Big Food has been trying to weather increasing evidence that UPFs cause harm. We think we’re beyond the tipping point – UPFs are slowly killing those who depend on them for sustenance – it’s a Big Tobacco moment for Big Food.
By Rob Verkerk PhD, founder, executive & scientific director
If you’re reading this, chances are you already try to avoid ultra-processed foods (UPFs), recognizing UPFs contain ingredients you wouldn’t want in your own kitchen.
But many of your friends, family, and wider networks may not be in the same place—and crucially, may still believe that the science is “uncertain.” That’s because Big Food has spent many years trying to defend its position to use these ingredients and has ploughed vast sums into research and marketing, a chunk of which has been used to justify its position.
But that position is increasingly hard to defend—as we aim to show in this article, using some of the most prominent systematic reviews and meta-analyses published in mainstream, high-impact scientific journals.
Where we are today—something I hope to justify below—is that we’ve arrived at a Big Tobacco moment for Big Food—the same playbook, different story and era.
When you can no longer hide from the science
A pivotal shift came in 2025 when the highly influential peer-reviewed journal, The Lancet, published an article by Monteiro et al. along with 12 linked articles. In their opener for the series, Professor Carlos A Monteiro, MD and colleagues from the University of Sao Paulo, Brazil, set out three biologically plausible mechanisms by which UPFs may drive harm:
- Disruption of appetite regulation, leading to overconsumption
- Direct biological effects of additives, altered food structures, and production of harmful byproducts
- Systematic displacement of health-promoting, minimally processed, protective foods
What we’re beginning to see now is a converging causal framework for how UPFs represent a classic slow-kill mechanism that underpins most of the chronic disease we see in industrialized societies that steals years and quality from lives, and threatens to overrun health systems.
Engineered to override satiety
Among the most compelling experimental evidence comes from a tightly controlled inpatient trial led by NIH researcher Kevin Hall. Participants consuming an ultra-processed diet ate ~500 kcal/day more and gained weight compared with those on a minimally processed diet—despite meals being matched for calories, sugar, fat, and fiber (Hall et al 2019).
This isn’t about someone’s willpower. It’s about design—foods designed to be addictive that create dependence. Texture, energy density, and hyper-palatability appear to bypass normal satiety signaling—directly supporting Monteiro’s first hypothesis.
The epidemiology is now overwhelming
Among the strongest syntheses of evidence to date comes from a systematic review and meta-analysis of 43 observational studies (including nearly 900,000 subjects) examining UPFs and chronic disease outcomes published by Lane et al 2021 in the peer-reviewed journal, Obesity Reviews.
The findings were striking:
- Higher UPF intake was associated with increased risk of obesity, cardiovascular disease, type 2 diabetes, and all-cause mortality
- Associations persisted across populations and study designs
Even allowing for residual confounding, the scale and reproducibility of these findings make dismissal increasingly untenable.
In case anyone is still in any doubt, a very recent meta-analysis and systematic review by Liang et al (2025) published in Systematic Reviews including 18 studies involving over 1 million subjects (and over 173,000 deaths), showed unequivocally that those who consumed the most UPFs had a 15% increase in risk of death from all causes.
Sorry, Big Food, you can no longer hide from the evidence that it’s UPFs that make-up over half the total energy consumed by populations in the US and UK (here and here), are killing consumers of its products slowly, but surely. More to the point, the risks are dose dependent—so any effort to eat less of it moves your risk profile in the right direction.
From pre-cradle to old age
The problem is akin to a ticking time bomb. We have yet to see the full age spectrum of industrialized societies exposed to UPFs from pre-conception to death.
What we know for sure is that young people are eating more of the stuff than older folk, and that should be a big wake-up call for individuals, families, and health authorities. The data also show that it’s the middle income groups that consume the most, not the poorest, this likely reflecting the relatively high cost of many UPFs.
The science is increasingly revealing that harms are not confined to any one life stage—they impact people across the lifespan:
- Children and adolescents: High UPF consumption is linked to increased adiposity, poorer metabolic health, and emerging links to mental health outcomes. Early exposure may also shape lifelong food preferences (Lane et al 2021)
- Older adults: Recent evidence links higher UPF intake with frailty, cognitive decline, and increased mortality risk, suggesting acceleration of biological ageing (Shahatah et al 2025)
But, that’s not all. UPFs have also been tied to reducing fertility, elevated risks during pregnancy and development of fetuses and infants.
Emerging research suggests UPFs may impair hormonal regulation, metabolic signaling, and fertility outcomes, including in males (Paula et al, 2022; Evans et al 2025; Preston et al 2025). While still developing, this aligns with known effects of metabolic dysfunction and inflammation on reproductive biology.
During pregnancy, the risks extend further. Maternal UPF intake has been linked to excess gestational weight gain and altered fetal development trajectories, raising concerns about long-term metabolic programming in offspring (Paula et al, 2022; Morales-Suarez-Varela & Rocha-Velasco 2025).
As shown in a comprehensive review by Rondinella et al 2025, common UPF components—particularly emulsifiers, artificial sweeteners, and other additives in UPFs—can:
- Disrupt microbiome diversity
- Damage the intestinal barrier
- Promote systemic inflammation
This provides a biologically coherent explanation linking UPFs to chronic disease pathways—from metabolic disorders to neurodegeneration.
This is not just about individual health or the choices, informed or otherwise, of the individual—what parents and young people are eating will likely also influence the health of the next generation.
Coming back to the story of Big Tobacco, we learned that the industry “got away with it” up until it was no longer feasible for its leaders to deny causation. Now, with Big Food and its addictive UPFs, we see a similar progression: the increasing evidence of consistency of effects across the entire life course is really beginning to bolster the case for causality.
UPF manufacture generates killer chemicals
Critics are right: not all processing is harmful. Fermentation, freezing, and cooking can enhance nutrition and safety.
But ultra-processing is different. It involves fractionation and recombination of food components, technological additives designed to mimic real food, and structural changes that alter digestion and absorption.
As Prof. Monteiro and colleagues propose in their second hypothesis, UPF manufacture may often also involve application of extreme heat or other technological processes that induce reactions that in turn yield new by-products. This generates chemicals that were not in the original foodthat are associated with increased inflammation, neurotoxicity, and cancer risk.
Even when adjusting for overall diet quality, studies continue to find independent associations between UPF intake and adverse health outcomes.
This suggests that UPFs are not merely markers of unhealthy diets—they are likely contributors to harm in their own right.
Time for honesty and accountability—not ‘healthwashing’
The food industry has long argued that “there are no bad foods, only bad diets.” That argument is becoming increasingly hard to sustain. Big Food’s response? “Healthwashing.”
Despite the growing body of negative scientific findings, food manufacturers, like their tobacco counterparts of yesteryear, are becoming increasingly adept at marketing ultra-processed products as part of a healthy lifestyle. Labels such as “high protein”, “low fat”, “gut friendly” or “plant-based” can create a powerful halo effect, even when the product remains highly processed.
Social media has amplified this phenomenon. Influencers, including celebrities and sports personalities, are frequently paid to promote food and drink products, blurring the line between genuine advice and advertising. The result is a digital landscape in which ultra-processed foods are not only normalized but actively positioned as desirable wellness choices.
At a systems level, there is a need to rebuild shorter, more transparent food chains that reconnect producers and consumers. Supporting regenerative agriculture, local food networks, and independent producers can play an important role in shifting the balance away from industrialized food systems. This is where we, as consumers, can play a powerful role in creating change in our food landscape by changing what we buy and where we buy from.
Policy change is equally critical. This includes developing more robust and meaningful ways to classify food, strengthening oversight of health claims—particularly in digital spaces—and investing in independent research that is free from commercial influence.
Time to reclaim real food
The debate around ultra-processed foods is both necessary and timely. But if it is to lead to meaningful change, it must move beyond simplistic narratives and address the deeper forces shaping our food system.
It’s time for people to engage, question and advocate for a more holistic approach—one that values real food, informed choice, and transparency at every level. Because ultimately, improving public health is not just about avoiding certain categories of food, but about rebuilding a system that truly nourishes both people and planet.
We cannot win this one without education. People have to know what they’re putting into their bodies and be cognizant of the ‘healthwashing’ that Big Food uses in its marketing, advertising and labelling.
Next we need to vote with our pockets – the message is a simple one: avoid UPFs most of the time.
Those wanting to go minimal-UPF or UPF-free need to focus on eating whole foods and ingredients that can be recognized as foods. If you want some help, a great starting point is our book Reset Eating: Reset your health and resilience by turning what and how you eat into powerful medicine and our Food4Health Guide within. Find out more below.
>>> Discover Reset Eating from the ANH team, your science-based guide to healthy, UPF-free eating that supports balanced nutrition—whatever your dietary preferences.
>>> For more information on using unprocessed ingredients for healthy UPF-free eating check out our Food4Health guide. For kids under 6, see our Food4Kids guide.
