A recent comprehensive study has uncovered significant confusion among Australian consumers regarding ultra-processed foods (UPFs), indicating a pressing need for clearer labelling and enhanced education to help shoppers navigate today’s complex food landscape.

Published in the journal Appetite, this research explored how Australian adults perceive, recognize, and understand UPFs. While many participants expressed valid concerns about the health impacts of UPFs and supported the implementation of clearer labelling policies, they also revealed a lack of understanding about what constitutes UPFs. This highlights a critical gap in public knowledge that needs to be addressed through educational initiatives.

During focus group discussions, many participants experienced a moment of realization regarding their misuse of the term “processed,” often conflating it with what researchers refer to as “ultra-processed.” This confusion points to an urgent need for public education that can help to clarify food terminology and improve consumers’ ability to make informed decisions.

Ultra-processed foods are increasingly linked to adverse health outcomes and have become a major source of energy intake in high-income nations, accounting for a staggering 56% of energy consumption in Australia alone. These foods are manufactured using industrial processes and contain ingredients that are typically not found in home cooking, such as artificial additives and flavourings designed to enhance taste and convenience. Although these foods can be appealing due to their convenience and hyper-palatable nature, studies suggest that their health risks transcend mere nutritional concerns and include factors like the disruption of gut health caused by certain additives.

Despite a growing consensus regarding the health risks associated with UPFs, as highlighted by a recent advisory from the World Health Organization (WHO) recommending reduced consumption of these foods, effective strategies for encouraging healthier eating habits are still in development. One potential solution is front-of-pack labelling (FoPL). Research has shown that FoPL can moderately aid consumers in making healthier choices. However, existing systems, such as Australia’s Health Star Rating (HSR), are based on nutrient profiles and may inadvertently conflict with processing-based classification systems like the NOVA framework.

This discrepancy can lead to confusion, as consumers may encounter products that carry a high health star rating even when they are ultra-processed. Furthermore, there has been little research conducted in Australia regarding consumer perception of UPFs, which is crucial for crafting effective labelling strategies that accurately reflect both nutritional value and processing methods.

The study involved 112 adults participating in 12 online focus groups across five Australian states, all of whom were selected through a professional agency to ensure a balanced demographic representation. Each participant was required to shop for food at least twice a month, and approximately 78% of them resided in metropolitan areas. The discussions, moderated by experienced researchers, began with general food selection habits before delving into the meanings of terms like “processed” and “ultra-processed.”

Participants were shown various food products with similar HSR but differing NOVA classifications to evaluate their ability to recognize UPFs. The analysis, conducted by a single coder, revealed significant trends across demographic groups, although it is essential to note that recognition findings were based solely on two food categories: bread and milk. This limitation may restrict the generalizability of the results to other food products.

Key findings from the study indicated that participants often described processed foods using phrases like “unnatural,” “a science experiment,” or “not real food,” revealing a deep-rooted association between industrial manufacturing processes and health-related apprehensions. Two primary themes emerged from the discussions: first, consumers’ concerns about UPFs and their confusion regarding their classification; second, a strong support for better labelling methods, alongside practical concerns about their implementation.

Many participants voiced their worries about potential health issues linked to food additives, strange ingredients, and preservatives. They frequently referenced ingredient lists when making food choices, yet many admitted to misunderstanding or misusing the terms “processed” and “ultra-processed,” with most participants having never encountered the term “ultra-processed” before. Those few who were somewhat familiar had learned about it mainly through media channels or literature.

When tasked with identifying UPFs based on packaging, participants often based their judgments on perceived naturalness and visual cues rather than the actual processing level. For instance, during a stimuli task, nearly all participants misidentified a supermarket-brand white bread (which is processed) as ultra-processed, favoring the appearance of an industrially produced packaged bread, which seemed more ‘artisan’ and natural. Conversely, most correctly identified oat milk (considered ultra-processed) as more processed than regular dairy milk (which is minimally processed).

While participants generally supported the inclusion of information on UPFs in food labelling, they struggled with how to best present this information. Suggestions included clearer, simplified ingredient lists or labels indicating the number of ingredients or production steps involved. Many emphasized that substantial educational efforts are essential for helping consumers differentiate between processed and ultra-processed foods.

Participants also expressed doubts regarding the credibility of existing health ratings, such as the HSR. They were particularly concerned about the potential for misleading consumers when products with different processing levels received the same health rating. A number of participants proposed integrating UPF classification directly within the HSR algorithm to enhance clarity. Nonetheless, some worried that a UPF label could unfairly stigmatize certain foods like oat milk.

Concluding the discussions, a tension emerged regarding food fortification: while fortifying foods with vitamins and minerals can benefit public health, it might conflict with consumer desires for simple and recognizable ingredient lists. This study underscores the substantial confusion Australians have about UPFs, even as concerns regarding their health impacts continue to escalate. While participants expressed support for FoPL to identify UPFs, their unfamiliarity with the term and difficulties in distinguishing between various types of processed foods may impede the effectiveness of these labelling strategies.

The necessity for public education campaigns was strongly highlighted, with suggestions to utilize familiar ingredient names or integrate UPF classifications into Australia’s current HSR system to mitigate possible conflicting messages. However, participants raised the valid concern that oversimplifying the complexities of food products might lead to misrepresentation, as not all UPFs should be viewed uniformly in terms of health impacts. This includes recognizing that some fortified foods or plant-based alternatives like oat milk can serve valuable roles in specific dietary contexts and that UPFs exist along a spectrum of health implications.

While this study is groundbreaking as the first of its kind in Australia, its qualitative and exploratory nature, coupled with the limited food categories examined, does restrict its generalizability. Future research needs to focus on testing specific labelling formats and how they influence consumer choices. Ultimately, implementing front-of-pack labels must be part of a larger policy framework that addresses the affordability, access, and marketing of ultra-processed foods.