Conclusion

Broadly, this rapid review suggests that the current literature on consumer awareness and understanding of UPFs, and related beliefs and concerns about these foods, is rather limited.  Whilst the non-systematic and rapid nature of this review could well mean that some existing studies have been missed, this does not undermine the broad conclusion that there is a paucity of research in this area, both internationally and in the UK specifically.

Whilst recognising the limitations of current evidence, it is possible to discern some key points from the existing literature:

• UPFs constitute a significant proportion of the diet for many consumers in high-income countries like the UK.
• There is considerable public discourse on the potential negative health and other consequences of UPFs, that is the cause of growing consumer concerns about these foods.  There is evidence that many consumers desire to reduce their consumption of UPFs as a result of this.
• Whilst there is widespread awareness of UPFs as a concept, many consumers do not understand the specific nature of UPFs well and are unable reliably to distinguish UPFs from other levels of food processing. In part, this reflects the rather complex and wide-ranging definition of UPFs and the fact that the distinction between UPF and other forms or processing is somewhat fuzzy.
• It is apparent that consumers have rather negative beliefs about UPFs, for example in terms of their healthiness and sustainability.  Broadly, these concerns are wrapped up in beliefs and worries about industrial food processing more generally. 
• At the same time, consumers do recognise the benefits that these foods can bring, for example in terms of price, convenience and shelf-life.
• There is some evidence that the provision of information on UPFs can influence beliefs about these products and purchase intentions.  Impacts on actual purchase behaviour, however, are largely unknown.

A key implication of these findings is that, whilst consumers may be receptive to communications about UPFs, designing and implementing an effective communication strategy around UPFs will be challenging.  If consumers are not clear about what a UPF is (according to existing, but not official UK classifications), and where understandings and beliefs about UPFs vary widely within the population, designing effective and equitable communication is likely to need further insight into consumer perspectives.  For this reason, the ACSS have not at this stage sought to answer research questions 8 and 9 on information needs and the nature of FSA support but have provided areas for potential future research.

The review suggests the need for more research on consumer awareness and understanding of UPFs, and beliefs and concerns about these foods, specific to the UK.  The extrapolation of results from studies elsewhere, and especially from Latin America where the food and wider context is quite different, is unlikely to provide reliable guidance on how UK consumers see UPFs and the implications for their purchase and consumption behaviour. In part, further research needs to delve deeper into some of the key issues thrown up by this review, specifically for the UK:

• How reliably can consumers discern UPFs and distinguish ‘Ultra’ processed foods from other levels of food processing, for example based on the NOVA classification?
• What concerns do consumers have about UPFs and why?
• How do consumer understanding and concerns about UPFs vary by products?
• How do consumer concerns about UPFs relate to concerns about food processing and/or the food industry more broadly?
• To what extent do consumers want to reduce or change their consumption of UPFs and what factors do they think make this more or less difficult?

Furthermore, there are some other key questions that the existing literature does not apparently address, both in the UK and internationally. The following questions could be explored in more extended further research:

• What factors do consumers use to distinguish UPFs from other types of processed foods, and how do these factors vary between consumers?
• What trade-offs might consumers make between perceived risks and benefits of UPFs?
• How can actual consumer purchasing behaviour of UPFs be tracked and explored?
• What additional information do consumers need and/or want when it comes to UPFs both generally and where the science is uncertain, and who should this come from?
• What information would help consumers make decisions about UPFs that are of benefit, rather than detriment to them?
• What actions (for example labelling and/or regulation) do consumers want to see when it comes to UPFs and who do they think should be responsible for such actions?
• What, if any, are the implications of the current largely negative media narrative around UPFs for consumer perceptions of food safety and nutrition and impacts of food choices?