Consumers' Understanding of Ultra-Processed Foods

Juliana Sarmiento-Santos, Melissa B N Souza, Lydia S Araujo, Juliana M V Pion, Rosemary A Carvalho, Fernanda M Vanin, Juliana Sarmiento-Santos, Melissa B N Souza, Lydia S Araujo, Juliana M V Pion, Rosemary A Carvalho, Fernanda M Vanin

Abstract

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.

Keywords: NOVA classification; baby food; consumer knowledge; food processing level; offer intention.

Conflict of interest statement

The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Distribution of answers from valid participants (n = 939) to the question “Do you know what is an ultra-processed food?”, with further indication of the best definition for ultra-processed food (UPF) by the participants.
Figure 2
Figure 2
Distribution of food classification presented to research participants as UPFs (blue) or not (red).
Figure 3
Figure 3
Distribution of intention to offer food to children under two years old.

References

    1. Bezerra I.N., Vasconcelos T.M., Cavalcante J.B., Yokoo E.M., Pereira R.A., Sichieri R. Evolution of Out-of-Home Food Consumption in Brazil in 2008–2009 and 2017–2018. Rev. Saude Pública. 2021;55:1–11. doi: 10.11606/s1518-8787.2021055003221.
    1. Rodrigues R.M., Souza A.D., Bezerra I.N., Pereira R.A., Yokoo E.M., Sichieri R. Most Consumed Foods in Brazil: Evolution between 2008–2009 and 2017–2018. Rev. Saúde Pública. 2021;55:4s. doi: 10.11606/s1518-8787.2021055003406.
    1. Soares M.M., Juvanhol L.L., Ribeiro S.A.V., Franceschini S.D.C.C., Araújo R.M.A. Prevalence of Processed and Ultra-Processed Food Intake in Brazilian Children (6–24 Months) Is Associated with Maternal Consumption and Breastfeeding Practices. J. Food Sci. Nutr. 2021;72:978–988. doi: 10.1080/09637486.2021.1885016.
    1. Dutra-de-Oliveira J.E., Marchini J.S. Ciências Nutricionais. Savier; São Paulo, Brazil: 1998.
    1. Lessa A.D.C., Fonseca L.B., Nobre L.N., Assis A.M.D.O., Lessa A.D.C., Fonseca L.B., Nobre L.N., Assis A.M.D.O. Dietary Patterns of Children during the First Year of Life: A Cohort Study—Dietary Patterns of Children. Food Nutr. Sci. 2017;8:1001–1011. doi: 10.4236/FNS.2017.811072.
    1. McCloat A., Mooney E., Hollywood L.E. Have Irish Parents Put Cooking on the Back Burner? An Island of Ireland Study of the Food Skills, Cooking Confidence and Practices of Parents. Br. Food J. 2017;119:992–1002. doi: 10.1108/BFJ-09-2016-0440.
    1. Navarro P., Mehegan J., Murrin C.M., Kelleher C.C., Phillips C.M. Adherence to the Healthy Eating Index-2015 across Generations Is Associated with Birth Outcomes and Weight Status at Age 5 in the Lifeways Cross-Generation Cohort Study. Nutrients. 2019;11:928. doi: 10.3390/nu11040928.
    1. Sadler C.R., Grassby T., Hart K., Raats M., Sokolović M., Timotijevic L. Trends in Food Science and Technology. Elsevier Ltd.; Amsterdam, The Netherlands: 2021. pp. 149–162.
    1. Ministério da Saúde . Guia Alimentar Para a População Brasileira. 2nd ed. Ministério da Saúde; Brasília, Brazil: 2014.
    1. Ministry of Public Health of Ecuador Documento técnico de Las Guías Alimentarias Basadas En Alimentos (GABA) Del Ecuador [Technical Document of the Food Based Food Guidelines (GABA) of Ecuador] [(accessed on 28 June 2021)]. Available online: .
    1. Serrano L., Luis M. Guías Alimentarias Para La Población Peruana. Instituto Nacional de Salud; Bogotá, Colombia: 2019. p. 55.
    1. Ministerio de Desarrollo Social Guía Alimentaria Para La Población Uruguaya | Ministerio de Desarrollo Social. [(accessed on 28 June 2021)]. Available online: .
    1. Flemish Institute of Healthy Living Voedingsdriehoek|Gezond Leven. [(accessed on 28 June 2021)]. Available online: .
    1. HCSP Pour Une Politique Nutritionnelle de Santé Publique En France. PNNS 2017–2021. [(accessed on 28 June 2021)]. Available online: .
    1. FAO Food-Based Dietary Guidelines | Food and Agriculture Organization of United Nations. [(accessed on 28 June 2021)]. Available online:
    1. Monteiro C.A., Cannon G., Levy R., Moubarac J.-C., Jaime P., Paula Martins A., Canella D., Louzada M., Camila Ricardo D., Calixto G., et al. The Food System. Volume 7 World Nutrition; Peacehaven, UK: 2016.
    1. Derbyshire E. Trends in Food Science and Technology. Elsevier Ltd.; Amsterdam, The Netherlands: 2019. pp. 98–104.
    1. Jones J.M. Food Processing: Criteria for Dietary Guidance and Public Health? Proc. Nutr. Soc. 2019;78:4–18. doi: 10.1017/S0029665118002513.
    1. Gibney M. Ultra-Processed Foods: Definitions and Policy Issues. Curr. Dev. Nutr. 2019;3:nzy077. doi: 10.1093/cdn/nzy077.
    1. Gibney M.J., Forde C.G., Mullally D., Gibney E.R. Ultra-Processed Foods in Human Health: A Critical Appraisal. Am. J. Clin. Nutr. 2017;106:717–724. doi: 10.3945/ajcn.117.160440.
    1. Poti J.M., Braga B., Qin B. Ultra-Processed Food Intake and Obesity: What Really Matters for Health-Processing or Nutrient Content? Curr. Obes. Rep. 2017;6:420–431. doi: 10.1007/s13679-017-0285-4.
    1. National Center for Health Statistics . Health, United States, 2009 with Special Feature on Medical Technology. National Center for Health Statistics; Hyattsville, MD, USA: 2009.
    1. Atkinson R., Flint J. Accessing Hidden and Hard-to-Reach Populations: Snowball Research Strategies. Volume 33 Department of Sociology, University of Surrey; Guildford, UK: 2001. Social Research Update.
    1. Fiori I.C., Consiglio Kasemodel M.G., Makishi F., Nunes R., Valentin D., Favaro-Trindade C.S., Silva V.L. Brazilian Consumers’ Understanding and Recognition Ability on Organic Processed Food. J. Food Prod. Mark. 2019;25:829–848. doi: 10.1080/10454446.2019.1683784.
    1. IBGE IBGE | Projeção Da População. [(accessed on 27 May 2021)]; Available online: .
    1. Granato D., de Araújo Calado V.Ô.M., Jarvis B. Observations on the Use of Statistical Methods in Food Science and Technology. Food Res. Int. 2014;55:137–149. doi: 10.1016/j.foodres.2013.10.024.
    1. Ministério da Saúde . Guia Alimentar Para Crianças Menores De 2 AnosI. 1st ed. Departamento de Promoção da Saúde, Ministério da Saúde; Brasília, Brazil: 2019.
    1. Lopes W.C., Marques F.K.S., de Oliveira C.F., Rodrigues J.A., Silveira M.F., Caldeira A.P., de Pinho L. Infant Feeding in the First Two Years of Life. Rev. Paul. Pediatr. 2018;36:164–170. doi: 10.1590/1984-0462/;2018;36;2;00004.
    1. Savage J.S., Fisher J.O., Birch L.L. Parental Influence on Eating Behavior: Conception to Adolescence. J. Law Med. Ethics. 2007;35:22–34. doi: 10.1111/j.1748-720X.2007.00111.x.
    1. Vidal L., Brunet G., Bove I., Girona A., Fuletti D., Ares G. Parents’ Mental Associations with Ultra-Processed Products for Their Infant Children: Insights to Improve Complementary Feeding Practices. Food Qual. Prefer. 2021;94:104335. doi: 10.1016/j.foodqual.2021.104335.
    1. Ares G., Vidal L., Allegue G., Giménez A., Bandeira E., Moratorio X., Molina V., Curutchet M.R. Consumers’ Conceptualization of Ultra-Processed Foods. Appetite. 2016;105:611–617. doi: 10.1016/j.appet.2016.06.028.
    1. Aguirre A., Borneo M.T., El Khori S., Borneo R. Exploring the Understanding of the Term “Ultra-Processed Foods” by Young Consumers. Food Res. Int. 2019;115:535–540. doi: 10.1016/j.foodres.2018.09.059.
    1. European Union Regulation (EC) No 1924/2006 of the European Parliament and of the Council of 20 December 2006 on Nutrition and Health Claims Made on Foods. [(accessed on 14 June 2021)]. Available online: .
    1. Menegassi B., de Almeida J.B., Olimpio M.Y.M., Brunharo M.S.M., Langa F.R. The New Food Classification: Theory, Practice and Difficult. Cienc. E Saude Coletiva. 2018;23:4165–4176. doi: 10.1590/1413-812320182312.30872016.
    1. Bleiweiss-Sande R., Goldberg J., Evans E.W., Chui K., Sacheck J. Perceptions of Processed Foods Among Low-Income and Immigrant Parents. Health Educ. Behav. 2019;47:101–110. doi: 10.1177/1090198119885419.
    1. Araújo C., Ribeiro K.D., Padrão P., Moreira P. Industrialized Foods in Early Infancy: A Growing Need of Nutritional Research. Porto Biomed. J. 2019;4:e47. doi: 10.1097/j.pbj.0000000000000047.
    1. Angelovičová M., Zeleňáková L., Zajác P., Čapla J. The NOVA System and Ultra-Processed Foods in Relation to Consumer Decision-Making in Foods Choice. Potravin. Slovak J. Food Sci. 2020;14:914–920. doi: 10.5219/1358.
    1. Monteiro C.A., Cannon G., Levy R.B., Moubarac J.-C., Louzada M.L., Rauber F., Khandpur N., Cediel G., Neri D., Martinez-Steele E., et al. Commentary Ultra-Processed Foods: What They Are and How to Identify Them. Public Health Nutr. 2019;22:936–941. doi: 10.1017/S1368980018003762.
    1. AAP Why Formula Instead of Cow’s Milk?-. [(accessed on 1 July 2021)]. Available online: .
    1. Ministério da Saúde . Guia Alimentar Para Crianças Brasileiras Menores De 2 Anos-Versão Resumida. Ministério da Saúde; Brasília, Brazil: 2021.
    1. Livsmedelsverket Good Food for Babies—Swedish Food Agency. [(accessed on 6 July 2021)]. Available online: .
    1. FDA FDA Advises Parents and Caregivers to Not Make or Feed Homemade Infant Formula to Infants | FDA. [(accessed on 1 July 2021)]; Available online: .
    1. Empório da Papinha Empório Da Papinha-Papinhas e Comidinhas Orgânicas e Saborosas Para Toda a Infância. [(accessed on 1 July 2021)]. Available online:
    1. Gourmetzinho Institucional–Gourmetzinho. [(accessed on 1 July 2021)]. Available online: .
    1. Nestlé Nestlé NaturNes. [(accessed on 1 July 2021)]. Available online: .
    1. Fuentes M., Brembeck H. Best for Baby? Framing Weaning Practice and Motherhood in Web-Mediated Marketing. Consum. Mark. Cult. 2016;20:153–175. doi: 10.1080/10253866.2016.1205493.
    1. Brembeck H., Fuentes M. Convenient Food for Baby: A Study of Weaning as a Social Practice. Food Cult. Soc. 2017;20:569–586. doi: 10.1080/15528014.2017.1357950.
    1. Cainelli E.C., Gondinho B.V.C., Palacio D.D.C., de Oliveira D.B., Reis R.A., Cortellazzi K.L., Guerra L.M., Cavalcante D.d.B., Pereira A.C., Bulgareli J.V. Ultra-Processed Foods Consumption among Children and Associated Socioeconomic and Demographic Factors. Einstein (São Paulo) 2021;19:1–8. doi: 10.31744/einstein_journal/2021AO5554.
    1. Longo-Silva G., Silveira J.A.C., Menezes R.C.E.D., Toloni M.H.D.A. Idade de Introdução de Alimentos Ultraprocessados Entre Pré-Escolares Frequentadores de Centros de Educação Infantil. J. Pediatr. 2017;93:508–516. doi: 10.1016/j.jped.2016.11.015.
    1. Vidal L., Bove I., Brunet G., Girona A., Alcaire F., Antúnez L., Ares G. Are the Recommendations of Pediatricians about Complementary Feeding Aligned with Current Guidelines in Uruguay? Public Health Nutr. 2021;24:641–650. doi: 10.1017/S1368980020005352.
    1. Ruggiero E., Esposito S., Costanzo S., di Castelnuovo A., Cerletti C., Donati M.B., de Gaetano G., Iacoviello L., Bonaccio M. Ultra-Processed Food Consumption and Its Correlates among Italian Children, Adolescents and Adults from the INHES Cohort Study. Public Health Nutr. 2021;24:6258–6271. doi: 10.1017/S1368980021002767.
    1. Bailey R.L., Fulgoni V.L., Cowan A.E., Gaine P.C. Sources of Added Sugars in Young Children, Adolescents, and Adults with Low and High Intakes of Added Sugars. Nutrients. 2018;10:102. doi: 10.3390/nu10010102.
    1. Menegassi B., Cardozo C.M.L., Langa F.R., Moreira C.C., Luz V.G. Classificação de Alimentos NOVA: Comparação Do Conhecimento de Estudantes Ingressantes e Concluintes de Um Curso de Nutrição. Demetra Aliment. Nutr. Saúde. 2020;15:e48711. doi: 10.12957/demetra.2020.48711.
    1. Braesco V., Souchon I., Sauvant P., Haurogné T., Maillot M., Féart C., Darmon N. Ultra-Processed Foods: How Functional Is the NOVA System? Eur. J. Clin. Nutr. 2022:1–9. doi: 10.1038/s41430-022-01099-1.
    1. Petrus R.R., do Amaral Sobral P.J., Tadini C.C., Gonçalves C.B. The NOVA Classification System: A Critical Perspective in Food Science. Trends Food Sci. Technol. 2021;116:603–608. doi: 10.1016/j.tifs.2021.08.010.
    1. Kanematsu L.R.A., Müller J., Scapin T., Fabri R.K., Colussi C.F., Bernardo G.L., Fernandes A.C., Pacheco Da Costa Proenca R., Uggioni P.L. Do Foods Products Labeled “Home-Made” Contain Fewer Additives? A Brazilian Survey. J. Food Prod. Mark. 2020;26:486–498. doi: 10.1080/10454446.2020.1811185.

Source: PubMed

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구독하다