Redesigning the Food Environment: The Lancet’s Call to Act on Ultra-Processed Foods

New evidence published in The Lancet highlights the scale and urgency of the challenge posed by ultra-processed foods (UPFs). The world’s largest review to date finds that UPFs are associated with harms across every major organ system and represent a significant – yet preventable – threat to global health. As UPFs rapidly displace fresh and minimally processed foods in the diets of children and adults worldwide, the evidence links their dominance to higher risks of obesity, type 2 diabetes, cardiovascular disease, depression, cancer, and a range of other non-communicable conditions.

The findings, from a series of three papers, shows that rising UPF consumption is not an inevitable outcome of modern living, but a pattern shaped by powerful commercial drivers. Intensive marketing, political lobbying, and strategies that influence public understanding and scientific debate have enabled large corporations to expand UPF markets and shape the food environments in which people make decisions. This dynamic is reshaping diets globally in ways that widen health inequalities and undermine efforts to build fairer, healthier, and more sustainable communities.

Drawing on more than 100 prospective studies, randomised controlled trials, and mechanistic evidence, Monteiro and colleagues confirm that UPFs now displace traditional dietary patterns based on whole and minimally processed foods. They identify mechanisms including hyper-palatability, disrupted food matrices, excessive energy density, and exposure to harmful additives and contaminants.

The companion papers examine the systems surrounding UPFs. Scrinis and colleagues outline how food environments, supply chains, and corporate practices drive the production, marketing, and affordability of UPFs, arguing that nutrient-based approaches alone are insufficient. They highlight mandatory policy measures, front-of-pack labelling, taxation, stronger school-food standards, and restrictions on marketing to children, that have already shown measurable impact in several countries.

Baker and colleagues focus on the commercial determinants of UPFs, documenting how corporate political strategies, from lobbying to manufacturing doubt, hinder effective regulation. They call for coordinated global action, strengthened safeguards against industry interference, and a just transition toward healthier, minimally processed diets.

For the UK, where UPFs account for more than half of total dietary energy, this evidence reinforces the need for a coherent national strategy. Measures such as mandatory advertising restrictions, fiscal levers, procurement standards, and strengthened school-food policies align with forthcoming WHO guidance and are essential to tackling the intersecting challenges of obesity, food insecurity, and health inequalities.