Eighty-six percent of US packaged product sales are ultra-processed, study finds

26 Jul 2019 --- Around 80 percent of Americans’ calorie consumption comes from store-bought food and beverages, which are mostly ultra-processed and generally unhealthy, according to a study from Northwestern Medicine, US. This means Americans are overexposed to products high in energy, saturated fat, sugar and salt, increasing their risk of chronic diseases such as obesity and cardiovascular disease. Researchers are now calling for food manufacturers to reformulate unhealthy products and for the government to take action.

“This study shows the need for system-level transformation to improve the diets of Americans. Product reformulation and replacement are needed en-masse, and voluntary regulations are not working to create a healthy food environment,” the authors of the study tell NutritionInsight.

“We need sociopolitical pressure to achieve those policy changes. We are still learning about the global packaged food and beverage supply and need data like this to understand cross-country comparisons better. The US Food and Drug Administration also identifies sodium and sugar as ‘generally regarded as safe,’ whereas other countries regulate the level of these nutrients of concern in the food and beverage supply.”

The researchers analyzed 230,156 products and, using the NOVA classification system, found 71 percent of products including bread, salad dressings, snack foods, sweets and sugary drinks were ultra-processed. These are foods substantially modified from their original form and may contain added salt, sugar and fat, as well as preservatives or artificial colors. Additionally, among the top 25 manufacturers by sales volume, 86 percent of products were classified as ultra-processed.

Foods are classified as ultra-processed if they are industrial formulations made entirely or mostly from substances extracted from foods (oils, fats, sugar, starch and proteins). Additionally, they are derived from hydrogenated fats and modified starch, and are synthesized in laboratories.

“The nutritional quality of foods is inversely correlated with processing, meaning that more processing is associated with decreased nutritional value and beneficial nutrients. Diets high in ultra-processed foods have been shown to be associated with adverse health outcomes such as cardiovascular disease and all-cause mortality,” lead author Abigail Baldridge, a Biostatistician in the Department of Preventive Medicine, explains to NutritionInsight. “Essentially, people eat more calories when snacking on ultra-processed foods and this leads to weight gain,” the other authors add. 

“I was surprised by how few products (28,808; 12.5 percent) were manufactured by the top 25 manufactures, for which the aggregate sales volume was 42.8 percent of 2018 US sales on packaged food and beverage products. This means that these manufacturers are producing relatively few food products that are purchased at very high volumes,” Baldridge remarks.

Americans consume a large amount of packaged foods, most of which are ultra-processed. An acutely American issue
American food is similarly healthy to that of other western countries but is more processed and has a higher median sugar and sodium content. Baldridge notes that while consumer taste and purchasing habits may drive the manufacture of unhealthy foods, policy also has a role. 

“We found that bread products in the US have a 12 percent higher sodium content than bread products in the UK. This can likely be attributed – at least in part – to national sodium reduction strategies that the UK implemented. The US recently banned trans-fats, and that shift in policy has had a substantial effect on trans-fat content in the food supply.”

In an interesting turn, however, a researcher has claimed that refined grains have been unfairly given a bad name due to their common association with unhealthy foods. The researcher also points out that in the US, processed bread is fortified with lots of important nutrients people would otherwise miss out on. 

The authors speculate that Americans derive such a large proportion of their calorie consumption from store-bought food and drinks due to people spending less time on food preparation compared with historical norms, which drives greater consumption of foods that require less preparation time. Baldridge notes that while store-bought foods are not necessarily unhealthy, unpackaged foods are generally healthier than packaged foods and fall on the lower end of the processing spectrum. 

Because dietary guidelines are frequently updated, but there is no regular surveillance about what is available on grocery stores, changing the food supply needs to start with a full assessment. However, this data collection is hindered by the average 20 percent annual turnover of packaged foods.

“We need to better capture real-time information of our constantly changing food supply if we’re going to track and improve its healthfulness,” says study co-author Dr. Mark Huffman, the Quentin D. Young Professor of Health Policy, Associate Professor of Preventive Medicine at Feinberg and a Northwestern Medicine cardiologist.

The study team, which includes researchers at The George Institute for Global Health in Australia, launched an American version of FoodSwitch – an app that lets consumers scan packaged foods to determine their healthfulness. Users are encouraged to crowdsource information if a product is not already present in the 268,000 product-strong database. 

It should be noted that despite having sodium-reduction schemes, the UK is still grappling with relatively high levels of sodium and salt consumption. Earlier this year, it was found that children’s meals in UK restaurant chains often have nearly as much salt as an adult’s entire daily recommended amount. Additionally, UK schools are rolling out a Sugarwise certification scheme in an attempt to cut high sugar consumption, with Irish, German and Belgian schools to follow later this year. 

By Katherine Durrell