New Research in the American Journal of Public Health Links Ultra-Processed Food to Chronic Disease, Corporate Influence, and Growing Calls for Government Action

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New Research in the American Journal of Public Health Links Ultra-Processed Food to Chronic Disease, Corporate Influence, and Growing Calls for Government Action

Leading academic researchers examine how tobacco companies helped shape today’s ultra-processed food system; identify product engineering built for overconsumption; and highlight growing support for stronger protections for children, greater transparency, and accountability

A major new feature section published in the July issue of the American Journal of Public Health (AJPH) presents one of the most comprehensive examinations to date of ultra-processed food (UPF) as a public health crisis shaped not only by nutrition, but by corporate practices, political influence, and regulation failures.

The collection of editorials, analytic essays, and research articles adds to the growing body of evidence linking ultra-processed food consumption to chronic disease, obesity, diabetes, cancer, dementia, and premature death. But the feature section also breaks new ground by examining how major tobacco companies helped build and scale the modern ultra-processed food industry — and by outlining what many public health experts say must come next: coordinated government intervention, stronger regulatory oversight, legal accountability, and greater protections for children from aggressive marketing and harmful food environments. The collection also examines how Nova and the UPF concept can inform and improve dietary guidance, dietary monitoring and target-setting, food regulation, and sustainable food system transitions.

“Taken together, this feature section shows that ultra-processed food is not simply an issue of personal responsibility or individual choice,” said Nicholas Chartres, lead editorial author and researcher at the University of Sydney and the Center to End Corporate Harm at the University of California, San Francisco. “The evidence increasingly points to a commercial system that has engineered, marketed, and normalized products linked to widespread chronic disease. The public health and government response must reflect that reality.” 

The AJPH feature section frames ultra-processed food as a “commercial determinant of health,” arguing that many of the same corporate strategies once used by the tobacco industry — including product engineering, targeted marketing toward children, political influence, and efforts to shape science and public understanding on the harms of these products — have also shaped today’s food environment.

“UPF-based policies should be seen as complementary to, rather than in competition with, existing policies that address dietary nutrient imbalances,” said Carlos Monteiro, MD, PhD, emeritus professor of nutrition and public health at the University of São Paulo and creator of the Nova food classification system. “Together, they strengthen the promotion of healthy diets and support the transition to healthier, more sustainable food systems.” 

New Research Highlights Health Harms and Addictive Potential 

The collection includes multiple new studies using nationally representative U.S. datasets showing that higher consumption of ultra-processed food is associated with:

• Increased risk of metabolic syndrome, diabetes, cancer, obesity, and all-cause mortality 
• Higher body mass index, blood sugar, and blood pressure 
• Poorer cardiometabolic health outcomes, even when accounting for overall diet quality 
• Greater risk of cognitive impairment and dementia in older adults 

The issue also features new research on the addictive potential of ultra-processed food. One study identified nutritional characteristics associated with foods perceived as having higher addictive potential, finding that many ultra-processed products combine refined carbohydrates, fats, high energy density, and other characteristics in ways rarely found in minimally processed food.

Researchers say ultra-processing makes it possible to combine these nutrients in dense, rapidly absorbed forms that strongly engage the brain’s reward systems – making these products more likely to trigger addictive patterns of eating.

Tobacco Industry Documents Reveal How Ultra-Processed Food Was Developed and Scaled 

Among the most significant findings in the collection are new analyses of internal company documents showing how major tobacco corporations helped shape the modern ultra-processed food system.

In the 1980s, Philip Morris purchased General Foods and Kraft with the goal of sharing chemical flavor additives, processing and packaging technologies, and product design expertise across its cigarette, beverage, and food businesses to drive growth and revenue.

One outcome of that effort to pool R&D across tobacco and food subsidiaries was the popular children’s product Lunchables. According to new analyses in AJPH, this product was launched and developed over 23 years by the tobacco giant, beginning with extensive research to design Lunchables based on understanding the unconscious desires of children and their mothers as consumers.

For children, Lunchables functioned like a toy, appealing to the child’s desire for independence, play, and control over their lunch. For parents, convenience, familiar ingredients, and gift-like packaging helped make a prepackaged meal feel more acceptable and special.

Philip Morris also used its “better-for-you” strategy developed for Marlboro cigarettes to create Low-Fat Lunchables, using the same processing technology that allowed Philip Morris to make a low-nicotine cigarette.

These strategies helped normalize highly processed, hyper-palatable foods throughout the U.S. and global food supply and influenced broader industry practices that continue today. Taken together, the new analyses in AJPH underscore the importance of protecting children from the harms that these marketing strategies have created and empowering parents with the help and information to ensure that.

New Polling Shows Bipartisan Support for Action 

Importantly, the AJPH feature section moves beyond documenting harms and examines growing public support for policy intervention.

New nationally representative polling included in the collection found that:

• Roughly 70% of Americans believe ultra-processed food is addictive 
• Approximately 73% support warning labels about health risks 
• Approximately 64% support advertising restrictions for children 
• Majorities across political parties support stronger government action to address harms associated with ultra-processed food 

Researchers found that while public awareness of ultra-processed food is growing, many Americans still lack a clear understanding of what qualifies as a UPF — reinforcing public calls for a consistent, science-based definition for policy purposes.

The issue also includes a review of 43 federal and state policy proposals introduced between 2021 and 2025 aimed at regulating ultra-processed food. The proposals include warning labels, marketing restrictions, school food policies, and efforts to limit harmful additives.

“Everybody gets that ultra-processed foods are not just a personal health issue, but a policy issue,” said Marion Nestle, PhD, MPH, author and professor emerita of nutrition, food studies, and public health at New York University. “What is striking about this research is the broad bipartisan support for practical measures like warning labels, marketing restrictions and bans, and improving access to healthier foods. Americans understand that the current food environment is failing too many people, and they want policymakers to act.” 

One analysis highlights lawsuits as another important tool for challenging harmful food industry practices, similar to how other industries — including tobacco, opioids, and automobiles — have faced lawsuits that helped expose internal practices, shift public opinion, and create pressure for stronger public protections.

Experts Call for Structural Reforms and Accountability 

Across the collection, authors argue that meaningful progress will require systemic reforms rather than relying solely on individual behavior change.

Proposed policy responses highlighted in the issue include:

• Establishing the science-based definition of ultra-processed food for policy purposes using the Nova food classification system 
• Going beyond regulating nutrient content to address how products are designed and marketed 
• Extending existing consumer protection laws to protect all American, especially children, to include UPFs, including health warning labels, taxes, restrictions on marketing and advertising to children, and other public health tools modeled on tobacco control 
• Improved school and community food environments, and greater investment in access to affordable minimally processed foods 
• Litigation and legal accountability for harmful corporate practices 

Several editorials also emphasize the disproportionate burden ultra-processed foods place on lower-income communities and the need for policies that improve access to affordable, minimally processed alternatives.

The collection further explores the environmental consequences of ultra-processed food production, including plastic pollution and climate impacts linked to major multinational corporations, including Coca-Cola and Unilever.

The feature section arrives amid growing public debate over ultra-processed food, increased scrutiny of food industry practices, and emerging lawsuits alleging that major food manufacturers knowingly marketed addictive and harmful products.

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The American Public Health Association champions optimal, equitable health and well-being for all. With our broad-based member community and 150-year perspective, we influence federal policy to improve the public’s health. Learn more at www.apha.org.

About the Featured Section The July issue of the American Journal of Public Health features an expansive collection of editorials, research articles, and analytic essays focused on ultra-processed food. The full list of authors and papers appearing in the issue include:

• Nicholas Chartres — Ultra‑Processed Foods and Corporate Influence: Evidence, Regulation, and Policy Pathways to Address Chronic Disease in the US
• Kelly D. Brownell — Litigation as a Necessary Tool to Challenge Food Industry’s Toxic Practices
• Lindsey Smith Taillie — Beyond the Body: the Ultra-Processed Food Industry’s Environmental Toll
• Marion Nestle — The Politics of Ultra-Processed Foods: Dietary Guidelines for Americans
• Nadine Gracia — Ultraprocessed Food, Food Insecurity, and Improving the Food Environment for All in the United States
• Gyorgy Scrinis — Policies to Address the Market Power and Strategies of Ultra-Processed Food Corporations
• Julia A. Wolfson — Practical and Equity Considerations for Ultra-Processed Foods Policies
• Tera Fazzino — Ultra-Processed Foods in the Global Food System: The Role of U.S. Tobacco Companies
• Carlos Monteiro — What Do Nova and the Ultra-Processed Food Concept Offer to Policy-Makers?
• Laura A. Schmidt — Tobacco Industry Contributions to the Development of Ultra-Processed Food: A Case Study of Lunchables
• Ashley N. Gearhardt — Nutritional Characteristics of Foods with Addictive Potential: A Machine Learning Approach
• Jeff Niederdeppe — Public Awareness and Support for Governmental Intervention to Address Harms Associated with Consumption of Ultra-Processed Foods in the United States
• Cristina R. Fernández — Associations Between Household Food Insecurity, Nutrition Assistance Programs, Ultra-Processed Food Intake, and Diet Quality Among Pregnant Women (NHANES 2001–2018)
• Heejin Lee — Ultra-Processed Foods and the Risk of Cognitive Impairment and Dementia in U.S. Older Adults
• Elise Sheinberg — The Intersection of Diet Quality and Ultra-Processed Food Intake in Cardiometabolic Health
• Daniel Wiese — Changes in Neighborhood Foodscapes from 2003 to 2023 by Area Rurality in the United States
• Juna Hatta-Langedyk — Ultra-Processed Food vs. Diet Quality in Relation to Cardiometabolic Health and All-Cause Mortality (NHANES 1999–2018)
• Aline D’Angelo Campos — Operationally Defining and Targeting Ultra-Processed Foods: Insights from U.S. Policy Proposals