A new feature section that will be 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 UPF consumption to chronic disease, obesity, diabetes, cancer, dementia, and premature death. The feature section also breaks new ground by examining how major tobacco companies helped build and scale the modern UPF 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 the NOVA food processing classification system and the concept of UPFs 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, M.D., Ph.D., 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 UPFs 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 UPF. 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.

UPF Development, Marketing Mirrors Tobacco Industry

Among the most significant findings in the collection are new analyses of internal company documents showing how major tobacco corporations helped shape the modern UPF 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. An outcome of this effort to pool research and development 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 

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 percent of Americans believe UPFs are addictive
• Approximately 73 percent support warning labels about health risks
• Approximately 64 percent support advertising restrictions for children
• Majorities across political parties support stronger government action to address harms associated with UPFs.

Researchers also found that while public awareness of UPF 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 UPF. 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, Ph.D., M.P.H., 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 UPF 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 Americans, especially children, to include UPFs. Extensions of consumer protection laws would include 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, as well as greater investment in access to affordable, minimally processed foods.
• Litigation and legal accountability for harmful corporate practices.

Several editorials also emphasize the disproportionate burden UPFs 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 UPF 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 UPF, increased scrutiny of food industry practices, and emerging lawsuits alleging that major food manufacturers knowingly marketed addictive and harmful products.