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Monday, August 7, 2023

Ultra-processed foods largely missing from US food policy

Few federal and state policies consider ultra-processed foods, but policy activity is growing

New York University

Ultra-processed foods -- including industrially produced packaged snacks, fruit-flavored drinks, and hot dogs -- have been linked to health issues ranging from weight gain to certain cancers. So where are the food policies helping Americans to steer clear of these foods?

A new study published in the American Journal of Preventive Medicine finds that only a small number of U.S. policies consider ultra-processed foods, lagging behind countries such as Belgium, Brazil, and Israel.

"In some countries, ultra-processed foods have been directly integrated into national dietary guidelines and school food programs, but in the U.S., few policies directly target ultra-processed foods," said Jennifer Pomeranz, associate professor of public health policy and management at NYU School of Global Public Health and the first author of the study.

After decades of focusing on single nutrients such as protein, fat, and carbohydrates in nutrition science and food policy, a growing body of evidence shows that there is more to dietary quality than nutrients.

"It's clear that the extent of processing of a food can influence its health effects, independent of its food ingredients or nutrient contents. Ultra-processed foods generally contain 'acellular nutrients' -- nutrients lacking any of the natural intact food structure of the source ingredient -- and other industrial ingredients and additives that together can increase risk of weight gain, diabetes, and other chronic diseases," said study co-author Dariush Mozaffarian, the Jean Mayer Professor of Nutrition at the Friedman School of Nutrition Science and Policy at Tufts.

Only a few countries around the world directly regulate ultra-processed foods, but those that do have limited its consumption in schools and recommend eating less ultra-processed food in dietary guidelines. The U.S. Dietary Guidelines for Americans, which inform the country's food and nutrition policies, do not currently mention ultra-processed food. 

However, the scientific advisory committee for the 2025-2030 U.S. Dietary Guidelines has been tasked with evaluating research related to ultra-processed foods consumption as it relates to weight gain.

To understand how U.S. policymakers have already addressed ultra-processed foods in policies, the researchers gathered all federal and state statutes, bills, resolutions, regulations, proposed rules, and Congressional Research Services reports related to "highly processed" and "ultra-processed" food.

They identified only 25 policies -- eight at the federal level and 17 at the state -- that were proposed or passed between 1983 and 2022. The vast majority (22 of 25) were proposed or passed since 2011, showing that U.S. policy making on ultra-processed foods is quite recent.

The U.S. policies on ultra-processed foods tend to mention them as contrary to healthy diets. Most policies had to do with healthy eating for children, including limiting ultra-processed foods in schools and teaching kids about nutrition. Another common theme was the relatively higher price of healthy food versus ultra-processed foods. 

Only one policy (a Massachusetts school food bill) actually defined ultra-processed foods, and three policies sought to address the broader food environment by providing incentives to small retailers to stock healthy foods.

"The emerging policy language in the U.S. on ultra-processed foods is consistent with international policies on the topic. We would urge a more robust discussion and consideration of ultra-processed foods for future policymaking," added Pomeranz. "The United States should consider processing levels in school food policies -- especially to update the 'Smart Snack' rules -- and to ensure the U.S. Dietary Guidelines reflect the evidence on ultra-processed foods and health."

Jerold Mande of the Harvard T.H. Chan School of Public Health and Nourish Science was also a co-author of the study. The research was supported by the National Institutes of Health (2R01HL115189-06A1).