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Ultra-Processed Foods and Global Health: A Comprehensive Analysis of Nutritional Crisis, Metabolic Risks, and Food System Transformation

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dr. Karunia Valeriani Japar

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Introduction: World Food Day and Food Rights

World Food Day, commemorated on October 16th each year, is a pivotal occasion that unites the global community in addressing the complex challenge of ensuring both food security and nutrition for all populations. The 2025, the theme “Hand in Hand for Better Foods and a Better Future” underscores the necessity for solidarity and multi-sectoral collaboration to transform food systems and deliver healthy diets to all people. This theme echoes a call to action across governments, communities, and individuals to work together in addressing huger, nutritional inadequacy, and environmental sustainability, fostering a future where better food is accessible and a dignifies standard for humanity [1,2,3,4,5,6].

Food as a human right is enshrined in international legal frameworks and underpins the global commitment to uphold physical and mental health through access to safe, nutritious, affordable, and culturally appropriate diets. The 2025 observance not only marks the 80th anniversary for FAO, but also serves to remind the world that equity and resilience in food systems are foundational pillars in achieving the Sustainable Development Goals and ensuring that “no one is left behind” in the pursuit of food justice and well-being [1,6,7,8].

The global food landscape is now marked by a complex coexistence of food scarcity, micronutrient deficiencies, and escalating rates of overweight, obesity, and non-communicable diseases, a phenomenon described as the double burden of malnutrition. Ultra-processed foods (UPFs) have proliferated in this environment, often relied upon for their low cost and convenience, especially in food insecure populations. While UPFs may address short-term hunger, their poor nutritional profiles contribute to long-term health risks and the displacement of traditional, nutrient rich dietary pattern [3,9,10].

Tackling hunger and malnutrition in the 21st century therefore demands efforts to not only increase food quantity, but to enhance quality, promote dietary diversity, and ensure environmental sustainability. The 2025 theme articulates the ethos that food security, nutrition, and planetary health are shaped responsibilities, requiring coordinated action to reduce reliance on UPFs and to foster food environments where whole, nourishing foods are prioritized for all [3,6,10,11,12].

Defining Ultra-Processed Foods: The NOVA System

The NOVA classification system is a globally recognized framework developed to categorize foods based on the extent and purpose of industrial processing, rather than their nutrient content. Within NOVA, foods are divided into four groups [14,15]:

  1. Group 1: Unprocessed or minimally Processed Foods- These include edible parts of plants (fruits, vegetables, seeds, leaves, roots) and animal products (meat, milk, eggs), as well as fungi and algae, that have undergone little to no industrial alteration apart from cleaning, cooling, or dying [15,16].
  2. Group 2: Processed Culinary Ingredients- Substances extracted from Group 1 foods or nature by processes such as pressing, refining, or grinding: examples include oils, butter, sugar, and salt [16].
  3. Group 3: Processed Foods- Products made by adding salt, oil, sugar, or other Group 2 ingredients to Group 1 foods, often by traditional preservation methods like canning, fermenting, or baking (e.g., cheese, canned vegetables, freshly made breads) [15,16].
  4. Group 4: Ultra-Processed Foods (UPFs)- Industrial formulations typically containing five or more (often many) ingredients, including substances not commonly found in home cooking, such as modified starches, protein isolates, hydrogenated oils, artificial sweeteners, colorings, flavorings, emulsifiers, and preservatives. UPFs are designed for convenience, hyper-palatability, and long shelf life. Examples include sodas, packaged snacks, instant noodles, processed meats, and ready to eat meals [15,16].

The clear differentiation between minimally processed, processed, and ultra-processed foods as delineated by NOVA is essential for interpreting food environments and dietary risks. Whereas minimally processed foods preserve their natural qualities, processed foods add basic culinary ingredients but remain recognizable, and ultra-processed food bear little resemblance to their agricultural origin, often engineered to maximize taste, shelf life, and purchase repeatability. This nuanced classification provides critical insight for public health intervention, research, and guidance on the reduction of ultra-processed food consumption in favor of whole, nutrient-rich options [14,16].

Global consumption of ultra processed foods (UPFs) has escalated dramatically over the past few decades, contributing to significant shifts in dietary patterns and their associated health risk worldwide [17,18,19].

The consumption of UPFs, industrial formulation typically high in added sugars, fats, salt, and low in fiber and micronutrients has expanded globally, particularly in high income countries where UPFs account for well over half of total energy intake in some populations. This trend is steadily increasing in middle- and low-income countries, propelled by market globalization, urbanization, and aggressive marketing strategies. Studies indicate that in regions such as North America, Europe, and Australia, up to 50-60% caloric intake is derived from UPFs, whereas middle-income countries like Brazil and China have observed annual increases in UPF sales, with notable acceleration in urban settings. As traditional diets decline, there has been an unequivocal nutritional shift from minimally processed staples and fresh foods to energy-dense, nutrient-poor products, leading to rising risk of obesity, metabolic syndrome and non-communicable disease.

Nutritional Shifts: Traditional vs. Ultra-Processed Diets

Traditionally, global diets were based on whole grains, legumes, and fresh foods with high micronutrient density and fiber content. The increased affordability and availability of UPFs have led to their substitution for these nutrient-rich staples. In many transitioning economies, convenience and cost drive preference for processed foods, despite their poor nutritional value. Cross-national dietary surveys consistently show that higher UPF intake is associated with lower and overall diet quality and reduced intakes of protein, fiber, vitamins, and minerals.

Sociodemographic Patterns

UPF consumption shows marked sociodemographic differences, with children, adolescents, and urban residents most impacted. Urban environments often expose populations to more fast-food outlets, convenience stores, and aggressive marketing, particularly towards youth. Data indicate that children and adolescents have the highest rates of UPF consumption due to greater exposure in schools and homes. In high-income regions, UPF intake is often highest among populations with lower socioeconomic status, while in low and middle-income countries, the fastest rise is among urban dwellers and young adults, influenced by changing lifestyles and market penetration.

Biochemical Properties and Mechanisms of Harm in Ultra Processed Foods

Ultra-Processed Foods (UPFs) pose substantial risks to metabolic health due to their distinctive biochemical composition. UPFs are consistently characterized by a high glycemic load, elevated levels of saturated fats, excess added sugars, and sodium, alongside a marked deficiency in dietary fiber and essential micronutrients such as vitamins and minerals. The predominance of refined carbohydrates and industrial fats leads to rapid increases in blood glucose and insulin, which may disrupt glucose metabolism over time. Additionally, the excessive sodium and sugars in UPFs contribute to hypertension, metabolic syndrome, and weight gain, while the minimal fiber reduces satiety and impairs glycemic control.

Micronutrient depletion is a hallmark of UPFs; processing strips away naturally occurring minerals and vitamins present in whole food matrices, resulting in foods that may be fortified but lack the full nutritional benefits of unprocessed sources. This nutritional inadequacy is compounded by frequent use of additives, preservatives, and artificial ingredients that have little nutritional value.

Several biological mechanisms have been proposed to explain the detrimental health effects associated with UPF consumption:

  • Increased energy intake: Hyper-palatable taste profiles, soft textures, and strategic marketing foster overeating and portion distortion.
  • Gut microbiome disruption: Emulsifiers, artificial sweeteners, and a lack of dietary fiber in UPFs alter gut microbial diversity, promote inflammation, and dysbiosis, leading to metabolic endotoxemia.
  • Inflammatory responses: UPFs often contain compounds such as oxidized fats and advanced glycation end-products which trigger low-grade systemic inflammation and impair insulin signaling [23].
  • Mitochondrial and hormonal effects: Rapidly absorbed carbohydrates and fats, together with micronutrient scarcity, stress mitochondria and disrupt hormonal regulation of appetite and metabolic homeostasis [23].

Collectively, these properties and pathways underscore the role of UPFs in increasing risk for obesity, cardiovascular disease, diabetes, and other non-communicable conditions, supporting urgent public health efforts to minimize consumption and promote whole, nutrient dense foods [17,20,21,22].

Epidemiological Evidence: Metabolic and Health Outcomes

A growing body of epidemiological research, encompassing meta-analyses and large-scale prospective cohort studies, has demonstrated compelling associations between ultra-processed food (UPF) consumption and obesity, type 2 diabetes, cardiovascular disease (CVD), various cancers, mental health disorders, and all-cause mortality. Meta-analyses indicate that each incremental rise in UPF intake significantly increases the risk for overweight, obesity, type 2 diabetes, and CVD, even after adjusting for cofounding lifestyle and dietary factors [3,23,24,25,26,27].

For instance, the NutriNet-Santé cohort in France revealed that individuals consuming the highest amount of UPFs experienced greater incidence of overall cancer and breast cancer compared with those eating minimally processed foods. Longitudinal studies have further correlated UPF intake with increased rates of depression, anxiety, and poor mental outcomes, underscoring that the adverse effects of UPFs extend beyond metabolic disease to mental health domains [3,23,24,26].

In addition, higher UPF consumption has been robust linked to increased all-cause mortality independent of total energy intake and baseline health status. Nevertheless, some studies have reported equivocal findings, with attenuated or nonsignificant associations between UPF intake and development of metabolic syndrome, reflecting considerable methodological variability. Variability in dietary assessment methods, study populations, cofounding factors and country-specific food definitions of UPFs complicate cross-study comparisons and meta-analyses [25,27].

These limitations highlight the need for standardized, context specific research protocols to better elucidate the metabolic health risk associated with UPF consumption [25,26,27].

Socioeconomic, Environmental, and Cultural Impacts

The proliferation of UPFs has reshaped global food landscapes exerting complex socioeconomic, environmental, and cultural effects. At the heart of this transformation lies the affordability versus nutritional quality paradox: while UPFs are widely accessible due to their low cost and long shelf life, their nutritional profile is poor, characterized by high energy density, excess sugars, fats, and sodium, and marginal micronutrient content. These marketing and pricing strategies often target low-income groups, who may be constrained by limited budgets, lack of access to fresh foods, and time scarcity, thus increasingly relying on UPFs to meet energy needs. This trend exacerbates health disparities by contributing to obesity, metabolic syndrome and deficiency-related disorders among vulnerable populations [25,26].

Culturally, UPF consumption displaces traditional dietary patterns that are often richer in whole foods, fibers, and diverse nutrients, leading to erosions of gastronomic heritage and social food practices. The global rise of packaged snacks, ready-to-eat meals, and sugar-sweetened beverages marginalizes longstanding culinary traditions, especially in urban and rapidly developing regions, this dietary homogenization undermines food sovereignty and weakens community resilience against the double burden of malnutrition [26].

From an environmental perspective, the industrial-scale production and distribution of UPFs contribute to extensive resource use, greenhouse gas emissions, and ecological degradation. The reliance on monocultures for raw ingredients such as corn, wheat, soy, and palm oil, drives deforestation, biodiversity loss, and soil depletion. Additionally, the packaging of UPFs, often using plastics and non-renewable materials, poses significant challenges for waste management and pollution, deepening sustainability concerns [3].

Taken together, the ascendancy of UPFs not only threatens public health but also perpetuates social inequality, erodes cultural food identities, and accelerates environmental harm, underscoring the urgency for coordinated policy action and advocacy [23,25,26].

Challenges in Regulation and Public Health Policy

Regulating UPFs presents persistent challenges due to the complexity of defining, categorizing, and legislating these products worldwide. Many countries have responded by adopting policies such as front of pack nutrition labeling (e.g., warning labels, traffic light systems) and implementing taxes on sugar sweetened beverages and high sugar snacks, aiming to discourage UPF consumption and assist consumers in making healthier choices. Restriction on marketing, particularly advertisements targeting children have also been enforced or proposed in several regions as a public health measure [23,25,26].

Public health agencies increasingly promote awareness campaigns that distinguish whole from ultra-processed foods, with school-based interventions and reformulated dietary guidelines advocating for prioritization of fresh, minimally processed foods. Policy initiatives in multiple countries include subsidies for fruits and vegetables, urban agriculture, and efforts to make healthy foods more affordable and accessible to low-income populations [23,25,26].

Despite these advances, significant barriers remain. Defining and classifying UPFs is hampered by a lack of universal criteria, with ongoing debate over the application and operationalization of classification frameworks like NOVA. This lack of consensus complicates both research and legislative efforts, resulting inconsistent regulatory approaches across jurisdictions. The powerful influence of the food industry including lobbying, marketing strategies, and policy advocacy often shapes regulatory boundaries, limits the scope of interventions, and slow progress on critical reforms. Furthermore, globalized trade and multinational food corporations facilitate the rapid distribution and marketing of UPFs across borders, exacerbating disparities in food environments and complicating international policy harmonization [3,26].

Addressing these regulatory and public health challenges demands robust, multisectoral strategies that combine clear definitions, transparent labeling, policy coherence, and effective support for fresh food environments [3,25,26].

Prevention Strategies and Clinical Implications

Reducing UPF intake remains central to modern public health and clinical strategies targeting metabolic disease and noncommunicable diseases. Population-based intervention has focused on shaping supportive food environments through policies that restrict UPF marketing, implement front of pack labeling systems, and subsidize the cost of fresh fruit and vegetables, demonstrating meaningful shifts in purchasing behavior and dietary intake, especially among high-risk groups. Nutritional education initiatives delivered in schools, communities, and workplaces to improve food literacy, enhance the ability to identify UPFs, and promote consistent selection of minimally processed, nutrient-dense foods. Community led efforts such as cooking workshops and urban gardening further expand accessibility and reinforce cultural preferences for whole foods [23,25,26].

Clinicians serve a frontline role, starting with comprehensive dietary assessment using validated tools such as 24-hour dietary recalls, food frequency questionnaires, and app-based nutrition trackers to quantify UPF exposure. Clinical counseling should include education on the NOVA classification system, dangers of UPF consumption, and evidence-based techniques for reducing intake, such as meal planning, reading labels, and healthy food substitutions. Promoting increased intake of fruits, vegetables, whole grains, legumes, and unsweetened dairy supports in transition to healthier eating patterns. Incorporating motivational interviewing and behavioral change strategies facilitates sustained patient engagement and progress. Practitioners should set realistic goals, provide practical strategies for overcoming barriers, and schedule follow ups to monitors and reinforce improvements [23,25,26].

Collectively, this multifaceted approach, both population intervention and individualized clinical care remain essential for reducing UPF intake and improving metabolic health outcome among diverse populations [23,25,26].

Conclusion

Addressing the global rise and health risk of UPFs necessitates a transformation of food systems grounded in solidarity, multisectoral collaboration, and policy innovation. While UPFs often fulfill short-term caloric needs, their poor nutritional quality and pervasive presence contribute toa double burden of malnutrition, displace traditional diets, and undermine long-term health outcomes. The NOVA classification offers a crucial framework for understanding and regulating the degree of food processing, supporting both research and targeted public health interventions. Efforts to curb UPF consumption must focus not only on increasing food quantity, but more importantly on improving dietary quality, promoting diversity, supporting fresh food environments, and ensuring that better food is accessible for all. Achieving these goals requires coordinated action from governments, communities, and individuals working “hand in hand for better foods and a better future”, to prioritize food justice, planetary health, and the human right to nutritious, culturally appropriate diets while leaving no one behind.

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