Carlos A. Monteiro
@CMonteiro_USP
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@carlos-monteiro.bsky.social. Emeritus Prof, School of Public Health, University of Sao Paulo. Researcher, USP Center for Epi Studies in Health and Nutrition.
Joined November 2010
Today in The Washington Post: An excellent summary by Anahad O'Connor on the work of a fantastic team at the University of São Paulo!
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🇧🇷Brazilian President Lula announces that ≥ 85% of the 2025 federal budget for public school meals—serving 10 million children in 150,000 schools—must be allocated to raw or minimally processed foods and freshly prepared meals (≥ 90% in 2026).
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An updated systematic review and meta-analysis of prospective studies (including seven published in 2024) confirms a significant and independent association between higher UPF consumption and an increased risk of diabetes and its complications.
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Given the absence of explicit guidance on artificial sweeteners in the current Scientific Report, it's likely that the next Dietary Guidelines for Americans won't address this topic (as well as UPFs). Fortunately, the US press is doing much better👏👏👏
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Wow: 'the credibility of nutrition research has repeatedly been questioned, since several RCTs did not confirm the findings of large epidemiological studies. However, our study shows clearly that most findings from individual RCTs were confirmed in best-matching cohort studies.'
Once again, ~92% agreement between nutritional RCTs and nutritional epidemiology has been identified. Didn't I tell y'all this, like, four years ago? This is precisely why I don't take "confounding tho" to be a serious criticism against the epidemiology.
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Interesting, but this is funny: 'In addition, there remains much disagreement over whether the processing of foods makes them unhealthy, or whether it is rather a correlation between processed foods and high levels of [added] fat, sugar, salt, etc.' Correlation? Who did add them?
@Euromonitor provides Five Trends Driving Sales of Staple Foods @PhilBakerNZ @MarkLawrence_Oz @CMonteiro_USP Fear of ultra processed food products to drive the staple food sales .
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" ... genetic engineering was just one way industrial food production was distancing us from natural ingredients. Today’s UPFs represent an even deeper departure — taking familiar ingredients and transforming them so fundamentally that our bodies no longer recognize them as food"
Non-GMO Project debuts label highlighting foods without ultra-processed ingredients via @FoodDive Progress on UPFs @CMonteiro_USP @PhilBakerNZ
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Contrary to claims often made by Nova critics, this study demonstrates that when a non-specific FFQ is used, "any potential misclassification related to the NOVA classification system has minimal, if any, impact on the interpretation of the results."
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Nutrition International, an organization that delivers nutrition interventions for those in need in 60+ countries, set clear boundaries on interactions with the UPF industry and emphasized keeping nutrition policy and regulatory spaces free from COI. Who's next?
In today’s world, the rapid spread of ultra-processed foods and sugar-sweetened beverages poses a serious threat to global nutrition. To safeguard our vision of a world free from all forms of #malnutrition, we are taking a bold step forward. Our new Principles of Engagement with the Ultra-Processed Food Industry (UPFI) provide a clear framework to: ✅ Protect nutrition policymaking spaces from conflicts of interest. ✅ Uphold our neutrality to ensure trust in our evidence-based approach. ✅ Support governments in tackling UPFI-driven malnutrition through policy, investment, and public awareness. These principles are a natural extension of @NutritionIntl’s longstanding commitment to building a world where everyone, everywhere is free from all forms of malnutrition and able to reach their full potential. Learn more about how we’re working to create a healthier future for all: #NutritionForAll
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Exciting news about Norwegian consumers' knowledge and attitudes towards UPFs—don’t miss it!
What happens when a small group of committed nutrition professionals in a small country like 🇳🇴 join to encourage consumers to: Reduce ultra-processed foods Choose less processed versions within each food group Cook at home, and chose meals from whole foods when eating out. 🧵
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A new systematic review suggests that high UPF consumption may increase the risk of diabetes, excessive weight gain, and hypertension in pregnant women, as well as growth/developmental deficits, increased adiposity, and mental disorders in their offspring.
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Another cohort study with European participants (exceptionally well-conducted) confirms the association between the UPF dietary share and several mortality outcomes after controlling for potential confounders, including adherence to the Mediterranean Diet
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Another pearl from Dary: 'food ingredients, additives, and processing methods must only be used when they meet SR-equivalent standards proving their long-term safety. Moreover, the DGAs should be able to recommend avoidance of any foods not meeting such standards of evidence.'
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Brilliant, Dary: 'the [USDG} SR included studies it should not have that had heterogeneous and poorly characterized assessments of UPF, and then concluded that heterogeneous and poorly characterized assessments of UPF limited the strength of the evidence'
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Why Is the American Diet So Deadly? A scientist tried to discredit the theory that UPFs are killing us. Instead, he overturned his own understanding of obesity.' By Dhruv Khullar, New Yorker, Jan 6 2025. An account of how the Nova theory is seen in the US.
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Now there are 13 cohort studies on UPF intake and diabetes: five in Europe (UK x2, France, Spain, Netherlands), four in the US, and one each in Australia, Brazil, Canada, and Korea. All show positive associations, with 11 reaching statistical significance.
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Thanks, Arun! Here’s the link to the California Executive Order directing state agencies to investigate health risks associated with UPF, synthetic food dyes, and other additives, and to recommend public actions. Highlighted text in the figure below
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Now with the right link. A long (historical) read on UPF, Nova, Nova-based dietary guidelines, and other accomplishments of our 35-year-old USP epi research center—and why these milestones were achieved outside the Global North.
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Here is a video interview based on the long read about UPF, the NOVA classification, and NOVA-based dietary guidelines.
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