“Radical” regulation needed to slash children’s ultra-processed food intake and obesity, flag UK scientists

15 Jun 2021 --- UK researchers are calling for “more radical and effective” public health actions to reduce children’s exposure and consumption of ultra-processed foods (UPFs). 

The team from Imperial College London analyzed longitudinal data from 9,000 children, which revealed a link between high UPF consumption and the risk of becoming overweight or obese.

“In our environment that so strongly promotes UPFs, it is very difficult for parents to make sure that children have a diet which is based on minimally processed and freshly prepared meals,” Dr. Eszter Vamos, senior clinical lecturer in Public Health Medicine at Imperial, tells NutritionInsight.

“Through a lack of regulation, and enabling the low cost and ready availability of these foods, we are damaging our children’s long-term health,” adds Christopher Millett, National Institute for Health Research (NIHR) professor of public health at Imperial College London. 

“We urgently need effective policy change to redress the balance, to protect the health of children and reduce the proportion of these foods in their diet.”Two in three calories consumed by children and adolescents come from UPFs. 

A multi-pronged approach
According to the researchers, national dietary guidelines should be updated to emphasize a preference for fresh or minimally processed foods and avoidance of ultra-processed foods. This is in line with guidelines developed in Brazil, Uruguay, France, Belgium and Israel.

For example, Brazil’s Ministry of Health recommends that people make natural or minimally processed foods the basis of their diets and that they avoid the consumption of UPFs. 

Meanwhile, the French government is aiming to reduce consumption of UPFs by 20 percent between 2018 and 2021. 

The researchers also argue that UPFs should be taxed and minimally processed foods should be subsidized to make healthier food choices more affordable. 

Other actions include restricting promotions and all forms of advertising of UPFs, especially those targeting children, and mandatory bold front-of-pack product labeling.

“The science pertaining to ultra-processed foods is still emerging, and we are yet to develop a robust understanding of the biological mechanisms underpinning their association with ill health, but we know enough to legitimize a policy response,” Rob Percival, head of food and health policy at the Soil Association and who was not involved in the study, tells NutritionInsight. 

“Unfortunately, the food industry remains resistant to stronger regulation and has sought to dismiss ultra-processed as a valid category, preferring a voluntary approach,” he argues. 

A significant proportion of diet
The researchers define UPFs as food and drink that is heavily processed during their making, such as frozen pizzas, fizzy drinks, mass-produced packaged bread and some ready meals. 

They were found to make up more than 40 percent of children’s diets in terms of grams and 60 percent in terms of calories. Notably, one in five children consumed 78 percent of their calories from UPFs. 

Major sources of UPFs in the highest consumption group (67.8 percent of gram intake) included fruit-based or fizzy drinks, ready meals and mass-produced packaged bread and cakes. 

Comparatively, diets in the lowest consumption group (23.2 of gram intake) were based on minimally processed foods and beverages, such as plain yogurt, water and fruit.

Long-term impacts
The researchers based their findings on data from a cohort of children in the Avon area in the West of England, who were born in the early 1990s. Food diaries were completed at age 7, 10 and 13, recording the food and beverages children consumed over three days. 

Data measures were also collected over 17 years, covering areas including body mass index (BMI), weight, waist circumference and measurements of body fat.

By 24 years of age, the participants in the highest UPG group had, on average, a higher level of BMI by 1.2 kg/m2, body fat by 1.5 percent, weight by 3.7 kg and waist circumference by 3.1 cm.

“One of the key things we uncover here is a dose-response relationship. This means that it’s not only the children who eat the most ultra-processed foods that have the worst weight gain, but also the more they eat, the worse this gets,” says Vamos.UPF consumption was shown to make a difference in children as young as 9 years old. 

The next steps
Further studies are now needed to determine the underlying mechanisms linking UPF consumption to worse health outcomes. 

Hypotheses include that UPFs produce lower satiety, meaning that people do not feel full after eating these products, encouraging excess consumption. 

More research is also needed to explore whether additives in highly processed food interfere with biological processes, such as hormones influencing appetite and glucose control.

“Consumption of UPFs in the UK is much higher than in many other countries, but alarmingly, UPF consumption is growing globally especially in low- and middle-income countries,” adds Kiara Chang, research fellow and first author on the paper, now published in JAMA Pediatrics. 

“We have more data from adults and there are studies providing evidence on the link between UPF consumption and obesity in adults.” 

Setting the stage for health issues
Vamos emphasizes that childhood is a critical time when food preferences and eating habits are formed with long-lasting effects on health.

“We also know that excessive consumption of ultra-processed foods is linked to a number of health issues including being overweight or obese, high blood pressure, cardiovascular disease, Type 2 diabetes and cancer later in life, so the implications are enormous,” she concludes.

In September, a report from the National Audit Office revealed that moves to reduce childhood obesity in the UK had limited success. 

Separately, analysis from the Institute for Public Policy Research previously called for a “whole society” preventative approach to reduce childhood obesity. 

By Katherine Durrell