The World Health Organization has opened up the public consultation process as it develops a guideline for ultra-processed foods amidst criticisms of bias in its selection of experts.
As ultra-processed foods (UPFs) spark debate about nutrition, food labelling, ingredient formulation, and misinformation, the World Health Organization (WHO) is the latest institution to weigh in.
The UN body has assembled a group of experts to develop a guideline for ultra-processed foods (UPFs), and is inviting comments from the public. “Consumption of such highly processed or ‘ultra-processed’ foods has been associated with a myriad of negative health effects,” it noted.
Some are questioning the composition of the panel that will review the evidence and provide global guidance on the topic, noting that it excludes food scientists due to the WHO’s conflict-of-interest rules. Further, there are criticisms about the organisation’s decision not to publish the comments, accusing it of a lack of transparency.
“Despite many applications from those of us active in the topic in food and [nutrition] research, the proposed committee is dominated by advocates of the UPF narrative,” remarked Ciaran Forde, a professor of sensory science and eating behaviour at Wageningen University & Research.
WHO’s UPF committee sparks concern
The WHO first made a call for experts to develop UPF guidelines in May, suggesting that guidance on UPF consumption was “much needed” as these products are linked to an increased risk of “a number of diet-related non-communicable diseases and other negative health outcomes”.
Applicants were required to have an advanced degree with proven expertise in relevant fields like nutrition science and epidemiology. They should also have had recent peer-reviewed scientific publications, and been actively involved in scientific advisory bodies.
These experts would help identify research gaps, devise the key questions that inform the evidence reviews, prioritise important outcomes for decision-making, and develop recommendations. These would need to take into account the benefits, risks, feasibility, equity, acceptability, resource requirements, and other factors.
The call had specifically outlined the WHO’s intention to review conflicts of interest. With the list of experts now published, its methodology has now come under scrutiny. Many of the panellists are outspoken critics of UPFs.
One of the most prominent names, for example, is Dr Carlos Monteiro, the Brazilian scientist who led the development of the Nova classification, which birthed the term UPF back in 2009. He has been highly critical of UPFs and has penned several studies outlining their links to health ailments. Other scientists, though, have warned that the Nova classification is too simplistic and broad, so a blanket rejection of all UPFs as unhealthy is misguided.
Another expert selected by the WHO is Kevin Hall, whose 2019 study linking UPFs to obesity (which scientists have said isn’t as straightforward) brought Monteiro’s research to mainstream prominence.
Many of the others have also published research on the harms of UPFs. Various health experts have repeatedly stated that the level of processing isn’t necessarily linked to a food’s nutritional value. In fact, some UPFs that are low in sugar, salt or saturated fat can be good for you, like plant-based milk and meat, whole-grain breads, and even lightly sweetened high-fibre cereals.
WHO faces pushback from food industry and nutrition experts
The fear for many food scientists, some of whom had applied to be on the WHO’s expert group but were rejected, is that this view will not be reflected in the WHO’s review of UPFs, considering the makeup of its panel. “For such guidelines to be taken seriously, they should reflect both sides of the current UPF debate, yet the current committee is unlikely to deliver a balanced perspective,” said Forde.
“Surely the bias in selected members and active omissions indicates potential conflict of interest in agendas?” added Martine Slayne, VP of scientific and regulatory affairs at ingredients giant Ingredion, whose business will likely be keenly affected by the UPF debate.
“WHO should be a pillar of [credibility] based on balanced science, welcoming and leveraging [the] best knowledge from all aspects,” he said. “Clearly, without key food expertise, how can this group conclude in a meaningful and positive way? Requesting comments on a clearly controversial group selection may well bring (desired?) drama and attention – but is this a blinkered agenda?”
Kavita Karnik, former head of nutrition and regulatory affairs at fellow ingredient manufacturer Tate & Lyle, said the WHO risks “losing its credibility” by its unbalanced approach to conflict of interest guidelines. The fact that it won’t publish comments either, she added, “doesn’t bode well for their own credibility and doesn’t help enhance the trust in evidence-based science”.
And it isn’t just food industry representatives that have voiced this concern. Marcia Terra, an advisory board member of Brazil’s National Association for Diabetic Care and a director at the Brazilian Society for Food and Nutrition, wrote: “The silence of honest scientists is exactly what serves those who want to dominate the debate.”
And Kantha Shelke, who heads a nutrition research firm that advises ingredient manufacturers and is a senior food safety lecturer at Johns Hopkins University, suggested: “Science-based policy requires diverse expertise, not echo chambers…Currently, the committee is heavily weighted toward advocates while notably excluding working food scientists.”
Although much of the opposition comes from the food industry, whose business interests will be impacted by the WHO’s guidelines on UPFs, all of this underlines the conflicting debate on the topic. It ought to be common sense that marinated tofu and fortified soy milk don’t have the same health impact as a pack of Oreos; yet, all are classified as ultra-processed.
The WHO’s process will take a maximum of two years, and it isn’t the only public organisation to investigate or take action against UPFs. In the US, the FDA is working to develop a definition of these products, and states like California, Arizona and Louisiana have banned their use in schools.
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