AJPH Just Dropped a Landmark Issue on Ultraprocessed Food. Here's What You Need to Know

A speedy summary

Unjunked Co-founder Ashley Gearhardt and I were in DC last week for the launch of the landmark special issue of the American Journal of Public Health on ultraprocessed food and to share the science directly with legislators across the aisle.

The AJPH special issue is a big deal because historically, the journal—and public health more broadly—has not had a strong focus on food or nutrition issues. However, the MAHA movement has created unprecedented national attention and catalyzed new interest by policymakers, creating a tipping point that very much feels like tobacco, where the science, public support, and political will are aligned. It was thrilling to meet with legislators and viscerally feel the enthusiasm.

Look at these happy scientists!

The journal launch also coincided with the launch of FedUP!, a new consumer education movement dedicated to translating science for the public and catalyzing policy action.

However, the special issue is a doozy- 17 articles! One journalist I spoke to said her brain hurt from trying to get through it all. It’s hard to believe not everyone wants to read 100s of pages of this stuff…so strange.

For the 90-second version, scroll to the bottom for top takeaways.

For the ~5 minute version, here’s a speed round on each article’s main finding.

From your friendly Unjunked Co-Founders:

• “Nutritional Characteristics of Foods With Addictive Potential: A Machine-Learning Approach” (Gearhardt et al)- Identifies a nutritional signature” — high carbohydrates, glycemic load, energy density, and fat — that is perceived as more addictive and is common in UPFs and rare in minimally processed foods.

• “Public Awareness and Support for Governmental Intervention to Address Harms Associated With Ultraprocessed Foods” (Niederdeppe et al). A national poll finds a bipartisan majority believes that food companies are creating addictive foods targeting kids, and also bipartisan support for government action on UPFs.

• “Operationally Defining and Targeting Ultraprocessed Foods: Insights From US Policy Proposals” (D’Angelo Campos et al—my brilliant postdoc!). Of the 43 federal and state UPF policies proposed in the last 5 years, most targeted school foods and used narrow, scientifically inconsistent definitions of ultraprocessed foods.

• “Beyond the Body: The Ultraprocessed Food Industry’s Environmental Toll” (Taillie et al). Editorial arguing that UPFs have serious environmental harms. UPF companies are the top global plastic polluters- and those plastics then leach into the soil, air, animals, and humans.

Other Original Research:

• “Ultra-Processed Foods in the Global Food System: The Role of US Tobacco Companies” (Fazzino et al). Uses industry’s own documents to show how US tobacco companies RJ Reynolds and Philip Morris purchased UPF companies then deployed tobacco tactics to sell and market the products (think: “low-tar” cigarettes==> “low-fat” cookies).

• “Tobacco Industry Contributions to the Development of Ultraprocessed Food in the United States, 1985-2007: A Case Study of Lunchables.” (Schmidt). Using internal industry documents, finds Philip Morris applied product design strategies from cigarettes to Lunchables by optimizing consumer appeal (i.e., making them look like toys) and using a “better-for-you” reformulation strategy to get health-conscious consumers to stay loyal.

• “Ultraprocessed Foods and the Risk of Cognitive Impairment and Dementia in Older US Adults” (Lee et al). Using nationally representative longitudinal data, finds that among older adults higher UPF intake is associated with higher risk of dementia and cognitive impairment.

• “Associations Between Household Food Insecurity and Participation in Nutrition Assistance Programs, and Ultraprocessed Food Consumption Among Pregnant Women” (Fernandez et al). Using national diet survey data, finds that food insecurity among pregnant women was linked to lower diet quality but not UPF consumption. WIC participation was associated with better diet quality but SNAP participation was not.

• “Ultraprocessed Food vs. Diet Quality in Relation to Cardiometabolic Disease Risk and All-Cause Mortality, NHANES 1999-2018” (Hatta-Langedyk et al). Using national diet data, finds that UPF intake is associated with higher BMI, HBA1c, blood pressure, worse cholesterol, diabetes, cancer, and mortality, and this association was only partly explained by nutritional quality.

• “The Intersection of Diet Quality and Ultraprocessed Food Intake: Cardiometabolic Profiles” (Sheinberg et al). Using national diet data, finds that US adults with low diet quality and high UPF intake have the least favorable metabolic profiles.

• “Changes in Neighborhood Foodscapes From 2003 to 2023 by Area Rurality.” (Wiese et al). Using longitudinal retailer data, finds that food swamps have increased over the last 20 years, with little progress in reducing food deserts, especially in rural areas.

• “What Do NOVA and the Ultraprocessed Food Concept Offer to Policymakers?” (Monteiro et al). Makes the case that the NOVA food classification system provides a practical, complementary framework for governments to update dietary guidance, regulate UPFs, and advance sustainable food system transitions.

Editorials

• “The Politics of Ultraprocessed Foods: Dietary Guidelines for Americans.” (Nestle) Argues that the 2025 Dietary Guidelines for Americans’s inclusion of recommendation to avoid highly processed foods (aka UPFs) was an important step, despite other concerns about the guidelines and the process to create them.

• “Food Environment Policies to Address the Market Power of Ultraprocessed Food Corporations” (Scrinis). Argues that existing food environment policies are insufficient because they focus on individual nutrients or products rather than directly targeting the market power and corporate portfolios of UPF companies.

• “Practical and Equity Considerations for Ultraprocessed Foods Policies.” (Wolfson) Cautions that UPF policies must account for concerns like the labor and time required for cooking fresh foods and also ensure everyone can access and afford a healthy, minimally processed diet.

• “Litigation as a Necessary Tool to Challenge Food Industry’s Toxic Practices” (Pomeranz et al) Argues that lawsuits— particularly those brought by state AGs—are a powerful but currently underused mechanism to hold the ultraprocessed food industry accountable .

• “Ultraprocessed Food and Corporate Influence: Evidence, Regulation, and Policy Pathways to Address Chronic Disease in the United States” (Chartres) Introduces the special issue examining UPF consumption, the role of tobacco-owned food companies, and the urgent need for evidence-based policy action.

• “Beyond Personal Responsibility: Lessons From the Tobacco War for Regulating Ultraprocessed Food” (Chartres) Argues that the same policy and legal playbook used against tobacco should now be applied to UPFs— including state litigation against UPF companies, which led to the pivotal Master Settlement Agreement leading to $206B payout, marketing restrictions, and releasing of internal documents.

• “Ultraprocessed Food, Food Insecurity, and Improving the Food Environment for All in the United States” (Gracia) Argues for the need to simultaneously address structural drivers of food insecurity, UPF consumption, and poor health.

What did we learn from all this?

Phew! That’s a lot. Here are my top takeaways :

• The data on health harms of UPFs continues to grow, with new evidence on cognitive impairment and dementia risks as well as metabolic risks. The UPF-health link is at least partially independent of nutrients (i.e., there is something else going on here besides the fact that these foods are often high in added sugar, sodium, & sat fat)

• Americans of all stripes increasingly view UPF companies as the culprit—and want policymakers to take action.

• In contrast to industry arguments, a science-based operational definition of UPFs exists and can be implemented for US policy.

• UPF companies are using tobacco company strategies to make these foods crave-able, health-wash them, market them to kids, and sell them in every corner of the globe. This is in part because many of the players are actually the same due to tobacco companies’ acquisition of UPF companies.

• Like in tobacco, successful litigation will be key for moving the needle on legislative and regulatory action.

  That’s a wrap! Would love to hear what you think:

• Were you surprised to learn about the role of tobacco companies?

• Does the polling data showing bipartisan support resonate with what you’ve seen in your community?

• Did you eat Lunchables as a kid? I loved them, especially the bologna ones and the pizza ones (NEVER the turkey—gross). The idea of them being a toy seems so obvious in retrospect!