Concerned but confused: Australian consumers' awareness, understanding, and recognition of ultra-processed foods

Calls to reduce ultra-processed food (UPF) consumption through population health strategies such as front-of-pack labelling are increasing. Gaining insight into consumer perceptions may help inform effective strategies in this area. This study explored (i) Australian adults' awareness, understanding, and recognition of UPFs and (ii) their interest in front-of-pack labelling to signpost UPFs. Twelve online focus groups were conducted with 112 Australian adults (49 % women, 78 % residing in metropolitan areas). Discussions covered food selection criteria, familiarity with 'processed' and 'ultra-processed' terminology, ability to recognise UPFs, and views on current and desired availability of processing-level information on packaged foods. Images of foods were used as stimuli to facilitate discussion. An inductive thematic analysis was applied to examine the data. Two key themes emerged: (i) concern but confusion around processing and UPFs, and (ii) support for UPF information provision but uncertainty about feasibility. Participants broadly supported strategies to help consumers identify UPFs and their characteristic ingredients, while noting that low awareness of relevant terminology may limit the effectiveness of labelling approaches without accompanying public education efforts. Participants relied on simple packaging cues to assess processing levels, highlighting the need for transparent and salient labelling strategies. There were concerns that co-locating a UPF front-of-pack label alongside existing health labels could cause confusion, particularly where nutritional quality and level of processing are misaligned. Integrating UPF information into existing labelling systems appeared to be an acceptable approach to support healthier food choices and may alleviate these concerns. The findings provide evidence to enhance communication about food processing and support labelling strategies.