Objective: To determine how children interpret terms related to food processing; whether their categorisation of foods according to processing level is consistent with those used in research; and whether they associate the degree of processing with healthfulness.
Design: Qualitative data were collected from ten focus groups. Focus groups were audio-recorded, transcribed verbatim, and thematic analysis was conducted.
Setting: Four elementary and afterschool programmes in a large, urban school district in the USA that served predominantly low-income, racial/ethnic minority students.
Participants: Children, 9-12 years old, in the fourth-sixth grades (n 53).
Results: The sample was 40 % male, 47 % Hispanic with a mean age of 10·4 ± 1·1 years. Children's understanding of unprocessed foods was well aligned with research classifications, while concordance of highly processed foods with research categorisations varied. Five primary themes regarding the way children categorised foods according to their processing level emerged: type and amount of added ingredients; preparation method; packaging and storage; change in physical state or sensory experience; and growing method. Most children associated processing level with healthfulness, describing unprocessed foods as healthier. The most common reason provided for the unhealthfulness of processed foods was added ingredients, including 'chemicals' and 'sugar'.
Conclusions: The current study demonstrated that children have a working knowledge of processing that could be leveraged to encourage healthier eating patterns; however, their understanding is not always consistent with the classification systems used in research. The vocabulary used by researchers and consumers to talk about processing must be reconciled to translate findings into actionable messages.
Keywords: Children; Nutrition education; Processed food; Qualitative research; Ultra-processed food.