SHIFTS-UPF: Study on Health Impacts of Food Taxes and Subsidies affecting Ultra Processed Food

What are the health and health inequality effects of fiscal policy interventions that impact the purchase of Ultra-Processed Foods (UPFs)? UPFs are industrially-formulated products made from substances extracted from foods, derived from food constituents, or synthesised in laboratories, often containing additives (e.g. crisps and sugary cereals). Their consumption is negatively associated with health outcomes, including obesity, type 2 diabetes, cardiovascular disease, NHS costs and environmental harms. Although taxation and subsidies have been shown to reduce the consumption of high fat, sugar and salt (HFSS) products, limited evidence exists on their impact on UPF consumption. This is because UPFs are defined by their processing level, not their nutrient content, meaning some UPFs (like artificially-sweetened drinks or plan-based meat substitutes) may not meet HFSS thresholds. This gap in policy-relevant evidence makes it difficult to design effective fiscal strategies targeting UPFs and highlights the need for dedicated research. This study aims to evaluate the potential impact of fiscal policies (taxes on UPFs and subsidies for healthier alternatives) on consumption patterns, health and environmental outcomes, household and NHS costs. A mixed-methods approach will ensure a comprehensive understanding of the problem and support the development of realistic and acceptable policy recommendations, including: • A review of proposed or implemented food-related fiscal policies relevant to UPFs • Public consultations to explore consumer attitudes toward potential fiscal measures and identification of key barriers, focusing on disadvantaged communities • Stakeholder engagement with policymakers and the food industry to ensure the feasibility and political acceptability of proposed fiscal measures • A systematic review of evidence of the links between UPF consumption and health to populate our health model • Statistical and microsimulation modelling to predict the impact of fiscal policies on dietary intake, disease burden, environmental outcomes, household and NHS costs across socioeconomic and demographic groups Our team has significant experience in co-designing and modelling HFSS-related fiscal measures and will build on this by adapting existing consumer demand, health and environmental models to account for the distinctiveness of UPFs. The project has four main Objectives that will be delivered over 2 years: 1: Overview of UPF purchases (based on analysis of consumer purchase data); 2: Co-design of fiscal policy scenarios (using a scoping review, public focus groups and stakeholder deliberative forums); 3: Consumer demand modelling (development of existing proven models); and 4: Modelling health, environmental and cost impacts. This project will generate new, policy-relevant evidence on the effectiveness of fiscal measures in reducing UPF consumption and trade-offs or synergies with current HFSS policies. This will support future policy development and contribute to national efforts to reduce diet-related disease, adverse environmental impacts, health inequalities, household and NHS costs. Dissemination, co-developed with PPIE collaborators, will target the general public, policymakers, food industry, and scientific and public health communities. Dissemination activities will be designed to communicate findings, support real-world application, and maximise the project’s influence on practice, policy, and public understanding.