As doctors, we see daily the effects poor diet has on health, with levels of obesity and diet-related illnesses continually rising.
In England alone 10.5% of children starting primary school are classed as obese, rising to 22% per cent by the time they are leaving primary school. This tracks into adulthood with more than 64% of adults aged over 18 years estimated to be overweight or living with obesity.
That is why the BMA has today set out renewed calls for Government action to improve the UK’s food environment. A new BMA report, Improving the nation’s diet: the impact of ultra-processed food, examines the consequences of harmful dietary patterns, including rising consumption of UPFs (ultra processed foods) and calls for measures to protect the health of the population.
Poor diet remains one of the most pressing public health challenges in the UK. Recommended levels of calories, fat, salt and sugar are frequently exceeded. This is not simply a matter of individual choice. The food environment is heavily shaped by industry practices. Sophisticated marketing techniques, such as TV and online advertising, price promotional and product placement, drive up sales of these foods. At the same time, there is limited accountability for promoting nutritional quality, contributing to persistent shortfalls of the intake of fruit, fibre and vegetables.
The increasing consumption of UPFs is also an additional concern. The UK is second only to the USA as the one of the world’s largest consumers of UPF intake, with approximately 56% of daily energy intake coming from these products. Diets high in UPF are associated with poor health outcomes, including poor liver health, depression, cardiovascular diseases, cerebrovascular disease, increased risk of COVID-19 infection, higher risk of dementia, chronic kidney disease, inflammatory bowel disease, type 2 diabetes, colorectal cancer, risk of frailty and eating disorders.
STRAIN: 'There is clear evidence base linking salt, sugar and fat to hypertension and obesity'
Association is not causation. However, the high saturated fat, sugar and salt content combined with low nutrient value, makes causation biologically plausible. Additionally, important questions remain about the degree to which processing per se contributes independently. Risk has been postulated owing to other UPF characteristics, such as factors involved in processing, additives, food structure and appetite regulation.
Children and young people are particularly affected. Estimates suggest that around two-thirds of UK adolescents’ daily energy intake comes from UPFs. School meals and baby and toddler food and other products marketed for children can all contribute. Healthier options are often less accessible and affordable, exacerbating existing health inequalities.
UK policies primarily focus on foods high in saturated fat, salt and sugars, (collectively known as HFSS) and nutritional value. There are valid reasons for this. There is clear evidence base linking salt, sugar and fat to hypertension and obesity. The evidence that processing independently drives poor health outcomes is still developing. Nevertheless, given the scale of UPF consumption, especially among children, the role of processing in dietary risk warrants continued scrutiny.
Progress on food policy must not stall. Existing and proposed regulation will only improve the health of the population if they are implemented in full, without delay and not weakened through voluntary industry approaches.
Government must continue to address the poor food environment of this country, including considerations around the inclusion of processing levels in UK regulation. Therefore, the BMA is calling UK Government to:
– implement effective food regulation without further delay
– strengthen industry accountability and reduce undue industry influence
– reduce children and young people’s exposure to and consumption of UPFs
– improve access to and affordability of healthy food
– invest in high-quality research on UPFs to inform future policy design
– improve public understanding of healthy diets and the role of food processing.
This report was helpfully informed by a BMA webinar in April 2025 called The Impact of Ultra-Processed Food on Health: Where Should Regulation Focus? in which expert speakers explored the evidence, what is needed to better understand and tackle the potential harms of UPF and how these fit with broader food and obesity policy strategies. We would like to give a special thanks to these speakers and all BMA members who attended.
David Strain is BMA board of science chair