A major new Science Advisory from the American Heart Association (AHA) says ultraprocessed foods (UPFs) are strongly linked with heart disease, Type 2 diabetes, obesity and premature death — but important questions remain about whether industrial processing itself, separate from poor nutrient profiles, drives those risks. The advisory synthesises observational studies showing dose–response relationships between UPF intake and cardiometabolic outcomes and calls for targeted research, stricter additive evaluation and policy tools to shift diets away from HFSS (high in saturated fat, added sugars and sodium) ultraprocessed items and toward whole-food dietary patterns (AHA advisory, Circulation; ScienceDaily summary).
This matters for Thai readers because Thailand is already wrestling with a rising burden of obesity and non‑communicable diseases (NCDs) linked to changing food environments. The WHO notes a steep increase in child and adult obesity in recent years and estimates that NCDs now account for roughly three quarters of deaths in Thailand, imposing large social and economic costs (WHO Thailand feature). At the same time, retail sales and household spending on ultraprocessed products in Thailand have risen sharply, mirroring global trends that the AHA highlights as drivers of poorer diet quality and cardiometabolic risk (Profiling UPFs in Thailand, Globalization and Health 2023).
The AHA advisory summarises three interlocking findings that are crucial for the public and policymakers. First, most UPFs consumed in high‑income diets are HFSS items — sugar‑sweetened beverages, packaged sweets, refined grain products and processed meats — and observational meta-analyses show higher UPF intake is associated with a 25–58% greater risk of cardiometabolic disease and a 21–66% increased risk of death compared with low UPF intake. Second, there is evidence that UPFs can promote excess calorie intake and weight gain through palatability, texture and ingredient combinations that alter eating behaviour and reward signaling in the brain. Third, knowledge gaps remain: few studies isolate whether industrial processing or specific additives independently increase disease risk beyond the known harms of saturated fat, sugar and salt (AHA advisory via PubMed; BMJ review on UPFs and health).
Experts who led the advisory emphasise nuance. The lead author notes that while “eating foods with too much saturated fat, added sugars and salt is unhealthy,” we still do not know whether particular additives or processing techniques make an otherwise nutritious food harmful — an especially relevant question for fortified or reformulated commercial whole‑grain breads, some low‑sugar dairy and plant‑based products that are technically ultraprocessed but may offer nutritional benefits (ScienceDaily summary quoting advisory lead). The advisory cautions against using processing level alone as a health label, because that could let manufacturers simply remove ultraprocessing markers while keeping HFSS nutrient profiles unchanged.
For Thai policymakers and health professionals, the advisory reinforces a suite of practical, evidence‑aligned strategies already being piloted in Thailand: reducing the marketing and availability of HFSS UPFs to children, improving the nutritional quality of school meals, levying taxes on sugar‑sweetened beverages and supporting reformulation to lower sugar, salt and unhealthy fats in commonly consumed products. Thailand’s Ministry of Public Health and WHO partners have promoted similar system‑level actions — healthy canteen policies, sugar taxes and marketing restrictions — aimed at shifting population diets and curbing rising obesity and NCD rates (WHO Thailand feature; Profiling UPFs in Thailand).
Key facts underpinning the advisory are drawn from national surveillance and large cohort studies. In the United States, a recent CDC data brief shows more than half of calories consumed (55%) between 2021–2023 came from ultraprocessed products — a troubling metric because countries that shift to high UPF consumption tend to see deteriorating diet quality and rising NCDs over time. The AHA advisory points to meta‑analyses of prospective studies with consistent dose–response signals: higher UPF intake correlates with increased heart attack, stroke, Type 2 diabetes, obesity and all‑cause mortality risks (CDC Data Brief No. 536; AHA advisory).
The advisory also highlights scientific and regulatory blind spots that matter for Thailand. Many food composition databases and dietary surveys do not capture processing methods or additive quantities, and manufacturers in many jurisdictions are not required to disclose the nature or levels of cosmetic additives used in production. This opacity makes it difficult to separate the health effects of HFSS nutrient content from potential harms related to certain additives, emulsifiers or altered food matrices. The AHA recommends more research, improved additive safety assessment, and better transparency from the food industry to allow regulators to evaluate risk more effectively (AHA advisory via PubMed; Lancet policy analysis on product identification).
Thai researchers have already begun mapping the local landscape. A national profiling study found rising sales and household expenditure on UPFs in Thailand and documented uneven nutritional quality across product groups, confirming that not all UPFs are identical and that some categories (e.g., certain fortified or low‑fat dairy items) may have a legitimate place in healthy diets when part of an overall pattern rich in vegetables, fruits and whole grains (Profiling UPFs in Thailand, Globalization and Health 2023). Still, the overall trend of UPF market growth, aggressive marketing to younger consumers and price advantages for UPFs over minimally processed foods is consistent with drivers of poor diet patterns globally.
Cultural and historical context helps explain both the threat and the opportunity for Thailand. Traditional Thai diets, centred on fresh herbs, vegetables, rice, fish and small portions of meat, historically supported relatively low rates of obesity compared with Western diets. But rapid urbanisation, more women joining the workforce, longer working hours and the convenience economy have made time‑saving UPFs attractive to busy families. Thailand’s strong family‑oriented culture and respect for community institutions offer an advantage: public health interventions that engage schools, temples, community health volunteers and local markets can leverage existing social structures to protect children and reshape food choices in ways that resonate culturally (WHO Thailand feature).
Looking ahead, the AHA advisory maps practical research and policy priorities that Thailand can adapt. Short term, expanding surveillance to capture processing details and additive exposures in national dietary surveys would clarify where harms are concentrated. Medium term, funding randomized feeding trials and mechanistic studies in Asian populations could test whether processing-related factors, independent of HFSS content, alter metabolic outcomes or appetite regulation. Long term, harmonised regulatory frameworks for additive evaluation, clearer front‑of-package labelling and stronger restrictions on child‑directed marketing would reduce exposure to the most harmful UPFs while preserving access to genuinely reformulated healthier packaged options (AHA advisory; Lancet policy analysis).
For Thai health services and communities this means a set of actionable steps that balance affordability, food safety and cultural acceptability. Ministries and local governments can prioritise funding for improved school meal programmes that favour local produce and whole grains, expand healthy canteen initiatives that limit HFSS UPFs, and use fiscal measures (such as targeted SSB taxes and subsidies for fruits and vegetables) to alter price incentives. The private sector can be encouraged or regulated to reformulate products to reduce HFSS content, while avoiding marketing tactics that simply resurface ultraprocessed branding without nutritional improvement (WHO Thailand feature; Profiling UPFs in Thailand).
Healthcare professionals can use the advisory’s nuanced message to guide clinical counselling: emphasise whole‑food dietary patterns (vegetables, fruit, legumes, nuts, seeds, whole grains, lean proteins and low‑sugar dairy) and recommend reducing frequent consumption of HFSS UPFs while recognising that some processed items may be pragmatic choices for food safety or nutrient fortification. Clear guidance for families — e.g., cooking more meals together, selecting minimally processed staples at markets, and reading labels for HFSS nutrients — fits Thai cultural priorities around family meals and respect for elders’ guidance on food (AHA advisory; CDC data on UPF prevalence).
There are limits to current evidence that readers should understand. Most studies linking UPFs to disease are observational and can show association but not definitive causation; residual confounding and dietary assessment limitations (under‑ or mis‑reporting) are persistent challenges. The advisory calls for high‑quality trials and mechanistic work to disentangle the effects of nutrient composition, additives and food structure. Policymakers should therefore act on the strong existing evidence against HFSS profiles while supporting research to refine recommendations and avoid unintended consequences that leave affordable, nutrient‑dense food out of reach for low‑income households (AHA advisory via PubMed; Lancet policy analysis).
In conclusion, the AHA advisory reinforces a clear short‑term public health message for Thailand: cut back on ultraprocessed products that are high in saturated fat, added sugars and sodium, and favour traditional, vegetable‑rich meals and whole grains to reduce cardiometabolic risk. Simultaneously, Thailand should invest in surveillance that captures processing and additive exposure, fund local trials and mechanistic research, strengthen additive regulation and front‑of-package labelling, and protect children from aggressive HFSS marketing. These steps combine Thailand’s cultural strengths — family meals, local markets and community health networks — with evidence‑based policy levers to slow the tide of obesity and NCDs and protect the next generation.
Sources: ScienceDaily summary of the AHA advisory (ScienceDaily story); the AHA Science Advisory in Circulation (AHA advisory); PubMed entry for the advisory (PubMed record); CDC NCHS Data Brief No. 536 on UPF consumption in the U.S. (CDC Data Brief); national profiling of UPFs in Thailand (Globalization and Health 2023); WHO Thailand feature on obesity and policy measures (WHO Thailand); BMJ review of UPFs and health outcomes (BMJ review); Lancet policy analysis on identifying unhealthy products (Lancet AM article).