Ultra-processed foods: "Someone must dare to do what was done with the smoking ban"

We have ended up with a food system driven by the industry's desire for profit, not by what people actually need, researchers believe.

For companies to increase their earnings, it helps if consumers buy more food – even when they don't actually need it.

These dynamics are behind the development of more and more easy-to-eat and irresistible ultra-processed products. 

So how are people supposed to choose healthy food and limit how much they eat?

"Is this solely the individual's responsibility?"

Apart from food safety regulations, there are few limits on the production and sale of such items. Instead, authorities issue dietary guidelines encouraging people to limit unhealthy food and calorie intake.

Data on what we actually eat – along with statistics on population weight – show that many of us are not very successful in following these recommendations.

"But is this solely the individual's responsibility?" asks Tine Sundfør, a clinical nutritionist with a PhD in nutrition. In her work, she helps people eat healthier.

Sundfør believes it's time for society to start regulating the marketing and sale of these profucts.

"Awareness campaigns alone are not enough. We need to move from guidelines to regulations," she says.

"We need radical changes"

Simon Dankel, professor at the University of Bergen, believes that we need radical changes.

"We are facing a health crisis, with a large increase in obesity and lifestyle-related diseases, so we have to do things differently," he says.

"Someone must dare to do what was done with the smoking ban – recognise the seriousness of the situation and put a stop to the industry using food to maximise profits," the professor adds.

Reintroduce the sugar tax

Sundfør recently served on an expert panel that examined which measures could improve public diets.

"We know that a sugar tax works," she says.

There used to be a tax on sweets, sugary drinks, and other confectionery in Norway, but it was removed in 2021.

Sundfør believes revenue from a reinstated sugar tax could be used to subsidise healthy products, such as free fruit and vegetables in schools. She also recommends strengthening education in health and cooking.

"Many people don't know enough about cooking. In the UK, a fifth of the population only has a microwave in their kitchen. Naturally, that leads to a lot of ultra-processed foods," she says.

Warning labels

Sundfør is also critical of what she calls the 'health-washing' of unhealthy ultra-processed products.

"Every other kid has a muesli bar in their lunchbox. It's marketed as healthy, but it's basically like a chocolate bar," she says.

Sundfør believes a new labelling system would make this clearer.

"We've had the keyhole label for a long time to mark the best choices, but maybe we also need a clear warning label on the most harmful products," she says.

Rules for portion sizes and marketing

Sundfør would also like laws that regulate portion sizes, for example how big snack bags are allowed to be.

"I don't think it should be legal to sell six litres of soft drinks wrapped together in plastic," she says.

Sundfør also believes there must be stricter rules for marketing and for where unhealthy products can be sold.

"It's completely absurd that soft drinks are sold in school canteens and that hospitals smell like baked goods and hot dogs from the kiosk. Or that children's sporting events are sponsored by energy drink companies," she says.

Dankel believes it's highly problematic that marketing from the food industry is allowed to influence people's food choices.

" I think the recently introduced ban on marketing aimed at children is a step in the right direction – and I think it should extended to adults as well," he says. 

Health authorities: "Regulating sales is intrusive"

Usman Ahmad Mushtaq, State Secretary in the Norwegian Ministry of Health and Care Services, says we must acknowledge that we have not achieved good enough results in the area of diet.

"There's a need for more structural measures that make it easier for people to make healthier choices," he writes to Science Norway.

This involves the types of food available where people spend their time, but also pricing, marketing, and labelling. Regulating sales, however, is another matter.

"Regulating the sale of products is quite an intrusive measure. Today this only applies to a very limited number of products we do not want the population to consume, such as tobacco, alcohol, and now also energy drinks for children," he writes.

"It's more difficult to imagine similar restrictions for food and drink in general, including products that should be limited but can still be part of a diet in small amounts," he writes.

Mushtaq also notes that not all ultra-processed foods are unhealthy.

"Can lead to stigma"

Senior researcher Paula Varela-Tomasco at Nofima believes that the availability, marketing, and convenience of ultra-processed foods are key characteristics of modern environments that promote obesity.

At the same time, ultra-processed foods have also played a role in ensuring cheap, stable, and safe food globally, especially in areas with limited access to fresh ingredients, she writes in an email to Science Norway.

"Criticism of ultra-processed foods must take social inequalities into account: low-income consumers often have limited choices. Demonising ultra-processed foods without considering factors such as price, availability, and time can lead to stigma," she writes.

"Effective measures must be comprehensive, combining economic incentives, practical solutions, and strategies that are sensitive to both gender and social factors," she writes.

So that eating less ultra-processed foods becomes a realistic and fair opportunity for everyone, writes Varela-Tomasco.

Some agreement

There has been much debate about what counts as ultra-processed foods, since products like whole-grain bread and yoghurt can sometimes fall into this category, and experts disagree on this.

Still, there is plenty they do agree on, Sundfør points out.

"For example, that we need to reduce our intake of sweets, snacks, soft drinks and other sugary drinks, store-bought cakes and biscuits, ready-made pizza and lasagne with lots of refined flour, and processed meats like sausages, burgers, and bacon," she says.

Dietary guidelines already recommend cutting back on these products. 

"If we focused on that from every direction, people wouldn't have to spend so much energy on the disagreements," she says.

Should have acknowledged its role in overeating

Dankel still believes it may be wise to also avoid ultra-processed products not already covered by the dietary guidelines. He thinks the recommendations should address additives and processing methods that enhance flavour or make us eat faster.

"The dietary guidelines should have acknowledged that these elements contribute to overeating and that we should avoid such food," he says. "I understand the criticism of the classification, but we need to change course. Someone needs to take the lead and look for a good direction forward."

Dankel says that choosing less processed food can be an effective way to gain control over food intake.

"We must acknowledge that profit-driven systems encourage processing because the goal is to get people to eat more. Research has shown this to be a harmful situation, and that means political change is justified," he says.

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Translated by Alette Bjordal Gjellesvik

Read the Norwegian version of this article on forskning.no

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