The South Asia Biobank study was the first large-scale analysis of UPF intake patterns in South Asian adults. It covers data from over 60,000 individuals across Bangladesh, India, Pakistan, and Sri Lanka, collected between 2020 and 2022.
The researchers noted that this was the first study to look at ultra-processed food intake in a large and diverse sample of South Asian adults, and they observed significant differences between regions.
Biscuits dominate, but country-specific trends emerge
Researchers used 24-hour dietary recalls conducted through in-person interviews to assess food intake. They then applied the NOVA classification system, which ranks food based on the extent and purpose of industrial processing.
Biscuits were the most commonly consumed UPF across all four countries, reflecting their widespread availability, low cost, and cultural familiarity. However, the types of UPFs people consumed varied sharply depending on the country. In Pakistan, sweetened beverages were the leading UPF, while in South India, packaged salty snacks topped the list. In Bangladesh, breakfast cereals were more commonly consumed.
Wide gaps in consumption levels
There were also large differences in overall UPF consumption between countries and regions. In Bangladesh, Sri Lanka, and North India, around 75% of respondents reported eating at least one UPF item in the previous 24 hours. In contrast, only 41% of participants in South India and Pakistan had done the same.
Among consumers, UPFs accounted for 13% to 17% of total daily energy intake. While these levels were lower than those seen in Western countries, the researchers cautioned that South Asia was undergoing a rapid shift in dietary patterns.
They noted that even if the current contribution of UPFs seemed modest, the growth in their sales and consumption pointed to a major shift that could worsen the burden of diabetes and cardiovascular disease.
Age and gender patterns not uniform
Demographic trends also varied by country. In Pakistan and Sri Lanka, UPF consumption was higher among younger adults aged 18 to 39. But in Bangladesh and North India, older adults were more likely to consume these products.
Gender also influenced intake. Across most regions, women were more likely to consume UPFs —except in Bangladesh, where intake was higher among the male population. In Sri Lanka, rural women had the highest UPF consumption, whereas in Pakistan, urban men topped the list.
These findings indicated that there was no single profile of a UPF consumer in South Asia. Therefore, public health campaigns will need to account for these regional and cultural differences.
Socioeconomic factors drive opposing trends
Income and education were also strong predictors of UPF consumption, but their effects differed by region.
In Bangladesh, Pakistan, and North India, people with higher education levels and higher household income were more likely to consume UPFs. However, in Sri Lanka and South India, the trend was reversed: UPF intake was higher among lower-income groups.
The researchers suggested that pricing and packaging strategies used by food companies could be driving this pattern. In markets like Sri Lanka and South India, manufacturers often offer smaller, low-cost packages that appeal to price-sensitive consumers in rural and low-income settings.
Multi-national companies (MNCs) have been highly effective in adapting products for affordability in emerging markets. This explains why biscuits and packaged snacks are often more commonly consumed among lower-income and rural groups.
Marital status and household size influence behaviour
Living arrangements also appeared to shape dietary habits. Across all four countries, married or cohabiting individuals consumed fewer UPFs than those who were single. In Bangladesh and Pakistan, people living in single-person households had the highest consumption rates.
This could be reflective of social eating patterns — those who cook for families may rely more on traditional, less processed foods, while individuals living alone may turn to packaged convenience products.
Implications for public health and industry
The findings come at a time when South Asia is experiencing a sharp rise in non-communicable diseases such as type 2 diabetes, heart disease, and obesity. Between 2001 and 2016, UPF sales increased by more than 200% in India and Pakistan, underscoring the urgency of targeted interventions.
The researchers noted that policies to reduce UPF consumption would need to be region-specific, as what would work in one country may not work in another. Tailored strategies could include clearer nutrition labelling, restrictions on advertising, or targeted campaigns that address popular products like biscuits.
The researchers further observed that the private sector would play a key role in shaping the future of food in the region. Manufacturers may face pressure to reformulate products, introduce healthier options, and comply with new regulations as governments respond to growing public health concerns.
“Further studies are needed to confirm our overall findings and to understand the barriers to consumption of less processed foods. Additionally, conducting similar studies in younger population groups, including infants, children, and adolescents, will provide valuable public health insights,” they said.
“Further research in South Asia will help to confirm and expand our findings on the drivers of UPF consumption. Combined with studies on the link between UPF consumption and health outcomes, this research will be vital in shaping effective public health strategies in South Asia as it navigates through economic growth, urbanisation, globalisation, and dietary transition.”
Source: The Lancet Regional Health — Southeast Asia
“Quantification of regional variation in ultra-processed food consumption and its sociodemographic correlates across Bangladesh, India, Pakistan, and Sri Lanka: insights from the South Asia Biobank”
https://doi.org/10.1016/j.lansea.2025.100633
Authors: Divya Bhagtani, et al.
