Carlos A. Monteiro [email protected]Center for Epidemiological Studies in Health and Nutrition University of Sao Paulo, Brazil 2019 Prince Mahidol Award Conference ‘The Political Economy of NCDs: a Whole of Society Approach’ Parallel session 1.3 ‘The commercial determinants of non-communicable diseases’ Bangkok, Thailand, 01 February, 2019 The role of the transnational ultra-processed food industry in the pandemic of obesity and its associated diseases: problems and solutions
Center for Epidemiological Studies in Health and NutritionUniversity of Sao Paulo, Brazil
2019 Prince Mahidol Award Conference ‘The Political Economy of NCDs: a Whole of Society Approach’Parallel session 1.3 ‘The commercial determinants of non-communicable diseases’
Bangkok, Thailand, 01 February, 2019
The role of the transnational ultra-processed food industry in the pandemic of obesity and its
Why regulatory policies to counteract strategies usedby TN ultra-processed food industries to increase thesales of their products inexist in most countries or are
restricted to a few products in others?
• ‘We all need food’
• ‘Consumed in moderation and combined with other foods, anyfood (even those processed) can make part of a healthy diet’
• ‘There are no unhealthy foods, only unhealthy diets’
The TN UPF industry narrative ‘food is not tobacco’
An alternative narrative(Nutrition and health. The issue is not food, nor nutrients, so much as processing. Public Health Nutr. 2009 May;12(5):729-31)
• ‘We all need food’
• ‘Any food can make part of a healthy diet except ultra-processedfoods, which are unhealthy by design and are formulated andmarketed to be overconsumed and to displace healthier foods’
• ‘As tobacco, ultra-processed foods should be strongly regulated’
‘Ultra-processed foods are technological formulations of raw and chemically modified food substances added of flavors, colors, emulsifiers and other cosmetic additives.’
* Monteiro CA et al. Ultra-processed foods: what are they and how to identify them? Public Health Nutrition 2019 (in press)
Ultra-processed foods as defined by NOVA food classification system*
Processes and ingredients of UPF allow the industry to obtain durable, ready-to-consume, hyper-palatable, and highly profitable products liable to replace all other NOVA food groups’
Ultra-processed foods are formulated to be over-consumedand to replace real food
Marketing of ultra-processed foods typically reinforces overeating ...
It is one after the other!The name says it all: ‘Non-stop is simply irresistible’.
`Nestlé Canada is thrilled to introduce Peelin’ Pops, a unique new frozen treat that looks like a banana and tastes like one too! With something so fun and tasty, kids and adults alike will be entertained each and every time, keeping them coming back for more.`
Global sales from these companies: US$1,1 bi /day (2013)
Articles in PubMed with the term ‘ultra-processed’
1 1 1 28 5
2127
38
91
0
10
20
30
40
50
60
70
80
90
100
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Source: Monteiro et al Pub Health Nutr 2017
X
Studies in Brasil, Chile, Colombia, Argentine, Mexico, US, Canada, UK, France, Australia, Japan, Taiwan … show that UPF had:
- higher energy density- higher content of free sugars and unhealthy fats- lower content of protein and fibre- lower content of vitamins and minerals
UPF All other foods
➢Effects on microbiome (Zinocker and Lindseth 2018)
➢Absence of bioactive compounds (Martinez-Steele 2017)
➢High glycemic index and low satiety (Fardet 2016)
Ultra-processed foods and chronic diseases: non-nutrient mechanisms
Cross-sectional and longitudinal studies show that ultra-processed food consumptionis associated with obesity, hypertension, dyslipidaemias, metabolic syndrome,
heart attacks, stroke, breast cancer and total cancer
India6.7
Indonesia23.8 Vietnam
37
Philippines52.9
Malaysia56.6
Thailand75.2
South Africa95.6
Brazil113
Italy113.3
Saudi Arabia149.6
Argentina185
Australia208.3
Mexico214
Canada231.5
USA308
0
50
100
150
200
250
300
350
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ia
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ited
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ited
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Annual retail sales of ultra-processed food and drink products in 80 countries (2013)
Source : PAHO 2015. Ultra-processed food and drinks products in Latin America. Washington, PAHO.
Kg/person
India6.7
Indonesia23.8 Vietnam
37
Philippines52.9
Malaysia56.6
Thailand75.2
Pakistan83.2
South Africa95.6
Brazil113
Italy113.3
Saudi Arabia149.6
Argentina185
Australia208.3
Mexico214
Canada231.5
USA308
0
50
100
150
200
250
300
350
Ind
ia
Ken
ya
Cam
ero
on
Nig
eria
Ind
on
esia
Uzb
ekis
tan
Egyp
t
Mo
rocc
o
Vie
tnam
Aze
rbai
jan
Ch
ina
Pe
ru
Ph
ilip
pin
es
Mal
aysi
a
Iran
Alg
eria
Geo
rgia
Bo
snia
an
d…
Ukr
ain
e
Thai
lan
d
Turk
ey
Tun
isia
Sou
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n
Bel
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ited
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ch R
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Bra
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Ric
a
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ia
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Ho
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ited
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ada
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ited
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Source : PAHO 2015. Ultra-processed food and drinks products in Latin America. Washington, PAHO.
