Why has the latest statement on UPFs from SACN prompted many eye rolls?

Writing from the Italian seaside, the clue is with the children.

If the Mediterranean Diet had an official fan club, I’d probably be the president if not the secretary. I find it amazing how conclusive the evidence on the benefits of the Medi Diet is and how well researched it is as an intervention (such as the SMILES trial and effective reduction of depression) or as a long-term exposure (hello EPIC and reduced overall risk of cancer).

I teach my medical students about it, and I recommend it to my clients. I’ve published a review about its efficacy as a great dietary tool for better health outcomes in pregnancy for both mother and baby. There really isn’t any confusion and it’s not a great mystery: the Mediterranean Diet, characterised by a high intake of vegetables, legumes, fruits and nuts, whole grains, extra virgin olive oil and fish with moderate to low everything else, is brilliant for health. It is also pretty excellent for the planet as a sustainable diet.

So why am I feeling a bit uneasy? How has being back in Italy, on a beautiful island where access to fresh fruits and vegetables, legumes and fish is easier and cheaper than most other places, prompted me to write this? I bought 4 huge ripe, organic delicious peaches, a bag of sweet and colourful tomatoes off the vine, candy sweet cherries, and a box of tender striped white courgettes for 10 Euros today. 10 Euros! But then the scientific advisory committee on Nutrition - aka SACN - released this statement after mounting pressure from the discourse about UPFs (ultra-processed foods).

It was disappointing and lacked foresight, calling for ‘more research’ because there haven’t been enough reviews of clinical trials on UPFs. The thing is, epidemiological studies that have, in their dozens, all pointed to the negative impact UPFs have on our health are surely enough of a huge red flag. Of course taking socio-economic background, metabolic health and all the other factors outlined in the statement into consideration is important. And yes more studies are always great (it is a common theme in academia that a paper is not complete unless you state that ‘more research is needed’). But in 15 years’ time, will we look back and be glad we waited that bit longer before taking decisive steps to reduce UPFs and ring the alarm? I don’t think so.

Back to Italy, where the children playing on the beach are changing. Last year we didn’t make it back to our favourite beach because of all the pesky BA flight cancellations. The year before that, with COVID still looming large, the beaches were emptier. So it’s fair to say I last really experienced this place in its full glory back in 2019. And in just 4 years, the population and their food seems to have shifted.

Best beaches in the world, according to me. Photo by Massimo Virgilio

As an Italian who moved abroad to London in childhood, I have a rose-tinted type of patriotism, knowing all the points of pride off by heart (lowest UPF consumption in Europe! Best food in the world! Phenomenal art! Tomatoes that taste like the sun!) whilst being blissfully ignorant of the actual challenges living here poses. My fellow Italian expats have a similar outlook; we love coming home and we love sharing our culture. We deeply feel the importance of family, food, and spending time by the sea. We all had similar upbringings and want to transfer these values to our own children. But are these values at risk if we don’t strive to maintain our food environment?