Consumers' conceptualization of ultra-processed foods.

Consumption of ultra-processed foods has been associated with low diet quality, obesity and other non-communicable diseases. This situation makes it necessary to develop educational campaigns to discourage consumers from substituting meals based on unprocessed or minimally processed foods by ultra-processed foods. In this context, the aim of the present work was to investigate how consumers conceptualize the term ultra-processed foods and to evaluate if the foods they perceive as ultra-processed are in concordance with the products included in the NOVA classification system. An online study was carried out with 2381 participants. They were asked to explain what they understood by ultra-processed foods and to list foods that can be considered ultra-processed. Responses were analysed using inductive coding. The great majority of the participants was able to provide an explanation of what ultra-processed foods are, which was similar to the definition described in the literature. Most of the participants described ultra-processed foods as highly processed products that usually contain additives and other artificial ingredients, stressing that they have low nutritional quality and are unhealthful. The most relevant products for consumers' conceptualization of the term were in agreement with the NOVA classification system and included processed meats, soft drinks, snacks, burgers, powdered and packaged soups and noodles. However, some of the participants perceived processed foods, culinary ingredients and even some minimally processed foods as ultra-processed. This suggests that in order to accurately convey their message, educational campaigns aimed at discouraging consumers from consuming ultra-processed foods should include a clear definition of the term and describe some of their specific characteristics, such as the type of ingredients included in their formulation and their nutritional composition.