Awareness, experiences, and beliefs related to ultra-processed foods among young people in Cebu, Philippines

Ultra-processed food (UPF) intake is rising in low- and middle-income countries, where non-communicable diseases are now the leading contributor to disease burden. The purpose of this study was to assess awareness and knowledge of UPFs, factors that influence consumption of UPFs, and beliefs about the relationship between UPF intake and health among young people (18-20 years old) in a metropolitan area of the Philippines, a lower middle-income country. We conducted eight focus group discussions across four strata defined by gender and urban-rural neighborhood designation. We applied deductive and inductive codes to transcripts and organized codes into themes. Sixty participants were included in the study. Although most were unfamiliar with the concept of UPFs, participants demonstrated an intuitive understanding of the meaning of the term. Vendors in or around schools were commonly reported as a source of UPFs, though most participants reported consuming UPFs at home as well. Factors that were reported as having influence over participants' UPF intake included taste, convenience, cost, influence from parents, peers, and others, and health knowledge and status. Participants expressed various beliefs about the link between overconsumption of UPFs and risk of multiple health outcomes, including diabetes, hypertension, and kidney disease. Some males, but not females, believed that some UPFs were neutral or beneficial with respect to health. Commonly cited sources of information about UPFs and their link to health included parents, schools, and social media. This study provides important insights into the factors that drive UPF consumption among young people in a lower middle-income country and should inform efforts to reduce UPF intake among young people in this and similar settings.