Watch what you eat: Why Big Food is the new Big Tobacco

South Africans are eating their way into a health disaster. Ultra-processed foods (UPFs) — sugary snacks, salty chips and packaged meals on supermarket shelves — are driving the country’s top killers: obesity, type 2 diabetes, high blood pressure and heart disease.

According to The New York Times, one classification widely used among the scientific community is that any foods or drinks made with ingredients you wouldn’t find in a home kitchen are defined as ultra-processed. It reported that if regulators adopted that kind of definition, nearly three-quarters of foods sold in the US could be deemed ultra-processed.

South Africa shares this danger. Athol Kent, a top University of Cape Town doctor and editor of the Journal Article Summary Service, calls these foods “pathologically unhealthy”. He warns that we’re “sleepwalking into the hungry arms of exploitative food and drink manufacturers”. Kent has extracted scientific opinions from global studies that show that UPF makers are copying Big Tobacco’s tricks to hook customers and boost profits.

Among the articles is a key study in the Milbank Quarterly that compares UPFs to cigarettes. Its researchers from Harvard, Duke and Michigan universities say tobacco and UPFs resemble each other in design, marketing and distribution. Common examples include supermarket ready meals, frozen pizzas, sweetened breakfast cereals, biscuits, sausages, ice cream, chicken nuggets, fish fingers and instant noodles.

UPFs, like cigarettes, are lab-engineered for addiction, not nutrition, the Milbank Quarterly says. They tweak recipes for maximum cravings: super-fast rewards from sugar and fat hits, addictive flavours, easy access and fake “healthy” labels (such as “low-fat” to hide the sugar bomb). This “health-washing”, it says, fools people into thinking that junk is good for you.

The researchers say UPFs hijack your brain and body, leading to overeating, disease — and huge medical bills. They push for tobacco-style fixes: lawsuits, ad bans, improved labelling, and holding companies accountable — not just blaming the eaters.

Another study in JAMA Health Forum labels UPFs addictive, like tobacco, built for profit while wrecking health.

We’re sleepwalking into the hungry arms of exploitative food and drink manufacturers

—  Athol Kent

In Canada, a study of 2,000 preschoolers found UPFs make up half of their daily calories. Children who consumed 10% more of their energy from UPFs at age three showed worse behaviour and emotions by age five — including greater anxiety, aggression and hyperactivity. Swapping foods that are ultra-processed for real foods (veggies, fruits and whole grains) improved everything. Small changes per child but huge impact nationwide.

In South Africa, the problem hits hard:

• 76% of packaged foods are ultra-processed;
• Supermarket snacks overflow with sugar, salt and bad fats; and
• Cheap prices and aggressive advertising make them a go-to, especially for low-income urban families.

Local studies match global ones: UPFs increase obesity, diabetes and heart conditions, which are South Africa’s biggest health threats. Key research includes the University of the Western Cape (2024) on low-income diets, the National Research Foundation (2023) on perceived “healthiness”, Wits University (2025) on snack marketing, the South African Medical Research Council’s South African National Health and Nutrition Examination Survey (2022) and Stats SA’s 2023 General Household Survey.

Dariush Mozaffarian, a cardiologist and the director of the Food is Medicine Institute at Tufts University in the US, told The New York Times that UPFs are “one of the most important policy actions around food that the US government has done for probably 25 years or more. Industry is going to fight tooth and nail because this is a fundamental threat to its entire model.”

Mozaffarian and other health experts argue that the US federal definition should adhere closely to a food classification system called Nova, which is used in most of the research linking UPFs to poor health. The Nova classification system is a framework that categorises foods based on the extent and purpose of industrial processing they undergo, rather than their nutrient content. It was developed in 2009 by a team at the University of São Paulo, Brazil.

Even supporters of President Donald Trump are in favour of removing UPFs from the American diet. According to a Politico poll published in April, Make America Healthy Again (an offshoot of the MAGA movement) said this is a core principle for people who identified as Trump supporters.

Mark Hyman, a physician and friend of US health secretary Robert Kennedy Jr, called UPFs the “single biggest threat to public health ever”. He characterised the food industry’s lobbying on the definition as its “usual shenanigans”, adding that it is “obfuscating, confusing and undermining the credibility of scientists”.