New Lancet series warns ultra-processed foods are reshaping diets and fuelling global burden of disease

A new three-part series published by The Lancet medical journal has ignited a hard-hitting global critique of transnational food corporations for manipulating and distorting global food systems with their production and relentless marketing of ultra-processed foods and drinks (UPF), which now make up high proportions of adults’ and children’s daily energy intake in countries around the world — as much as 60% in the United States, 50% in the United Kingdom and 40% in South Africa.

Ultra-processed food and drink products — many researchers hesitate to call them “food” because they are so far removed from their original, whole form — are increasingly dominating what people around the world eat every day. The Lancet series’ central idea, based on hard evidence from a systematic review of 104 research papers, is that the now-global domination of UPF has caused “the displacement of long-established dietary patterns” and is driving the “escalating burden of multiple diet-related chronic diseases” such as type 2 diabetes, obesity, some cancers, depression and cardiovascular diseases, which are the top cause of death worldwide.

The Lancet series was published online on 18 November 2025, and was launched globally on 19 November in Sydney, Australia.

At the launch, Dr Carlos Monteiro, the University of Sao Paulo professor who coined the term “ultra-processed food” as part of the Nova system of food classification in 2008, and one of the lead authors of the series, said the scientific findings confirmed by the series “indicates that ultra-processed foods harm every major organ system in the human body. The evidence strongly suggests that humans are not biologically adapted to consume them.” UPFs “are not modified foods but formulations made mostly or entirely from substances derived from foods or additives”.

The increased consumption of UPF results in deterioration of diet quality, the series says, especially in relation to the prevention of chronic (non-communicable) diseases, and is driven by transnational corporations (think Unilever, Pepsico, Nestlé — Figure 2 below) using their immense budgets to fund tactics that enable the growth of their profits, including aggressive marketing, undermining scientific findings and influencing government policy formation.

Dr Neena Prasad, head of the Food Policy Program at Bloomberg Philanthropies, which funded the Lancet series, at the launch in Sydney, Australia, described travelling the world for work and visiting supermarkets wherever she goes.

“No matter the country or its income level, the shelves now look remarkably similar: bright packages, long ingredient lists and foods that seem familiar but are increasingly far removed from what they once were. And what’s concerning — and what this Lancet series so powerfully shows — is that these ultra-processed foods, designed to maximise profit, are displacing healthy foods, reshaping global diets and fuelling an epidemic of preventable disease.”

What the series says

The Lancet team examined sales of 10 UPF “subgroups” — sweetened carbonated drinks, sweetened non-carbonated drinks, baked goods, sweet snacks, ready meals, savoury snacks, dairy products, sauces and dressings, reconstituted meat products, and other solid foods — in 93 countries, to understand how much UPF consumption has risen in the past 15 years. They also reviewed a huge body of further evidence, demonstrating links between UPF consumption and damage “across nearly all organ systems” in the body, examining policies “to protect, incentivise and support dietary patterns based on fresh and minimally processed foods, particularly for lower-income households”, and highlighting barriers to, and strategies for, reducing the UPF industry’s power in food systems.

Overall, the series emphasises the necessity for strong government policies “to halt and reverse the rise in ultra-processed food production, marketing and consumption”. It states clearly that the main barrier to making progress on governments establishing the necessary policies is “the industry’s corporate political activities, coordinated globally to counter opposition and block regulation”. The series calls for a different kind of “unified global action”: To combat the food industry’s power and to set in motion sufficiently strong public health responses — as was done on a global scale 20 years ago for tobacco control, once the science on the harms of smoking became overwhelmingly persuasive.

Dr Karen Hofman, one of the Lancet series’ authors and founding director of the SAMRC Centre for Health Economics and Decision Science/Priceless SA at the University of Witwatersrand, told Daily Maverick: “This foundational series should alert governments across the globe of the urgent need to regulate advertising of ultra-processed foods. South Africa is no exception. Bombarding our citizens with relentless marketing has ‘normalised’ the eating of cereals and fast food, as well as cold drinks. Legislation that increases the taxes on cold drinks at least by inflation on an annual basis, should be a priority for preventing organ damage and the heavy burden this has imposed on families and the departments of health across our country.”

The tax Hofman refers to is the so-called Health Promotion Levy (HPL), aka “the sugar tax”, introduced in 2018 at 10% instead of the WHO-recommended 20% because of alleged industry interference, and not increased — even to keep up with inflation — since then.

The global picture of UPF consumption

Between 2007 and 2022, the Lancet shows, consumption of ultra-processed food in 22 lower-middle-income countries increased by 40%, in 26 upper-middle-income countries by 20%, and in Uganda, the only low-income country assessed, by 60%. In 44 high-income countries, where UPF had been dominant much earlier and had already reached high levels (up to 60% of total daily energy intake in the US), overall sales of UPF remained stable. (Examined more closely, this meant that declining sales of sugar-sweetened beverages were offset by increased sales in other UPF categories.)

This explains why lower- and middle-income countries are where “Big Food” is focusing its attention: there is much greater potential for growth than in the high-income countries where UPFs were born, which the global food industry has been able to ruthlessly exploit, not least due to the absence of adequate food policy to protect public health.

There has been some critique of the series, mainly about what some consider a “too broad” definition of UPF, that excludes some healthier foods, specifically if “UPF” is used as a basis for imposing taxes on those foods (much like the “sugar tax”). Greg Garrett, Executive Director of the Access to Nutrition initiative (ATNi), wrote on LinkedIn: “We need a more nuanced approach to categorising UPFs so that the few which are healthy and useful — e.g. fortified breads which reach millions of vulnerable populations with essential micronutrients — are not taxed.”

The Nova definition of UPF defines them as “industrial formulations made mostly or entirely from substances extracted from other foods” and that have added sugars, fats, salt and harmful cosmetic additives such as emulsifiers, flavourants and colourants.

The South African picture

Though South Africa was not one of countries assessed by the Lancet series, it, too, has seen a shockingly steep rise in UPF consumption, according to the first study of UPF consumption ever done in South Africa, led by University of the Western Cape researcher Dr Tamryn Frank, published in the international journal Public Health Nutrition in 2024.

Frank’s study, as reported in DM last year, assessed the daily food intake and nutritional adequacy of more than 2,500 people living in three low-income areas (Langa and Khayelitsha in the Western Cape, and Mount Frere in the Eastern Cape). The average UPF proportion of their total energy intake was almost 40% (39% among women, 37% among men). While most people were consuming enough energy every day, only a very small proportion met the WHO’s guidelines for the daily consumption of fresh fruit and vegetables (7%) and fibre (18%).

What’s next?

What is needed, the Lancet experts say, is a globally coordinated public-health response much like the one against tobacco, 20 years ago, when the World Health Organization introduced the first internationally negotiated treaty under its auspices, and countries acted on it.

“We know progress is possible,” Dr Prasad said, “because we’ve seen it before.” The world’s experience of government and cross-sectoral support for tobacco control demonstrated, she said, that “while evidence is essential, it must be reinforced by strong policy and regulatory commitment to withstand the influence of commercial interests and achieve lasting change”. DM

Adèle Sulcas is a food systems and global health writer, and Senior Adviser to the Daily Maverick’s Food Justice project.