Exploring the understanding of the term "ultra-processed foods" by young consumers

How Promising Are "Ultraprocessed" Front-of-Package Labels? A Formative Study with US Adults

High levels of food processing can have detrimental health effects independent of nutrient content. Experts and advocates have proposed adding information about food processing status to front-of-package labeling schemes, which currently exclusively focus on nutrient content. How consumers would perceive "ultraprocessed" labels has not yet been examined. To address this gap, we conducted a within-subjects online experiment with a convenience sample of 600 US adults. Participants viewed a product under three labeling conditions (control, "ultraprocessed" label, and "ultraprocessed" plus "high in sugar" label) in random order for a single product. The "ultraprocessed" label led participants to report thinking more about the risks of eating the product and discouraging them from wanting to buy the product more than the control, despite not grabbing more attention than the control. The "ultraprocessed" plus "high in sugar" labels grabbed more attention, led participants to think more about the risks of eating the product, and discouraged them from wanting to buy the product more than the "ultraprocessed" label alone. "Ultraprocessed" labels may constitute promising messages that could work in tandem with nutrient labels, and further research should examine how they would influence consumers' actual intentions and behaviors.

From harmful nutrients to ultra-processed foods: exploring shifts in 'foods to limit' terminology used in national food-based dietary guidelines

OBJECTIVE

The choice of terms used to describe 'foods to limit' (FTL) in food-based dietary guidelines (FBDG) can impact public understanding, policy translation and research applicability. The choice of terms in FBDG has been influenced by available science, values, beliefs and historical events. This study aimed to analyse the terms used and definitions given to FTL in FBDG around the world, including changes over time and regional differences.

DESIGN

A review of terms used to describe FTL and their definitions in all current and past FBDG for adults was conducted, using a search strategy informed by the FAO FBDG website. Data from 148 guidelines (96 countries) were extracted into a pre-defined table and terms were organised by the categories 'nutrient-based', 'food examples' or 'processing-related'.

SETTING

National FBDG from all world regions.

PARTICIPANTS

None.

RESULTS

Nutrient-based terms (e.g. high-fat foods) were the most frequently used type of term in both current and past dietary guidelines (91 %, 85 %, respectively). However, food examples (e.g. cakes) and processing-related terms (e.g. ultra-processed foods) have increased in use over the past 20 years and are now often used in conjunction with nutrient-based terms. Regional differences were only observed for processing-related terms.

CONCLUSION

Diverse, and often poorly defined, terms are used to describe FTL in FBDG. Policymakers should ensure that FTL terms have clear definitions and can be integrated with other disciplines and understood by consumers. This may facilitate the inclusion of the most contemporary and potentially impactful terminology in nutrition research and policies.

Is food produced by farmers healthier, more natural, and gaining more popularity? Research on the influencing mechanism of food producer labels on consumers' food choices

Introduction

Extant studies have demonstrated the relationship between naturalness and healthiness, and the effectiveness of various food labels in influencing consumers' perception of food and subsequent food choices. However, little attention has been given to food producer labels.

Methods

Drawing on Stimulation-Organism-Response theory, the current study explored the causal relationship between food producer labels and consumers' food choices. Three studies (562 participants) were employed to test the main effect, the mediating effect, and the moderating effect.

Results

The results showed that: (1) food producer label could influence consumers' food choice, that is, produced-by-farmer label (vs. produced-by-enterprise label vs. control group) could significantly increase consumers' food choices, while there is no significant difference between produced-by-enterprise label and control group. (2) Perceived naturalness and standardization perception mediate the effects on consumers' food choices of food producer labels. (3) Food processing level moderates the effect of food producer label on consumers' food choices.

Discussion

The current study enriches the research of food label and food choice, expands the application of Stimulation-Organism-Response theory in consumer behavior, and provides some practical suggestions for consumers, enterprise and policy-maker. Various kinds of experiments (online and offline) enhanced the conclusions' ecological validity. Finally, the limitations and future research are discussed.

A Preliminary Study on the Validity and Stability of Projective Methods: An Application of the Structural Approach of Social Representations with Traditional Mexican Cheeses

Projective methods are qualitative tools used to study food consumer behavior. In recent years, there has been an increase in studies that use these tools to analyze consumer behavior, particularly with the word association (WA) technique. However, one of the challenges in using these methods is the stability and validity of the data. This research aimed to obtain preliminary information on the stability and validity of the associations generated by consumers with the WA technique, using the structural approach of social representations. For this, two studies were carried out; for the first study, a face-to-face survey was carried out in which 89 consumers participated, who wrote the first words that came to mind with the stimulus “Aculco” on a ballot paper. For the second study, 122 consumers completed the same task as in the first study; however, the participants were recruited from an online survey. A random sample (n = 50) of both studies was selected to explore the stability and validity of the results. In the three study samples, the words were grouped into categories and analyzed through the structural approach of social representations. The frequency of mention of the identified categories was compared with the chi-square test and the average position (AP) and the Cognitive Salience Index (CSI) were calculated. Prototype maps were built to study the structure of the categories according to the central core and peripheral areas. Cluster analysis was performed to corroborate the structure of the representations. Finally, multiple factor analysis (MFA) was performed to determine the similarity of the results obtained from the three samples using the RV coefficient. No statistical differences (p > 0.05) were identified in most of the representations (n = 11) generated from the WA task. Furthermore, the representation “Cheese and dairy products” was positioned in the central core of the three maps. The APs and the CSIs of each representation were similar in the three study samples. The RV coefficient (≥0.80) indicated similarity in the representations obtained. Results of this research can be useful for future studies that attempt to compare the stability and validity of the information based on qualitative and more flexible methodologies. Some methodological implications related to the validity and stability of projective methods are discussed.

Representations of Ultra-Processed Foods: A Global Analysis of How Dietary Guidelines Refer to Levels of Food Processing

BACKGROUND

As evidence grows about negative health impacts of ultra-processed foods (UPFs), nutrient-centred advice is contested, and food-based dietary guidelines are increasingly utilised. Previous analyses of dietary guidelines evaluated their potential impact on health and sustainability, but little research has been conducted to examine how the concept of UPFs is reflected in dietary advice for consumers. This paper systematically analyses whether and how UPFs are represented in dietary guidelines internationally.

METHODS

Based on a systematic online search, the consumer-targeted key messages of 106 dietary guidelines were identified and a qualitative content analysis was conducted. A coding framework was developed to classify messages as 'eat more' or 'eat less' according to the language used (eg, 'choose' vs 'avoid') and to differentiate between a focus on nutrients or food processing. Specific foods mentioned in 'eat less' guidelines were classified according to their level of processing using the NOVA framework.

RESULTS

99% of guidelines utilised some type of nutrient-based message, either promoting 'positive' nutrients (eg, vitamins) or discouraging the consumption of 'negative' nutrients (mainly salt, sugar and fat). Explicit references to food processing were present in 45% of 'eat less' guidelines and 5% of 'eat more' guidelines. Implicit references (eg, promoting 'raw' or discouraging 'packaged' foods) were found in 43% of 'eat less' and 75% of 'eat more' guidelines. 53% of the specific foods referred to in 'eat less' advice were UPFs.

CONCLUSION

Overall, nutrient-based messages were more common than messages about processing levels. The majority of discouraged foods were UPFs, however some minimally processed foods were discouraged, which points to tensions and contradictions between nutrient- and processing-based dietary advice. As dietary guidelines begin to include advice about food processing, it is important to consider both consumer understanding of the terms used and their capacity to act on the advice.

Consumer Awareness of the Degree of Industrial Food Processing and the Association with Healthiness-A Pilot Study

Consumption of ultraprocessed foods (UPFs) has been associated with lower diet quality, obesity, and adverse health effects. Not much is known about how consumers evaluate the degree of processing of a food product and how they relate this to healthiness. An online questionnaire was completed by a total of 277 Dutch, 204 Italian, and 181 Brazilian consumers. Consumers were aged 18-65 year, mean 38 ± 13 year, 31% were males, and 71% were highly educated. Pictures of several common food products were evaluated on the degree of industrial processing and healthiness. Thirteen food categories were included, each including one minimally processed food (MPF), one High NS_UPF (Nutri-Score A or B), and one Low NS_UPF (Nutri-Score D or E). Lastly, knowledge and attitude about UPFs were assessed. Ultraprocessing was perceived as unhealthy by the majority of consumers (Dutch, Italian: 55%; Brazilian: 75%) and contributed to weight gain according to: 38% Dutch, 51% Italian, and 70% Brazilian consumers. Low NS_UPFs were correctly rated toward "processed" and "not healthy" in all countries. High NS_UPF were rated as processed but showed large variations in healthiness scores. In conclusion, consumers rated UPFs relatively low in healthiness compared with MPFs with similar Nutri-Scores within the same food category. These preliminary findings suggest that consumers incorporate, to some extent, the degree of industrial processing while assessing the healthiness of food products.

How Do Consumers Understand Food Processing? A Study on the Brazilian Population

Food guides are official documents that guide consumers’ food choices. They inform the qualitative classification of food groups and messages on how to adopt a healthy diet. The classifications and nomenclatures adopted in these documents vary according to cultural, nutritional, and scientific criteria. This study aimed to evaluate the understanding of Brazilian consumers regarding food classification according to the Food Guide for the Brazilian Population (FGBP) concepts. An instrument was constructed to assess consumer understanding. It was named “Understanding of the Level of Processing of Food” (ULPF) and validated according to the concepts of constructs presented by psychometrics such as the Delphi methodology. The instrument was composed of 36 items approved by experts (concordance > 80% and with good internal consistency). A total of 2333 Brazilians from all regions participated in the study. The results suggest that food classification according to the level of processing was difficult for participants to understand. About 85% of them did not understand or did not know the definitions and classification of food and preparations according to food and science technology (FST) and the FGBP. More than 50% of the participants believed that it was easier to classify food according to food groups.

Meat consumption and consumer attitudes - A Norwegian perspective

Norway has lower meat consumption than other North European countries. Meat is acknowledged as important for food security in Norway, as Norway's agricultural possibilities are best suited for free-ranging and self-foraging animals. Meat has a strong position in the Norwegian diet, particularly as a centrepiece for special occasions. Good taste, product variety, and affordable price make meat a convenient choice. Norwegian consumers are not worried about animal welfare in local production, nor highly driven by environmental motives for reducing their consumption. Meat analogues have a very small market share, and taste and processing level do not make it a primary replacement for meat reducers. Still, Norwegian consumers' attitudes towards meat have become more diverse in later years. More consumer segments display meat-reducing behaviours citing both health and sustainability reasons. Females are particularly interested in reducing meat consumption, young age and urban lifestyle are other characteristics of meat reducing segments.

Consumers’ Understanding of Ultra-Processed Foods

Food classification systems have been proposed to improve food quality criteria. Among these systems, “processing level” has been used as a criterion. NOVA classification, as the denotation “ultra-processed” food (UPF), has been widely used in different countries. However, even though some studies have pointed out some controversial aspects, no study has evaluated its comprehension by the population where it is used as reference. Therefore, this study explored the understanding of the term UPF for Brazilian consumers, where this denotation has been used in the last 8 years. A questionnaire was used, with questions referring to different aspects of self-assessment of knowledge about UPF. Altogether, 939 valid participants completed the questionnaire, and 81.9% of them declared to know the term UPF. For 78.2%, a better definition for UPF should be “foods that have gone through many processes in industry”. Finally, it was concluded that the term UPF is still confusing for most Brazilians, indicating the risk of use and the urgent necessity to improve the classifications systems and consequently consumer understanding. Only when all parties interested in healthy food work together could this problem be solved.

Modelling the Impact of Reducing Ultra-Processed Foods Based on the NOVA Classification in Australian Women of Reproductive Age

Women of reproductive age have a high proportion of overweight/obesity and an overall poor nutritional intake and diet quality. Nutritional modelling is a method to forecast potential changes in nutrition composition that may offer feasible and realistic changes to dietary intake. This study uses simulation modelling to estimate feasible population improvements in dietary profile by reducing ultra-processed food (UPF) consumption in Australian women of reproductive age. The simulation used weighted data from the most recent 2011–2012 National Nutrition and Physical Activity Survey. A total of 2749 women aged 19–50 years was included, and 5740 foods were examined. The highest daily energy, saturated fat, and added sugar and sodium came from UPF. Reducing UPF by 50% decreased energy intake by 22%, and saturated fat, added sugar, sodium, and alcohol by 10–39%. Reducing UPF by 50% and increasing unprocessed or minimally processed foods by 25% led to a lower estimated reduction in energy and greater estimated reductions in saturated fat and sodium. Replacement of 50% UPF with 75% of unprocessed or minimally processed foods led to smaller estimated reductions in energy and nutrients. Our results provide insight as to the potential impact of population reductions in UPF, but also increasing intake of unprocessed or minimally processed foods, which may be the most feasible strategy for improved nutritional intake.

Color and Marbling as Predictors of Meat Quality Perception of Argentinian Consumers

In Argentina, color and intramuscular fat are the main attributes of raw beef quality; however, it is necessary to clarify how consumers use them, in order to establish different marketing strategies. Consumer preferences are affected by multiple factors. Thus, the objective of the present study was to identify the Argentinian consumer's choice behavior regarding beef color and fat content. An online survey was carried out in Argentina. It inquired about socio-demographic characteristics, purchase and consumption habits and beliefs, showing pictures related to color, marbling and the amount of fat. Choice behavior was evaluated by asking why consumers chose a particular picture out of the ones shown. Several Kruskal-Wallis tests evaluated the different hypotheses. Three different decision trees using the CHAID analysis method were created. Multifactorial analysis was carried out for clustering consumers. Regarding consumer beliefs, 90% of the respondents agreed with the sentence, "The two main characteristics defining beef quality at purchase time are meat color and marbling". Socio-demographic characteristics affected purchase habits and beliefs; they also affected perceptions about meat color and marbling. It was possible to build three consumer groups for future marketing strategies: "hedonic" focused on a pleasing sensory experience, "appearance" prioritized the visual aspects, and the "health-conscious" consumers were interested in their healthy nutrition.

Diet Quality According to Mental Status and Associated Factors during Adulthood in Spain

Common mental disorders (CMD) are characterized by non-psychotic depressive symptoms, anxiety and somatic complaints, which affect the performance of daily activities. This study aimed to analyze prevalence of diet quality among adults with and without CMD from 2006 to 2017, to study the frequency of food consumption and diet quality according to mental status and age, and to determine which sociodemographic, lifestyle and health-related factors are associated with poor/moderate diet quality, according to mental status. A nationwide cross-sectional study was performed in adults with (n = 12,545) and without CMD (n = 48,079). The data were obtained from three Spanish National Health Surveys (2006, 2011/2012 and 2017). Two logistic regression analyses were used to identify factors associated with diet quality in people with and without CMD. Among those with CMD, the probability of having poor/moderate diet quality was significantly lower for overweight or obese people and those who took part in leisure-time physical activity. Among those without CMD, university graduates were less likely to have a poor/moderate diet quality. Good diet quality was observed more in older adults (≥65 years old) than in emerging (18–24 years old) or young adults (25–44 years old), regardless of mental status.

Cross-cultural representations of gastronomy among consumers in two Latin American countries

Gastronomy is one of the cultural emblems of each region and represents the way each society feeds. The aim of this article was to understand the cross-cultural representations of the concept of gastronomy among consumers in Argentina (ARG) and Mexico (MEX). A survey in which 479 consumers of both countries were recruited (ARG = 249, MEX = 230), who had to complete a word association task, was designed. Words were grouped into categories and the differences in the frequency of mention were analyzed with the Chi Square test. Furthermore, results were analyzed to identify the central core and the peripheral areas of the social representations. Cognitive Salience Index (CSI) was calculated to determine the most important representations. The representations of the gastronomy concept in both countries indicate a strong link to culture, food, pleasure by eating and sensory characteristics of foods and dishes. However, the field of representation, the hierarchy of representations and the cognitive and attitudinal importance were different among Mexican and Argentine consumers, which suggests that gastronomy promotion campaigns for both countries should be oriented according to consumers' perceptions.

Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies

Background

Consumption of ultra-processed foods (UPFs) plays a potential role in the development of obesity and other diet-related noncommunicable diseases (NCDs), but no studies have systematically focused on this. This study aimed to summarize the evidence for the association between UPFs consumption and health outcomes.

Methods

A comprehensive search was conducted in PubMed, Embase, and Web of Science to identify all relevant studies. Epidemiological studies were included, and identified studies were evaluated for risk of bias.A narrative review of the synthesized findings was provided to assess the association between UPFs consumption and health outcomes.

Results

20 studies (12 cohort and 8 cross-sectional studies) were included in the analysis, with a total of 334,114 participants and 10 health outcomes. In a narrative review, high UPFs consumption was obviously associated with an increased risk of all-cause mortality, overall cardiovascular diseases, coronary heart diseases, cerebrovascular diseases, hypertension, metabolic syndrome, overweight and obesity, depression, irritable bowel syndrome, overall cancer, postmenopausal breast cancer, gestational obesity, adolescent asthma and wheezing, and frailty. It showed no significant association with cardiovascular disease mortality, prostate and colorectal cancers, gestational diabetes mellitus and gestational overweight.

Conclusions

This study indicated a positive association between UPFs consumption and risk of several health outcomes. Large-scale prospective designed studies are needed to confirm our findings.

Identifying consumers’ profile and factors associated with the valorization of pulque: A traditional fermented beverage in Central Mexico

The aims of this work were to (i) identify the consumers’ profile of pulque through their consumption frequency and their sensory perception of this beverage and (ii) identify the factors that contribute to the valorization of pulque among Mexican consumers. A survey was designed and conducted with 221 consumers in pulque-selling locations (pulquerías) in a place of Central Mexico. Consumers were characterized according to their consumption frequency. Factors associated with the valorization of pulque were identified through Binary Logistic Regression model. Two types of consumers were identified: Frequent Consumers and Not Frequent Consumers. Both groups were comprised mostly of men, including students with medium to high levels of education. However, the first group showed more traditional and conservative behavior patterns since there was a higher proportion of consumers with a low educational level ( p < 0.05) and they had more years of consumption, spend more time in the selling locations, and preferred “natural pulque.” The second group of consumers was comprised mostly ( p < 0.05) of women, including students with a high educational level who prefer “cured pulque.” In this sense, our results showed that gender and time spent in the pulquerías together with sensory, cultural, and functional characteristics associated with the beverage influence its valorization among consumers. These results can help both producers and marketers to classify segments of consumers according to their preferences and consumption patterns in order to revalorize the pulque market. Finally, it is necessary to highlight that young consumers with high educational level show interest in this beverage, since for years its consumption has been associated with low-income populations.