Why is there no regulation despite evidence that ultra-processed foods are hazardous to long-term health?

Non-communicable diseases (NCDs) have exceeded infectious diseases as a global health threat. This shift has occurred concurrently with changes to lifestyle and diet, of which the increased consumption of ultra-processed foods (UPFs) is particularly concerning. UPFs are defined by industrial processing of often cheaply sourced natural food and inclusion of non-nutritional additives such as azo-dye colourants, non-caloric sweeteners, emulsifiers and preservatives. They now account for approximately half of the caloric intake in many countries and notably by children. These products can compromise nutritional quality while promoting hedonistic hunger and disrupting the gut microbiota. Population studies are increasingly demonstrating an association between high UPF consumption and increased all-cause mortality, obesity, cardiovascular disease, cancer risk, mental health and neuro-behavioural disorders. While association studies cannot account for all potential confounding factors, triangulation through combining large-scale cohort studies with animal/in vitro models and human challenge studies provides more compelling evidence that UPFs increase the risks of NCDs. Despite the increasing evidence, regulatory action on their use has remained limited. We review the evidence and explore the reasons why effective regulation is lacking, with increasing examples of inappropriate food industry influence on political decisions in several countries. The current focus on reducing consumption of high fat, sugar and salt has distracted attention from the adverse effects of alternative non-nutritional additives. We propose changes to food labelling and call for public health interventions to combat and minimise UPF consumption. These interventions are especially vital for socioeconomically disadvantaged populations and children, who increasingly consume UPFs as attractive and cheaper alternatives to fresh or minimally processed products. Urgent action is needed to promote healthier dietary practices worldwide.