A narrative review of public and expert perceptions of ultra-processed foods: Knowledge, opinions, and educational directions

Ultra-processed foods (UPFs; e.g., packaged salty snacks, packaged desserts, soda), “Group 4” foods of the NOVA classification system, are tasty, readily available, convenient, affordable, and rewarding. However, UPFs have been linked to numerous physical and mental health consequences, such as overweight/obesity and depression. Despite UPFs garnering attention as a public health concern and the NOVA system becoming more heavily researched, there remains some uncertainty about UPFs, including how to apply the NOVA classification system to identify UPFs and the pros and cons of UPFs in our environment. Public health initiatives focused on UPFs will likely need to involve educational efforts to fill knowledge gaps, but it is important to first understand population-wide perspectives of UPFs. This narrative review examines literature published in the past 10 years and explores knowledge and perceptions of UPFs among general population samples, expert populations (nutrition experts), and niche populations (children, athletes, and university students/staff). While this review finds that many are aware of UPFs and perceive them as unhealthy, misidentification commonly occurs for specific UPFs (i.e., breads, granola) possibly because these products are viewed as healthier foods. Based on the research available, we do not have a clear global understanding about knowledge and perceptions of UPFs. This review also discusses how educational initiatives, such as school-based education or gamification, may be utilized to fill knowledge gaps to empower consumers to make informed consumption choices.