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Operationally Defining and Targeting Ultraprocessed Foods: Insights From US Policy Proposals
Aline D'Angelo Campos1, James W Krieger1, Carmen E Prestemon1
1Aline D'Angelo Campos, Lindsey Smith Taillie, Carmen E. Prestemon, and Bridget A. Hollingsworth are with the Carolina Population Center, University of North Carolina at Chapel Hill. Lindsey Smith Taillie and Carmen E. Prestemon are also with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. James W. Krieger is with the Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, and with Healthy Food America, Seattle.
None:
Objectives. To examine operational ultraprocessed food (UPF) definitions and policy scope in existing US policy proposals. Methods. We conducted a search for federal and state policy proposals targeting UPFs through December 2025. Results. We identified 43 proposals targeting UPFs between 2021 and 2025. Most (93%) hailed from states. About a third (35%) defined UPFs by listing narrow sets of specific food additives. Some provided definitions more closely related to Nova's: 9% referenced classes of additives considered "cosmetic" by Nova, whereas 21% directly referenced or paraphrased Nova but lacked comprehensive lists of targeted ingredients. A final third (35%) did not provide any definition. Most targeted foods served or sold in schools (58%). Others proposed UPF warning labels (12%) and marketing restrictions (5%). Conclusions. Proposals mostly targeted school foods and frequently defined UPFs using narrow lists of additives that lack evidence as reliable UPF indicators. Public Health Implications. Informing policymakers about existing and emerging operational UPF definitions consistent with science-based approaches is urgent. (Am J Public Health. 2026;116(7):1025-1029. https://doi.org/10.2105/AJPH.2026.308464).
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