‘Ultra-processing’ is main dietary cause of obesity: Commentary

A rapid rise in consumption of ‘ultra-processed’ food and drinks could be the main dietary cause of obesity, claims a new commentary published in the Journal of the World Public Health and Nutrition Association.

Carlos Monteiro of the Center for Epidemiological Studies in Health and Nutrition at the University of São Paulo suggests that the significance of food processing is often overlooked or marginalized in terms of its possible health impacts. He claims that rising rates of obesity have mirrored rising consumption of highly processed foods and beverages since the 1980s.

Monteiro outlines three different types of processing: Type one includes processing that does not significantly change the nutritional profile of foods, such as drying, parboiling or pasteurization; type two involves extracting substances from unprocessed foods by crushing, use of enzymes, extrusion or refining, for example. And a third type of processing, which Monteiro dubs ‘ultra-processing’, combines several type two ingredients, perhaps with very small amounts of unprocessed or minimally processed ingredients.

“The purpose of type 3 food processing is the creation of durable, accessible, convenient, attractive, ready-to-eat or ready-to-heat products,” Monteiro wrote, adding that they are problematic in two ways.

“First, their principal ingredients (oils, solid fats, sugars, salt, flours, starches) make them excessive in total fat, saturated or trans-fats, sugar and sodium, and short of micronutrients and other bioactive compounds, and of dietary fiber,” he wrote. “…Second, their high energy density, hyper-palatability, their marketing in large and super-sizes, and aggressive and sophisticated advertising, all undermine the normal processes of appetite control, cause over-consumption, and therefore cause obesity, and diseases associated with obesity.”

Industry is no demon…

The commentary repeatedly stresses that the issue is not an attack on the food industry, or with processed food in general.

“To demonize the food industry as a whole would be ignorant, foolish, and in effect irresponsible,” he wrote.

However, he admits that he is indeed “sharply critical” of the current practices of some manufacturers of ‘ultra-processed’ food, such as reformulating products to contain less fat and then marketing them as ‘lite’ or ‘better for you’.

…But needs regulating

In addition, he argues that the only way to prevent widespread over-consumption of ultra-processed foods is through regulation.

“A rationally and carefully regulated market, with its implication of a ‘level playing field’, is in the interests of industry,” wrote Monteiro. “Any unregulated ‘free-for-all’ makes the more responsible companies the victims of their most ruthless competitors. Also, the transnational and other big food and drink manufacturers could do quite a lot themselves. Product reformulation can have some benefits, even if this only slows down increases in the prevalence of epidemic disease. Other initiatives genuinely in the interests of public health can also be taken.”

Monteiro points out that the five most commonly consumed foods in the United States – sugared soft drinks, cakes and pastries, burgers, pizza, and potato chips – are all ultra-processed products.

The full commentary is available online here.