Ultra-processed foods (UPFs) have more in common with cigarettes than with fruit or vegetables and require far tighter regulation, according to a new report from researchers at Harvard, the University of Michigan and Duke University. The study, published on 3 February in the Milbank Quarterly, draws on data from addiction science, nutrition and public health history to argue that UPFs are engineered to encourage addiction and consumption, much like tobacco products.
UPFs are industrially manufactured food products that often contain emulsifiers, artificial colouring and flavours. The category includes soft drinks, crisps and biscuits. The researchers point to similarities in production processes and manufacturers' efforts to optimise the “doses” of products and how quickly they act on reward pathways in the body. They suggest that marketing claims such as “low fat” or “sugar free” amount to “health washing” that can stall regulation, akin to the advertising of cigarette filters in the 1950s as protective innovations that offered little meaningful benefit.
Prof Ashley Gearhardt of the University of Michigan, a clinical psychologist specialising in addiction, said her patients often compare their habits to smoking: “They would say, ‘I feel addicted to this stuff, I crave it – I used to smoke cigarettes [and] now I have the same habit but it’s with soda and doughnuts. I know it’s killing me; I want to quit, but I can’t.’” The authors argue that while food is essential for survival, this makes action doubly necessary because it is difficult to opt out of the modern food environment.
The study suggests that lessons from tobacco regulation, including litigation, marketing restrictions and structural interventions, could offer a guide to reducing harm related to UPFs. They call for public health efforts to shift from individual responsibility to food industry accountability. However, Prof Martin Warren of the Quadram Institute cautioned against “overreach” in the comparisons, questioning whether UPFs are intrinsically addictive in a pharmacological sense or whether they exploit learned preferences and convenience. He also noted that adverse health effects might stem from UPFs replacing whole foods rich in fibre and micronutrients.
Dr Githinji Gitahi of Amref Health Africa said the study reinforces a growing public health alarm across Africa, where weak government regulation on harmful products has allowed corporations to thrive. The researchers concluded that “many UPFs share more characteristics with cigarettes than with minimally processed fruits or vegetables and therefore warrant regulation commensurate with the significant public health risks they pose.”
