Research

Mixed

Joining US Free Trade Agreements (FTAs) causes a statistically significant increase in the per capita sales of ultra-processed foods, processed culinary ingredients, and infant formula.

If you are involved in policy or public health advocacy, recognize that Free Trade Agreements with the US are a key driver of increased ultra-processed food and infant formula sales in partner countries. To protect public health, advocate for health exemptions in trade agreements, similar to tobacco carve-outs, to allow governments to regulate or tax these products without fear of legal challenges from corporations.

GoodSupportsHIGH confidence
After countries join a US FTA, sales are estimated to increase by: 0·89 (95 % CI 0·16, 1·6; P = 0·016) kg per capita per annum for ultra-processed products, 0·81 (95 % CI 0·47, 1·1; P < 0·001) kg per capita per annum for processed culinary ingredients and 0·17 (95 % CI 0·052, 0·29; P = 0·005) kg per capita under age 5 per annum for baby food.
Krycia Cowling et al. · Public Health Nutrition · 2020

Why this rating

Uses a rigorous comparative interrupted time-series (CITS) design with matching, though it is observational and relies on sales data as a proxy for consumption.

Source

The relationship between joining a US free trade agreement and processed food sales, 2002–2016: a comparative interrupted time-series analysis

Krycia Cowling et al. · Public Health Nutrition · 2020

DOI 10.1017/s1368980019003999

cohort · n=21Cited 8×
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DOI resolved against Crossref · corpus check 2026-06-10

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