

Many adults are trying to make healthier food choices while navigating a confusing mix of advice from doctors, social media, marketing, and friends. But even when people want to cut back on ultra-processed foods, practical considerations of time, cost, and convenience often shape what they actually buy and eat.
A new interview study led by Duke University researcher Michael Essman while at the University of Cambridge examines how people understand ultra-processed foods and how they make everyday decisions about them. The research was funded by an Emergent Public Health Priority grant from the National Institute for Health and Care Research (NIHR) School for Public Health Research.
Ultra-processed foods are industrially produced products designed for convenience and taste. Research has linked higher consumption to poorer diet quality and increased risk of chronic disease.
“From a policy perspective, there is a lot of interest in reducing ultra-processed foods. But to be effective, we have to understand how any proposed policies would interact with how and why people consume UPFs,” said Essman, a research scientist at Duke’s World Food Policy Center.
Researchers conducted 30 in-depth interviews with UK adults responsible for household food decisions, asking how they define ultra-processed foods, where they hear about them, and what shapes their choices. The study was conducted in collaboration with colleagues at Imperial College London and the University of Cambridge.
Key findings
Participants described a mix of uncertainty, competing information, and practical constraints shaping their food choices. Several themes emerged:
- Uncertainty about what counts as ultra-processed: Many participants were unsure where “processed” ends and “ultra-processed” begins, often relying on cues like ingredient lists, packaging, or whether a food seemed like something they could make at home.
- A crowded and confusing information environment: Participants described navigating advice from health professionals, news, social media, marketing, and personal networks. Many said it was difficult to sort reliable guidance from conflicting messages. Some participants said they were skeptical of industry-linked messaging, while others found influencer stories or personal recommendations more relatable and trustworthy.
- Decisions shaped by experience as much as advice: When choosing what to buy and eat, people often relied on personal experience and trial and error, especially when different sources offered inconsistent recommendations.
- Barriers that outweigh intentions: Even when participants were concerned about ultra-processed foods, factors like time, cost, convenience, taste, and household routines often made it difficult to change habits.
- Support for a mix of solutions: Participants pointed to clearer labeling, better public education, limits on marketing, and policies that make healthier options more affordable and accessible.
“We know that price, convenience, and daily habits matter, but we were surprised by how complex the information environment is,” Essman said. “People are not just hearing from healthcare providers. They are also turning to social media and word of mouth.”
These findings suggest people may benefit from clearer, more actionable guidance. They also point to policies that make less processed options more affordable, available, and convenient, so healthier choices are easier in daily life.
Because the study is qualitative and based on a small sample, the findings offer insight into how people think about ultra-processed foods rather than results that apply to all populations.
Media Contact:
Matt LoJacono
matt.lojacono@duke.edu
(703) 740-7871
About NIHR
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research.
We do this by:
- funding high quality, timely research that benefits the NHS, public health and social care
- investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services
- partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research
- attracting, training and supporting the best researchers to tackle complex health and social care challenges
- collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system
- funding applied global health research and training to meet the needs of the poorest people in low and middle income countries
NIHR is funded by the Department of Health and Social Care.
Our work in low and middle income countries is principally funded through UK international development funding from the UK government.