Understandings of ultra-processed foods: a qualitative interview study of UK adults with responsibility for household food activities

BackgroundThere is accumulating evidence that ultra-processed foods are associated with many non-communicable diseases. In the United Kingdom, ultra-processed foods account for more than half of mean daily energy intake. There is limited evidence describing how individuals make sense of ultra-processed foods in their daily lives. We aimed to explore: public perceptions of ultra-processed foods and their relationship to health; how these are shaped by different information sources; whether perceptions influence purchasing and consumption; and proposed solutions for reducing ultra-processed food consumption. MethodsWe undertook 30 qualitative, one-to-one interviews with people living in the UK, aged 18 years or older, with household responsibility for food activities recruited using social media advertisements. Interviews followed a semi-structured topic guide reflecting the aims. Data were analysed using reflexive thematic analysis. Members of a Public Involvement and Engagement group helped interpret emergent findings. ResultsFood processing often made more sense to participants as a continuum rather than ordinal categories. There was particular confusion regarding the boundary between processed and ultra-processed food. Participants described an overwhelming food-related information environment. Personal and anecdotal experience was particularly powerful. While industry-sponsored information was met with scepticism, the personal testimonies of social media influencers were seen as relatable or helpful. Participants perceptions of ultra-processed foods sometimes influenced their purchasing and consumption. However, cost, convenience, taste and family practices were often as or more important. Approaches to help reduce UPF consumption ranged from education to fiscal policies. ConclusionsThese findings suggest that the public need help navigating the complex food information landscape and not just with filling specific knowledge gaps around ultra-processed foods and other food-related topics. Policy approaches should combine improved public communication with upstream interventions that modify the food environment to make choosing less processed foods easier and more appealing.