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Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study

BMJ 2024; 385 doi: https://doi.org/10.1136/bmj-2023-078476 (Published 08 May 2024) Cite this as: BMJ 2024;385:e078476

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Ultra-processed foods linked to higher mortality

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Re: Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study

Dear Editor,

As ultra-processed foods flood our diets, a hidden health crisis is emerging—one that’s disproportionately impacting Black, Asian, and Minority Ethnic (BAME) communities. While these quick, calorie-packed foods pose health risks for everyone, the toll they take on BAME communities is deeper and more complex. Beneath the surface of what seems like a modern dietary trend, there’s a web of genetic, socioeconomic, and environmental factors that make this crisis uniquely urgent for these populations.

Ultra-processed foods, rich in sugars, unhealthy fats, refined carbs, and additives, are convenient but ultimately damaging, especially for those who consume them in high quantities. In the U.S., these foods now account for a shocking 57% of the daily caloric intake for adults and even more for youth. But this isn’t just about convenience—it's a systemic issue that’s feeding into health disparities, particularly affecting BAME communities.

Studies reveal that in Western nations like the UK and US, BAME communities face higher rates of obesity, diabetes, heart disease, and other chronic illnesses compared to their Caucasian counterparts. Genetics play a role, too. For example, South Asians often show what’s known as a “thin-fat” phenotype, where they might appear lean but carry more hidden, dangerous fat around their organs. This makes them more prone to metabolic issues and heart problems, even at lower body weights. So, a South Asian person eating the same diet as a Caucasian peer may face a higher risk of diabetes or heart disease due to these genetic factors.

And then there’s the socioeconomic angle. Many BAME communities deal with economic challenges that make healthier options hard to afford. In urban areas, where access to fresh, affordable produce is often limited, cheap, calorie-dense processed foods become the default choice. While Caucasian communities also experience food insecurity, they generally have a wider range of food choices and resources, which can cushion the health impact somewhat. But for BAME communities, this reliance on ultra-processed food isn’t just about convenience or taste—it’s often a matter of necessity.

These factors only scratch the surface of a much larger issue. The reality is that ultra-processed food consumption among BAME communities represents just the tip of an iceberg. Beneath the waterline, we’re looking at a crisis that’s fueled by layers of historical, environmental, and genetic factors. This isn’t just a dietary problem; it’s a public health emergency.

To tackle this, we need a public health strategy that’s both broad and deeply respectful of cultural diversity. Health campaigns must reach people where they are, providing relevant and culturally sensitive information. Partnering with community leaders and creating programs that resonate with specific cultural needs can make healthy eating a reality for everyone.

Government policies have a role to play, too. Subsidizing fresh produce in lower-income areas and enforcing stricter rules on marketing unhealthy foods to children could make a significant difference. And, importantly, we need more research on how diet affects different ethnic groups and how traditional foods can be integrated into healthier eating patterns, especially for BAME populations.

This challenge requires more than just updated dietary guidelines. It calls for an approach that directly addresses the unique struggles facing BAME communities in our food systems. The health risks associated with ultra-processed foods are serious for everyone, but they’re amplified for BAME individuals by layers of socioeconomic and genetic factors. By adopting a targeted, culturally informed strategy, we can work towards truly equitable health outcomes.

Our food choices shape our health, and the choices we have are shaped by the systems around us. Recognizing and addressing the unique vulnerabilities of BAME communities isn’t just about food—it’s about health, equity, and a fairer future for all.

Competing interests: No competing interests

06 November 2024
Vikram Anumakonda
Consultant Physician, Critical Care, Acute and Internal Medicine,
The Department of Acute Medicine, Dudley Group Hospitals NHS Foundation trust, Birmingham, UK
Dudley DY1 2HQ