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01 Dec 2023 BANT POSITION STATEMENT: ULTRA PROCESSED FOOD & DRINKS

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BANT Position Statement, last updated 20 November 2023

Context:

There is increasing evidence that Ultra Processed Foods & Drinks (UPFDs) are harmful to health yet there is still no meaningful legislation to protect consumers and regulate the food industry. The National Food Strategy (1) sought to legislate High Fat, Salt, and Sugar (HFSS) products with a reformulation tax alongside other proposals to regulate promotional activity in store (banning of Buy One Get One Free – BOGOF promotions on junk foods), and limit advertising of UPFDs before the 9pm watershed. The DEFRA white paper (2) published in response to the paper failed to recommend that any of the measures be legislated and the current conservative government deferred all action on BOGOFs and Advertising until 2024 (3). Current retail purchase data indicates that almost 50% of the average UK basket is spent on UPFDs (as compared to only 11% in Italy) indicating that the UK diet is heavily dependent on these foods and moving further away from a healthy diet (4). The gap between national Food Based Dietary Guidelines (FBDG) and actual eating habits is getting bigger with only 0.1 % of the UK population achieving the current UK Eatwell* guidelines for a healthy and sustainable diet (5). Diet-induced disease continues to rise in the UK with non-communicable diseases such as Obesity, Type 2 Diabetes, Metabolic Syndrome, CVD, Cancer all on the increase. The correlation between UPFDS and diet-induced disease is clear, and we need decisive action to reverse the crisis.

*NB The Eatwell Guidelines were last updated in 2016 and are not recognised by BANT as promoting a healthy & sustainable diet.

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BANT Position Statement

BANT believes that Ultra Processed Foods and Drinks (UPFDS) are detrimental to the health and well-being of individuals and that a real whole food diet is best. The scientific evidence associating high consumption of UPFDS with chronic disease is unequivocal. It is time to move away from political squabbling over definitions, and deferring government policy based on the need for more research. We have the research. We need government action. Decades of inaction on the Food Industry have led to the current situation where UPFDS now make up more than fifty percent of the average British diet (4). This statistic alone is alarming. As a nation, we are moving further away from a wholefood home-cooked diet.

 

BANT considers it a matter of national urgency to address ‘diet-induced’ chronic disease and to do so using a two-pronged approach to tackle UPFDS and promote healthy diet and lifestyle interventions.

The NHS is struggling to cope under the burden of chronic disease. The number of UK adults living with overweight, and obesity has reached an all-time high of 63.8% (25.9% of which obese) (6) and people affected by diabetes has topped five million for the first time (7). The combined incidence rates of cancer are projected to rise by 2% in the UK between 2023-2025 (8). National health statistics are worsening. Since 1992, 14 government-led strategies and 680 polices related to obesity have failed (9). Yet, we still have no meaningful policy on UPFDS despite the growing evidence.

 

BANT disputes the findings by the The Scientific Advisory Committee on Nutrition (SACN) in their statement on UPFDS, in which they claim there are uncertainties around the quality of evidence available that increased consumption of (ultra-) processed foods is associated with increased risks of adverse health outcomes (11). BANT maintains that there is sufficient statistically valid evidence adhering to current hierarchies where systematic reviews and meta-analyses are at the top of the pyramid. BANT do however, acknowledge the limitations expressed by SACN with regards to using the NOVA classification system. Both points are further illustrated below:

 

  • There is increasing research showing a positive linear association between UPFDS consumption and abdominal obesity (12) and risk of developing T2DM (13,14), worse blood lipid and blood pressure profile (15), an increased burden and mortality for cancers (16), associations with adverse mental health (17) and dementia (18). A European study of nineteen member states found a significant positive association was found between national household availability of ultra-processed foods and national prevalence of obesity among adults (19). Simply put, the greater the availability of UPFDS the greater the risk to health.

 

  • BANT feels there is a disproportionate focus on classification systems, such as NOVA, which are being considered by SACN to determine which foods and drinks should be considered UPFDS. BANT’s position on this is clear, we should first be focussing on promoting real whole food and minimally processed foods – defined by BANT as foods containing fewer than five ingredients. We need policy to educate on food and food preparation. We need to facilitate healthy food choices by making real whole food readily accessible and affordable. BANT agrees that categorisation systems are necessary for defining research parameters in clinical studies however, there are shortfalls when applied to public health guidelines, with examples of natural foods containing essential fatty acids and saturated fats being misclassified. In other words, classification in a research context is critical but in a clinical context may at times be unhelpful.

BANT finds SACN’s statement misleading and unhelpful to public health policy, considering the information available. In addition to the risks of adverse health outcomes there are many nutritional considerations that academics also outline in the research (20).

  • UPFDS are processed to such an extent the nutrients either deteriorate or are destroyed, leaving a final product which is nutrient-poor – a source of empty calories. Extreme processing therefore leads to a destruction of the food matrix and reduction in nutrient intake and absorption.

 

  • UPFDS are typically high in inflammatory industrially-modified fats, salt, and sugars incl. non-nutritive sweeteners (HFSS), and low in fibre, making them highly palatable. Hyper palatability encourages people to eat too much and makes UPFDS a risk-factor for overweight and obesity.

 

  • UPFDS typically contain additives, flavourings, emulsifiers, colourings, and artificial sweeteners which can impact gut microbiota, potentially leading to gut inflammation and other symptoms.

 

Current research indicates that 14% of the global adult population are addicted to UPFDS (21). These foods are in fact so addictive they meet the criteria for ‘diagnosis of substance use disorder’ with listed behaviours including intense cravings, symptoms of withdrawal, less control over intake, and continued use despite such consequences as obesity, binge eating disorder, poorer physical and mental health, and lower quality of life.

BANT believes the promotion of real whole food should prioritise government policy to improve nutritionally-poor UPFDS. However, BANT is in favour of longer-term legislation to mandate product reformulation of UPFDS high in fat, salt, and sugar (HFSS) with the caveat that Government addresses flaws in the current proposals which fail to include fructose and modified starches. Both masquerade as sugars in their current usage. The science shows they are as detrimental to health as simple sugars (22).

 

 

Modified starches, such as maltodextrin are typically made using corn, wheat, or potato). These starches – derived from carbohydrate foods which naturally contain sugars – are often used to replace fats in foods and help reduce the total number of calories in that product. This is a tool widely used by UPFDS food manufacturers precisely because they do not have to be declared as sugar despite having a high GI.

 

BANT strongly believes in the scientific merits of eating a real whole food diet to support health and well-being and reduce modifiable risk factors for metabolic dysregulation and chronic disease.

Evidence supports the correlation between healthy dietary patterns, healthy aging and longevity, and nutrition as prevention for diet-induced chronic disease (23,24,25,26).

Healthy changes to diet and lifestyle habits can be quickly and economically implemented and have an instantaneous impact on metabolic health markers (27,28). Investment in chronic-disease prevention should be a priority and will have the most immediate impact on public and individual health.

The role that different food groups, essential nutrients, and active food components play in health and disease are continually being researched and as scientific understanding shifts, so too should dietary and nutritional recommendations.

Nutrition science has contributed to our understanding of nutrients and the role they play in health and disease, for example:

  • Fibre for gut health (29,30), shaping public health guidelines of 30g/day and prompting fortification of many everyday foods to lower risk of heart disease and diabetes (31).
  • Vitamins C and D as support for immune health (32,33).
  • Folate / Folic Acid in pregnancy, and population health (34).
  • Vitamin B12 supplementation in individuals following vegetarian and vegan diets (35).

Emerging evidence on phytonutrients (the collective name given to active compounds in plant foods) indicates the extensive protective role these nutrients play in many aspects of health and disease prevention (36,37).  The collective evidence demonstrates that eating natural, whole food ingredients, with their full complex of nutrients, is health promoting. Whilst, there is overwhelming evidence that high consumption of UPFDS is a risk factor for diet-induced chronic disease.

  • ENDS –

 

References:

  1. https://www.nationalfoodstrategy.org/
  2. Accessed 09/10/2023 https://commonslibrary.parliament.uk/research-briefings/cdp-2022-0179/#:~:text=The%20Government%20responded%20to%20the,July%202022)%20contains%20more%20information. Paper downloadable as pdf https://researchbriefings.files.parliament.uk/documents/CDP-2022-0179/CDP-2022-0179.pdf
  3. https://www.gov.uk/government/news/government-delays-restrictions-on-multibuy-deals-and-advertising-on-tv-and-online
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