The Lancet Series on Ultra-Processed Foods
and Human Health
Now is the time to act on Ultra Processed Foods (UPFs) as a global health issue.
Nova: the food classification based on the extent and purpose of processing t eiro
1 4
n
Mo
Ultra-processed foods
s
Unprocessed or minimally
arlo
Prof C
processed foods
Branded products made from
cheap, food-derived substances and
additives, designed and marketed 20 years ago, while studying
to displace real food (Nova groups changes in Brazil’s food supply
1–3) and freshly prepared meals, linked to rising obesity, we realised
2
while maximising industry profits. that the purpose of food processing
Processed culinary had shifted from preserving foods
ingredients to creating profitable substitutes
No Fat using cheap food substances and
additives. That insight led us to
create the Nova classification—with
its fourth group of ultra-processed
3
foods—to capture not just
Processed foods
nutrients, but also the extent and
purpose of food processing as a key
determinant of diet quality and risk
of ill health.
The ultra-processed dietary pattern is globally displacing diets based
on Nova groups 1–3 and their preparation as dishes and meals.
The energy contribution of UPFs to diets has surged From 2007 to 2022, total UPF sales increased in
globally over recent decades low-income and middle-income countries, but
remained stable in high-income
UPFs (proportion of total energy, %) Sales (kg) per capita
countries, where consumption is
100 250
already entrenched.
80 200
High income
60 USA 150
Canada UK
40 100 Upper-middle income
Argentina
Spain
20 50 Lower-middle income
Mexico South Korea Low income
0 Brazil China 0
1938 1952 1966 1980 1994 2008 2022 2007 2010 2013 2016 2019 2022
Year Year
Our systematic review of 104 studies found 92 showing an association between the ultra-processed dietary pattern and
increased risk of one or more chronic disease outcomes. Meta-analyses of 15 outcomes found statistically significant
associations with adverse health conditions for 12, including:
Type 2 diabetes 25%
Depression 23%
Overweight or obesity 21%
All-cause mortality 18%
Cardiovascular disease or mortality 18%
0 5 10 15 20 25
Increased risk (%)
The totality of evidence shows that
The ultra-processed dietary pattern has ...several plausible mechanisms explain associations with
displaced, and continues to displace, increased chronic disease risk, including:
long-established patterns based on the Multiple nutrient imbalances Overeating
first three first Nova groups and their
preparation as dishes and meals, ...
Increased intake of Exposure to potentially harmful
toxic compounds additives and additive mixtures
PFAS
Ace-K
DBP
BPA E250
BBP Aspartame
DEHP E
Taken together, these findings support the thesis that the ultra-processed dietary pattern is a major driver of the escalating
global burden of diet-related chronic diseases. Public health policies and actions are justified at all levels to preserve, protect,
and promote diets based on whole foods, and their preparation as dishes and meals.
Ultra-processing is highly profitable Between 1962 and 2021, of the US$2·9 trillion in shareholder
payouts by corporations operating across all food sectors, more
than 50% was distributed by UPF manufacturers alone.
UPF manufacturers
Food producers, food services,
food retailers, etc.
2·9 Market
trillion
US$
The high profits of UPF manufacturers
provides them with surplus resources for:
Globally coordinated influence Well resourced and intensive This translates into growing
on policy makers marketing strategies corporate power in food systems
and control over what people eat
Improving diets cannot rely on consumer behaviour change alone —it also requires
policies that regulate UPF marketing and production, confront corporate power, and reshape
food systems to prioritise health, justice, and sustainability, over corporate profits.
Fat
Identifying UPF products Food environments
No
UPFs Policies must complement Implement taxes, marketing
reductions in fat, sugar, and and labelling regulations, and
salt to target UPFs as a category healthy food procurement
Policy ULTRA High in High in High in
package
PROCESSED calories salt saturated fat
Zero
No Fat
Governments
Corporations Supply chains
Reduce corporate power in End subsidies for ingredient
food systems and agri-commodities, regulate
Regulation Dietary guidelines
redistribute resources plastics, ban green-washing,
and revise trade rules
Dietary surveillance Use government funds to provide
resources for lower-income households to
Integrated policy actions for the whole food system purchase healthy, fresh, and minimally
reinforce each other and are essential for generating processed food
lasting impact.
A global health response is urgent and feasible
Prioritise UPFs as a global health issue Ensure a just transition to low-UPFs diets
Political action on UPFs has low priority despite the chronic Policies should integrate participatory
disease burden; viewing them as commercially driven, like governance, economic inclusion, and household support while
tobacco, shifts blame to corporate accountability. ensuring food security and gender equity, and avoiding stigma.
Multilevel coalition-building The recipe for collective action
Build coalitions globally and nationally, uniting civil society, Latin America and sub-Saharan Africa show how to scale:
experts, government officials, UN agencies, and media to mobilise civil society, recruit political champions, and use
drive policy change and counter corporate power. advocacy, media, and research to drive policy change.
The Lancet Series on Ultra-Processed Foods and Human Health
The Lancet 2025; published online November 18. [Link]
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