Q&A: Growing concern over the prevalence of ultra-processed foods in American diets

The accessibility, affordability and convenience of ultra-processed foods have made them a common staple in stores and pantries. But these foods, which are high in added sugars, oils, fats and other substances that normally wouldn’t be used in cooking, are growing more pervasive in American diets, especially for kids.

This trend is a major cause for concern for nutrition researchers like Katie Meyer, ScD, and Lindsey Smith Taillie, PhD, two assistant professors from the Department of Nutrition at the UNC Gillings School of Global Public Health. They have co-authored an editorial in the Journal of the American Medical Association (JAMA) that highlights a new study on the more than five percent increase in the share of ultra-processed foods found in youth diets over the past two decades. They call for action from public health leaders and researchers to understand of the role these foods play in the American food system and develop policies to reduce their consumption.

Taillie, a Faculty Fellow at the Carolina Population Center, answered some questions about her latest research.

What trends have you found concerning ultra-processed foods and kids?

Overall, ultra-processed food intake is increasing in kids and comprises a very large share of daily calories- in fact, the majority of kids’ calories (70%) come from UPF.

Who are these foods marketed to?

Both kids and parents. To kids, companies use child-directed marketing strategies, such as cartoon characters, sports figures, and move tie-ins. To parents, companies use health and nutrition claims. This creates a one-two punch that is very hard to counteract. Part of the reason why is due to “pester power,” or the idea that kids will annoy their parents to purchase something in the store, and then the parents will buy it to avoid a tantrum, make their kid happy, or simply because they think it is the only way they’ll get their kid to actually eat. The health and nutrition claims make parents feel better about their choices. The problem with this is that we have also found that these claims are highly misleading, are influential, and are not associated with better nutritional quality of products.

Here’s a good example: Frozen marketing hooks the kids, nutrient claims assuage the parents.

What kinds of policies can be put in place to reduce consumption?

One of the biggest is banning the use of child-directed marketing on ultra-processed foods that are high in nutrients of concern, including sugar, sodium, saturated fat, and (for kids), non-caloric sweeteners. These foods could also be prohibited from being sold in schools. This enables healthy preference learning for kids: it would give them time to try new foods- such as healthy, unprocessed options- and develop a preference for them. This is notoriously difficult because kids are prone to food neophobia- or being afraid to try new food- and so they need time and repeated exposure to develop a liking for these foods.

The US already has some voluntary actions to reduce child-directed marketing on unhealthy foods, but a lot of research has shown that these voluntary pledges are ineffective.

Other options could target the parental side, to try to provide them more information in a way that is easy to understand, even for a stressed out, time-strapped parent. For example, the FDA could require disclosures or warning labels to alert parents to the presence of high levels of sugar, saturated fat, or sodium. Another option would be to place greater restrictions on the types of products that are allowed to carry nutrition or health claims.

Currently, the FDA is researching the potential development of a “healthy” icon that could be used to signal healthy products, although to my knowledge, they are not limiting this necessarily to unprocessed foods and there is very limited evidence that these types of voluntary positive logos are effective.

Have you seen evidence of this in other countries?

In Chile, from focus groups, we have learned that their combined approach of reducing child-directed marketing, using warning labels, and banning the sales of unhealthy foods in schools has helped kids and their parents learn what is unhealthy. Probably the most important thing we have learned is that a package of actions is necessary to help create a food environment that supports healthy choices.