
Introduction to Ultra-processed foods (UPF’s)
In today’s fast-paced world, convenience often takes precedence over nutrition, leading to the widespread consumption of ultra-processed foods (UPFs). These foods, which include items like chips, sugary cereals, frozen dinners, and fizzy drinks, have become staples in many diets globally. However, the convenience of UPFs comes at a significant cost to our health.
Recent studies have highlighted a concerning statistic: one in five deaths globally is linked to poor diet1. This alarming figure underscores the importance of understanding the impact of UPFs on our health. Unlike whole, unprocessed foods, UPFs are often high in unhealthy fats, sugars, and salts, while being low in essential nutrients. The transformation of simple, whole foods into these highly processed products results in a loss of nutritional value and an increase in harmful additives and preservatives.
The rise in UPF consumption is not just a matter of personal choice but is also driven by corporate profit motives and misleading advertising. Companies prioritize profit over consumer health, employing cost-cutting measures that compromise food quality and using marketing strategies that falsely present UPFs as healthy choices.
Statistics show that UPFs make up over 50% of daily calories consumed in the United States2. In fact, 73% of the food on grocery store shelves in America is ultra-processed3. This trend is not limited to the US; the UK also ranks high in UPF consumption3. The increase in UPF consumption is linked to urbanization, industrialization, and the global spread of Western dietary habits.
This blog post aims to delve deep into the hidden dangers of ultra-processed foods, exploring their various categories, the health risks they pose, and the corporate practices that promote them. By understanding these factors, we can make more informed dietary choices and advocate for a shift towards whole, unprocessed foods for better health and well-being.
1: Global Food Research Program 2: Ballard Brief 3: UPI
Understanding Ultra-Processed Foods
Definition and Characteristics of UPFs
Ultra-processed foods (UPFs) are industrial formulations typically made from substances derived from foods, along with additives. These foods undergo multiple physical, biological, and chemical processes, resulting in products that are far removed from their original state. Common characteristics of UPFs include high levels of added sugars, unhealthy fats, and salt, as well as artificial flavors, colors, and preservatives.
Differences Between Processed and Ultra-Processed Foods
While processed foods may include items like canned vegetables or whole-grain bread, which retain some nutritional value, ultra-processed foods are significantly altered and often contain little to no whole food ingredients. The extensive processing strips away essential nutrients and introduces various additives that can be harmful to health.
Categories of UPFs
- Junk Food: Includes items like chips (e.g., Doritos, Lay’s), snack cakes (e.g., Twinkies, Little Debbie cakes), and other packaged snacks. These foods are typically high in calories, fats, and sugars, but low in nutritional value.
- Treats and Desserts: Examples include cookies (e.g., Oreos, Chips Ahoy), cakes (e.g., Hostess cupcakes, Sara Lee pound cake), and ice cream (e.g., Ben & Jerry’s, Häagen-Dazs). These items are often loaded with sugar and unhealthy fats.
- Frozen Food Dinners: TV dinners (e.g., Stouffer’s, Lean Cuisine), frozen pizzas (e.g., DiGiorno, Totino’s), and other ready-to-eat meals (e.g., Hungry-Man dinners). They are convenient but often high in sodium and preservatives.
- Fizzy Drinks: Sodas (e.g., Coca-Cola, Pepsi), energy drinks (e.g., Red Bull, Monster), and other sugary beverages (e.g., Fanta, Mountain Dew) are major contributors to excessive sugar intake.
- Candies: Chocolates (e.g., Snickers, M&M’s), gummies (e.g., Haribo, Gummy Bears), and other sweets (e.g., Skittles, Starburst) are high in sugar and often contain artificial colors and flavors.
- Breakfast Cereals: Many popular cereals (e.g., Frosted Flakes, Froot Loops) are high in sugar and low in fiber, despite being marketed as healthy options.
- Frozen Breakfast Foods: Items like waffles (e.g., Eggo), breakfast sandwiches (e.g., Jimmy Dean), and pancakes (e.g., Aunt Jemima) are convenient but often contain unhealthy fats and preservatives.
- Fast Food: Includes items from fast food chains such as burgers (e.g., McDonald’s Big Mac, Burger King’s Whopper), fried chicken (e.g., KFC, Popeyes), and fries (e.g., McDonald’s fries). These foods are typically high in unhealthy fats, sodium, and calories.
- Restaurant Food: Many restaurant dishes, even those that seem healthy, can contain numerous processed ingredients and UPFs. Examples include:
- Sauces and Dressings: Many sauces and dressings used in restaurants, such as ranch dressing, barbecue sauce, and Alfredo sauce, often contain high levels of preservatives, artificial flavors, and added sugars.
- Processed Meats: Items like deli meats, sausages, and bacon used in various dishes are often highly processed and contain nitrates and other preservatives.
- Breads and Baked Goods: Many breads, buns, and pastries served in restaurants are made with refined flours and contain additives to enhance texture and shelf life.
- Fried Foods: Fried appetizers and sides, such as mozzarella sticks, onion rings, and chicken tenders, are typically coated in batters that contain multiple processed ingredients and are fried in oils that can be high in trans fats.
Understanding these categories helps highlight the prevalence of UPFs in our diets and the need for greater awareness of their health impacts.
The Nutrient Loss and Toxicity of UPFs
Processing of Whole Foods
Ultra-processed foods (UPFs) undergo extensive processing that strips away essential nutrients and introduces various additives. This transformation often involves multiple physical, biological, and chemical processes, resulting in products that are far removed from their original state.
Nutrient Loss in UPFs
The intense industrial processes used to produce UPFs destroy the natural structure of the food ingredients and strip away many beneficial nutrients such as fiber, vitamins, minerals, and phytochemicals1. Here are some key points on how nutrient loss occurs:
- Refining and Milling: Processes like refining grains remove the bran and germ, which contain most of the fiber, vitamins, and minerals. This results in products like white flour and white rice, which are less nutritious than their whole-grain counterparts1.
- High-Heat Processing: Techniques such as baking, frying, and extrusion (used in making snacks and cereals) can degrade heat-sensitive nutrients like vitamins A, C, and E1.
- Addition of Unhealthy Ingredients: To improve taste and shelf life, manufacturers add unhealthy fats, sugars, and salt, which can displace the natural nutrients originally present in the food1.
- Use of Additives: While additives like preservatives and artificial colors enhance the appearance and longevity of UPFs, they do not contribute to the nutritional value and can sometimes have adverse health effects1.
Specific Additives in UPFs
UPFs contain a wide range of additives designed to enhance flavor, texture, shelf life, and appearance. Here are some common additives found in UPFs:
- High-Fructose Corn Syrup (HFCS): A sweetener made from corn starch that is commonly used in sodas, candies, and baked goods. HFCS is linked to obesity and metabolic disorders1.
- Hydrogenated Oils: These oils are chemically altered to stay solid at room temperature and are found in margarine, snack foods, and baked goods. They contain trans fats, which are associated with heart disease1.
- Artificial Sweeteners: Substitutes for sugar, such as aspartame, sucralose, and saccharin, are used in diet sodas and sugar-free products. Some studies suggest they may affect gut health and metabolism1.
- Emulsifiers: Additives like lecithin, mono- and diglycerides, and polysorbates are used to improve texture and extend shelf life in products like ice cream, salad dressings, and baked goods. They may disrupt gut bacteria and contribute to inflammation1.
- Preservatives: Chemicals such as sodium benzoate, potassium sorbate, and nitrates are used to prevent spoilage and extend shelf life in processed meats, canned foods, and beverages. Some preservatives have been linked to cancer and other health issues1.
- Artificial Colors: Synthetic dyes like Red 40, Yellow 5, and Blue 1 are used to enhance the appearance of foods and beverages. These colors have been associated with hyperactivity in children and other health concerns1.
- Flavor Enhancers: Additives like monosodium glutamate (MSG) are used to enhance the taste of savory foods. MSG has been linked to headaches and other adverse reactions in some individuals1.
- Thickeners and Stabilizers: Ingredients such as xanthan gum, carrageenan, and guar gum are used to improve texture and consistency in products like sauces, dairy products, and baked goods. Some thickeners may cause digestive issues1.
Comparison with Whole Foods
Whole, unprocessed foods do not contain these additives and retain their natural nutrients. Consuming whole foods, such as fruits, vegetables, whole grains, and lean proteins, provides essential vitamins, minerals, and fiber without the added chemicals found in UPFs. This makes whole foods a healthier choice for maintaining overall well-being.
Understanding the specific additives in UPFs highlights the potential health risks associated with their consumption and underscores the benefits of choosing whole, unprocessed foods.
Would you like to proceed with the next section on corporate profit over safety and quality?
Corporate Profit Over Safety and Quality
Corporate Profit Motives in the Food Industry
The food industry is driven by profit motives that often prioritize financial gain over consumer health and safety. Here are some key aspects of how corporate profit motives shape the food environment:
- Cost-Cutting Measures: To maximize profits, food companies often use cheaper ingredients and additives. This can lead to the inclusion of unhealthy fats, sugars, and preservatives in products, which can be detrimental to health1.
- Marketing and Advertising: Food companies spend billions on marketing, particularly targeting children and young adults. For example, in the United States, food companies spend about $10 billion annually marketing foods high in added sugars to children1. This aggressive marketing creates a demand for unhealthy foods and influences dietary habits from a young age.
- Lobbying and Policy Influence: Large food corporations invest heavily in lobbying efforts to influence food policies and regulations. This can result in weaker regulations on food labeling, safety standards, and nutritional guidelines, allowing companies to continue producing and marketing unhealthy products1.
- Misleading Health Claims: Companies often use “halo” advertising schemes to make UPFs appear healthier than they are. This includes highlighting certain positive aspects, such as added vitamins or low-fat content, while downplaying the high levels of sugar, salt, and unhealthy fats1.
- Externalizing Health Costs: The health impacts of consuming UPFs, such as obesity, diabetes, and heart disease, result in significant social and economic costs. However, these costs are often borne by individuals and public health systems, rather than the corporations that produce and market these foods1.
Examples of Corporate Practices
- Processed Grains and Added Sugars: The calorie content of the US food supply has increased due to the widespread use of processed grains and added sugars. These ingredients now comprise up to 40% of calories in the average American diet1.
- High Profit Margins: The food processing industry enjoys high profit margins, with a gross profit margin of 31.99% and a net profit margin of 12.1% as of early 20242. These margins are significantly higher than the market average, indicating the profitability of producing and selling UPFs2.
- Price Inflation: In recent years, food corporations have been charging premiums for their products, citing supply chain disruptions. This has led to record profits for these companies, even as consumers face higher food prices3.
Understanding the profit motives behind the production and marketing of UPFs highlights the need for greater transparency and regulation in the food industry. By recognizing these corporate practices, consumers can make more informed choices and advocate for healthier food environments.
Further Examples of Corporate Practices
- Using Low-Cost, Low-Quality Additives: To maximize profits, food companies often use inexpensive, nutrient-devoid additives that further lower the quality of their products. Common additives include:
- Cellulose: A plant fiber used as a filler and thickener in products like shredded cheese and ice cream. It adds bulk without nutritional value1.
- Maltodextrin: A highly processed carbohydrate used as a thickener and preservative in snacks and sauces. It has a high glycemic index and can spike blood sugar levels1.
- Sodium Nitrite: Used in processed meats to preserve color and prevent bacterial growth. It has been linked to an increased risk of cancer1.
- Artificial Flavors and Colors: Synthetic chemicals used to enhance taste and appearance. They can cause allergic reactions and other health issues1.
- High-Fructose Corn Syrup (HFCS): A sweetener linked to obesity and metabolic disorders1.
- Hydrogenated Oils: Contain trans fats, which are associated with heart disease1.
These practices not only reduce the nutritional quality of foods but also introduce potentially harmful substances into the diet.
1: Union of Concerned Scientists 2: Investopedia 3: Civil Eats
Scientific Testing and Development for Addiction
Food corporations employ scientific testing and development to create products that are not only palatable but also addictive. This strategy ensures repeat purchases and maximizes profits. Key methods include:
- Hyper-Palatability: UPFs are engineered to be hyper-palatable, combining high levels of sugar, fat, and salt to create flavors that are difficult to resist. This combination triggers the brain’s reward system, similar to addictive substances2.
- Flavor Enhancers: Additives like monosodium glutamate (MSG) and artificial flavors are used to enhance taste and create a more intense eating experience2.
- Texture and Mouthfeel: Scientific research is used to perfect the texture and mouthfeel of UPFs, making them more enjoyable to eat and encouraging overconsumption2.
- Marketing to Vulnerable Populations: Aggressive marketing strategies target children and young adults, who are more susceptible to developing addictive eating behaviors2.
Studies have shown that the addictive potential of UPFs can be comparable to that of drugs and alcohol. The Yale Food Addiction Scale (YFAS) has been used to measure food addiction, revealing that approximately 14% of adults and 12% of children exhibit signs of addiction to UPFs2. This addiction is linked to reward-related neural dysfunction, impulsivity, and emotional dysregulation, further driving the consumption of these unhealthy foods2.
Understanding these corporate practices highlights the need for greater regulation and transparency in the food industry to protect consumer health and well-being.
Would you like to proceed with the next section on health decline linked to UPFs?
Health Decline Linked to Ultra-processed foods
Comprehensive Review Findings
Recent studies have highlighted the significant health risks associated with the consumption of ultra-processed foods (UPFs). An umbrella review analyzing studies involving almost 10 million people identified 32 harmful health effects linked to UPFs. These include:
- Heart Disease: UPFs are high in unhealthy fats, sugars, and sodium, which contribute to the development of cardiovascular diseases.
- Type 2 Diabetes: The high sugar content in UPFs leads to insulin resistance and increased risk of diabetes.
- Obesity: UPFs are calorie-dense and nutrient-poor, promoting weight gain and obesity.
- Poor Mental Health: Diets high in UPFs have been linked to depression, anxiety, and other mental health issues.
Mechanisms Behind the Health Risks
The health risks associated with UPFs can be attributed to several factors:
- Nutritional Quality: UPFs are often high in unhealthy fats, sugars, and salt, while being low in essential nutrients. This imbalance can lead to various health issues, including obesity, diabetes, and heart disease.
- Eating Behavior: The lack of structure and texture in UPFs can lead to faster eating and increased blood sugar levels. This can result in overeating and weight gain.
- Additives and Chemicals: UPFs contain various additives and preservatives that can have adverse health effects. For example, artificial sweeteners may affect gut health and metabolism, while preservatives like sodium nitrite have been linked to cancer.
Variability in Health Effects
The health effects of UPFs can vary depending on the specific foods and the population consuming them. Some UPFs may have more harmful ingredients than others, and certain populations may be more susceptible to the negative health impacts. Large-scale studies are essential to identify the specific harmful foods and understand their effects on different populations.
Graphing Health Decline
Visual representations of health trends since the introduction of UPFs can help illustrate the impact of these foods on public health. Graphs showing the rise in obesity, diabetes, and other health issues can provide a clear picture of the health decline linked to UPFs.
Prevalent Diseases
- Heart Disease: The leading cause of death globally, with UPFs contributing significantly to its prevalence.

- High Cholesterol: Diets high in trans fats and unhealthy oils found in UPFs can lead to elevated cholesterol levels.

- High Blood Pressure: The high sodium content in many UPFs is a major risk factor for hypertension.

- Diabetes: Both type 2 diabetes and trends in infant and youth diabetes are on the rise due to high sugar consumption from UPFs.

Impact of Sugar and Fizzy Drinks
Sugary beverages, including sodas and energy drinks, are major contributors to the health decline associated with UPFs. These drinks are high in added sugars, leading to increased risks of obesity, diabetes, and other metabolic disorders.
Understanding the health decline linked to UPFs underscores the importance of making informed dietary choices and advocating for healthier food environments.
The Rise of Obesity and Overweight from Ultra Processed Food
Graphing Obesity Trends
The rise in obesity rates over the past few decades has been alarming. Visual representations of obesity trends can help illustrate the impact of ultra-processed foods (UPFs) on public health. Here is a graph showing the increase in obesity rates in the United States and Europe from 1980 to 2020, alongside the increasing consumption of UPFs:

Correlation with Ultra-processed foods Consumption
The correlation between the rise in obesity and the increased consumption of UPFs is evident. UPFs are calorie-dense and nutrient-poor, leading to overconsumption and weight gain. Several factors contribute to this correlation:
- High Caloric Density: UPFs are often high in calories but low in essential nutrients, leading to excessive calorie intake without providing the necessary nutrients for a healthy diet.
- Low Satiety: The lack of fiber and protein in UPFs means they do not promote a feeling of fullness, leading to overeating.
- Addictive Properties: The combination of sugar, fat, and salt in UPFs can trigger the brain’s reward system, similar to addictive substances, encouraging overconsumption.
Impact on Different Populations
The rise in obesity is not uniform across all populations. Certain groups, such as children and low-income communities, are more vulnerable to the effects of UPFs. Factors contributing to this include:
- Targeted Marketing: Food companies often target children and low-income communities with aggressive marketing campaigns for UPFs.
- Accessibility and Affordability: UPFs are often more accessible and affordable than healthier options, making them a more attractive choice for low-income families.
- Lack of Education: Limited access to nutrition education can lead to poor dietary choices and a lack of awareness about the health risks associated with UPFs.
Global Impact
The influence of Western dietary habits, characterized by high UPF consumption, has spread globally. This has led to a rise in obesity rates in both developed and developing countries. The global impact of UPFs includes:
- Urbanization and Industrialization: As countries urbanize and industrialize, the availability and consumption of UPFs increase, leading to higher obesity rates.
- Cultural Shifts: The adoption of Western dietary habits in other cultures has resulted in a shift away from traditional diets, which are often healthier and more balanced.
- Economic Burden: The rise in obesity and related health issues places a significant economic burden on healthcare systems worldwide.
Understanding the rise of obesity and overweight linked to UPFs underscores the importance of making informed dietary choices and advocating for healthier food environments. By addressing the factors contributing to obesity, we can work towards reducing its prevalence and improving public health.
Section 6: Global Impact of Western Dietary Habits
Western Influence on Global Diets
The spread of Western dietary habits has significantly influenced global food choices. This shift is characterized by an increased consumption of ultra-processed foods and fast foods high in fat, salt, and sugar. These dietary patterns, once prevalent mainly in Western countries, are now becoming common in various parts of the world, including developing nations.
Impact on Health in Both Third-World and First-World Countries
The adoption of Western dietary habits has had profound health impacts globally. In third-world countries, the introduction of ultra-processed foods has led to a rise in non-communicable diseases such as type 2 diabetes, cardiovascular diseases, and certain cancers. These health issues are exacerbated by limited access to healthcare and nutritional education.
In first-world countries, the prevalence of obesity and related health conditions continues to rise. The convenience and affordability of fast food contribute to poor dietary choices, leading to increased rates of chronic diseases. The environmental impact is also significant, as the production of these foods often involves unsustainable practices that contribute to pollution and resource depletion.
Case Studies
Several countries have experienced notable health declines due to the influence of Western dietary habits:
- Mexico: The rise in consumption of sugary beverages and fast food has led to an obesity epidemic. Mexico now has one of the highest rates of obesity in the world, with significant increases in diabetes and heart disease.
- India: Urbanization and economic growth have introduced Western fast food chains, leading to a dietary shift away from traditional foods. This has resulted in a surge in obesity and diabetes, particularly among urban populations.
- China: Rapid economic development and urbanization have led to increased consumption of Western-style fast foods. This dietary shift has been linked to rising rates of obesity, hypertension, and other diet-related diseases.
- Brazil: The rise in consumption of ultra-processed foods and sugary beverages has led to increased rates of obesity and related health issues such as diabetes and hypertension. The traditional diet, rich in fruits, vegetables, and legumes, is being replaced by fast food and processed snacks.
- South Africa: Western dietary patterns have become more prevalent, contributing to a surge in obesity and non-communicable diseases. The shift from traditional diets to fast foods high in fat, salt, and sugar has had a significant impact on public health.
- Lebanon: The adoption of Westernized dietary patterns, characterized by higher intakes of packaged and fast foods, has been associated with increased rates of hypertension and higher body mass index (BMI) among the population.
- Japan: Although Japan traditionally has a healthy diet, the influence of Western fast food chains has led to a rise in obesity and related health problems, particularly among younger generations.
Here are some health studies with full-text access that explore the impact of Western dietary habits on various countries:
Mexico
- Trends in the dietary patterns of Mexican adults by sociodemographic characteristics
https://nutritionj.biomedcentral.com/articles/10.1186/s12937-020-00568-2 - Western and Modern Mexican dietary patterns are directly associated with incident hypertension in Mexican women
https://nutritionj.biomedcentral.com/articles/10.1186/s12937-018-0332-3
India
- Dietary patterns in India: a systematic review
https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/dietary-patterns-in-india-a-systematic-review/2E87DD7E1D9272CD12C98F2C6715A697 - A comparison of the Indian diet with the EAT-Lancet reference diet
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-08951-8
China
- Exploring the traditional Chinese diet and its association with health status—a systematic review
https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuae013/7624152 - Analysis of the health effects of the transition of traditional Chinese food on the emergence of nontraditional eating behaviors
https://journalofethnicfoods.biomedcentral.com/articles/10.1186/s42779-021-00087-3
Brazil
- Health, lifestyle and sociodemographic characteristics are associated with Brazilian dietary patterns
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247078 - Dietary patterns of Brazilian farmers and their relation with sociodemographic, labor, and lifestyle conditions
https://nutritionj.biomedcentral.com/articles/10.1186/s12937-020-00542-y
South Africa
- Knowledge, Perception and Consumption of Indigenous Foods in Gauteng Region, South Africa
https://www.mdpi.com/1660-4601/20/20/6961 - Dietary habits among health professionals working in a district hospital in KwaZulu-Natal, South Africa
https://www.academia.edu/49323626/A_Western_dietary_pattern_is_associated_with_overweight_and_obesity_in_a_national_sample_of_Lebanese_adolescents_13_19_years_a_cross_sectional_study
Lebanon
- A Western dietary pattern is associated with overweight and obesity in a national sample of Lebanese adolescents
Full Text - Dietary Intake among Lebanese Adults: Findings from the Updated LEBANese natiONal Food Consumption Survey
https://www.mdpi.com/2072-6643/16/11/1784
Japan
- Effects of Differences of Breakfast Styles, Such as Japanese and Western Breakfasts, on Eating Habits
https://www.mdpi.com/2072-6643/14/23/5143 - Food intake patterns and cardiovascular risk factors in Japanese adults
https://nutritionj.biomedcentral.com/articles/10.1186/s12937-017-0284-z
These studies provide valuable insights into how Western dietary habits are influencing health outcomes in these countries.
Long-Term Consequences of These Dietary Shifts
The long-term consequences of the global shift towards Western dietary habits are multifaceted and significant. Here are some key impacts:
Health Consequences
- Increased Prevalence of Chronic Diseases: Diets high in ultra-processed foods, saturated fats, sugars, and salts are linked to a rise in non-communicable diseases such as obesity, type 2 diabetes, cardiovascular diseases, and certain cancers. These conditions place a heavy burden on healthcare systems worldwide.
- Nutritional Deficiencies: The Western diet often lacks essential nutrients, leading to deficiencies in vitamins and minerals such as Vitamin A, Vitamin C, Vitamin D, and Zinc. This can impair immune function and overall health.
- Mental Health Issues: Poor dietary patterns are associated with mental health problems, including depression and cognitive decline. High-calorie, high-fat diets can stimulate inflammation, which is linked to various mental health conditions.
Environmental Consequences
- Resource Depletion: The production of ultra-processed foods and fast foods often involves unsustainable agricultural practices that deplete natural resources and contribute to environmental degradation.
- Pollution: The food industry, particularly the production of processed and packaged foods, is a significant source of pollution. This includes greenhouse gas emissions, water pollution, and plastic waste.
Socioeconomic Consequences
- Healthcare Costs: The rise in diet-related chronic diseases leads to increased healthcare costs. For example, in the U.S., dietary factors drive more than $50 billion in annual healthcare costs related to conditions such as heart disease, type 2 diabetes, and stroke1.
- Economic Burden: The economic impact extends beyond healthcare costs to include lost productivity due to illness and premature death. This can strain economies, particularly in developing countries where healthcare infrastructure may already be limited2.
Cultural Consequences
- Loss of Traditional Diets: The global spread of Western dietary habits often leads to the erosion of traditional diets, which are typically healthier and more sustainable. This cultural shift can result in the loss of culinary heritage and traditional food practices.
Addressing these long-term consequences requires a comprehensive approach, including public health initiatives, policy changes, and education to promote healthier and more sustainable eating patterns.
1: NHLBI 2: Global Nutrition Report
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