The role of the transnational ultra-processed food ...€¦ · The role of the transnational...
Transcript of The role of the transnational ultra-processed food ...€¦ · The role of the transnational...
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Carlos A. Monteiro
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
associated diseases: problems and solutions
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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?
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• ‘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’
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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’
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‘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’
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Ultra-processed foods are formulated to be over-consumedand to replace real food
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Marketing of ultra-processed foods typically reinforces overeating ...
It is one after the other!The name says it all: ‘Non-stop is simply irresistible’.
New brand of ultra-processed products in Brazil
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`
http://www.corporate.nestle.ca/en/media/pressreleases/...treat-kids-will-go-bananas-over
... and the displacement of healthy foods!
`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.`
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Global sales from these companies: US$1,1 bi /day (2013)
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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
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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
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➢Effects on microbiome (Zinocker and Lindseth 2018)
➢Absence of bioactive compounds (Martinez-Steele 2017)
➢High glycemic index and low satiety (Fardet 2016)
➢Hyper-palatability (Kessler 2009; Brownell 2012; Moss 2013; Ifland 2018)
➢Mindless eating (Cohen & Farley 2008)
Ultra-processed foods and chronic diseases: non-nutrient mechanisms
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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
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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
Ind
ia
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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
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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
th K
ore
a
Pak
ista
n
Bel
aru
s
Kaz
akh
stan
Gre
ece
Ecu
ado
r
Ro
man
ia
Co
lom
bia
Slo
ven
ia
Ru
ssia
Un
ited
Ara
b…
Sou
th A
fric
a
Sin
gap
ore
Do
min
ican
…
Lith
uan
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Cro
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Hu
nga
ry
Ven
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Latv
ia
Bo
livia
Mac
edo
nia
Po
rtu
gal
Taiw
an
Cze
ch R
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Bra
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Ital
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Gu
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ala
Bu
lgar
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Co
sta
Ric
a
Slo
vaki
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ia
Fran
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Ho
ng
Ko
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Po
lan
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Uru
guay
Sau
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rab
ia
Den
mar
k
Swed
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Spai
n
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Fin
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ited
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tes
Source : PAHO 2015. Ultra-processed food and drinks products in Latin America. Washington, PAHO.
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Actions and policies that are not working:
Misleading nutritional labelling
Cosmetic product reformulation
Marketing self-regulation
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The real best buys:Taxation, warning labels and strong marketing restrictions on ALL UPF
Dietary guidelines based on real food and real mealsConsistent food procurement policies
A global framework convention on food systems to limit the influence of TN UPF industry
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Thank you!