Front–of–pack nutrition labeling: ultra-processed foods are the elephant in the room

I commend the authors for their detailed documentation of the progress with the introduction and implementation of nutrition front-of-pack labeling (FoPL) displayed on food products in the Americas.¹ That region of the world is a pioneer in protecting and promoting healthy diets. However, all existing FoPL models are reductionists, only considering nutrients and calories to limit in foods. In a few countries, labels also mention some ingredients which consumption is to be avoided, particularly in children, like sweeteners and caffeine. As such, other ingredients and additives, and the degree of processing of foods, are not explicitly covered, anywhere, by existing FoPL legislation. This is a crucial issue that the authors omitted to discuss. There is ample evidence that the consumption of ultra-processed foods (UPF) is leading to poor health – with dozens of studies actually coming from Latin America.2, 3, 4 There is also emerging evidence that when individuals shift from products that are "too high in", they may turn to products that may not be any healthier. For example, recent studies in Chile have found an increase in the consumption of artificial sweeteners - which are markers of ultra-processing - after the adoption of its food laws on labeling and advertising.⁵ Hence, despite some good progress that the authors noted in their article, the protection and promotion of healthy diets in the Americas and elsewhere would greatly be strengthened with a change of paradigm and introduction of “markers of processing” profiling models, on which public policies such as FoPL could be based.

Contributors

Mélissa Mialon was responsible for writing this correspondence article.

Declaration of interests

I declare no competing interests.