictions, and structural interventions,” could serve as a guide to reducing UPF-related harms, calling for public health efforts to “shift from individual responsibility to food industry responsibility.”

Professor Martin Warren, scientific director of the Quadram Institute, a food research centre, said that while there were parallels between UPF and tobacco, the authors risked going too far in their comparisons.

Questions arose, he said, about whether UPFs were, like nicotine, “intrinsically addictive in a pharmacological sense, or whether they primarily exploit learned preferences, reward conditioning, and convenience.”

He added that it was also important to determine whether the adverse health effects attributed to UPFs came from their contents or from the fact that they replaced “whole foods rich in fiber, micronutrients and protective phytochemicals.” He said: “This distinction is important because it determines whether regulatory responses should reflect tobacco control or instead prioritize food quality, reformulation standards and diversification of the food system. »

Dr Githinji Gitahi, Managing Director of Amref Health Africa, said: “This newspaper article reinforces a growing public health alarm resounding across Africa. [where] Companies have found a comfortable and profitable link: weak government regulation on harmful products and a changing consumption pattern.

“All of this is putting new, avoidable pressures on already strained health systems,” he said. “Without public interventions to combat the growing burden of noncommunicable diseases, we risk the collapse of health systems. »