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| Author(s): |
Evelyn Oliveira da Silva
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR) |
| Defense date: | 2023-08-28 |
| Examining board members: |
Maria Laura da Costa Louzada;
Gustavo Andres Cediel Giraldo;
Josiane Steluti
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| Advisor: | Maria Laura da Costa Louzada |
| Abstract | |
Introduction: Science has increasingly shown the deleterious effects of inadequate nutrition on human and planetary health. In this scenario, the study of nutrition considering food processing has gained prominence, leading to the development of the Nova classification, which categorizes foods based on the degree, extent, and purpose of processing. This classification has been widely used in epidemiological studies. However, these studies share a common limitation: the use of non-specific dietary assessment tools for food processing, which may lead to biases in measuring dietary intake and its effects on global health. Objective: To develop and validate a food frequency questionnaire (FFQ-Nova) that assesses the habitual food intake according to the Nova classification in Brazilian adults. Methods: The FFQ-Nova is a self-administered, quantitative questionnaire. The food list included the most consumed foods (at different degrees of processing) by the Brazilian adult population, based on data from two 24-hour dietary recalls from the Household Budget Survey 2017-2018 (POF 17-18). We conducted a pre-test with a sample of 20 adults to assess the understanding of the instrument. We used data from the NutriNet Brazil study, which investigates the relationship between dietary patterns and morbidity/mortality from non-communicable chronic diseases in Brazilian adults for validation. 1,200 participants were invited through the study platform. Participants completed two 24-hour recalls previously developed and validated to assess food processing (R24h-Nova) in the previous year and completed the FFQ-Nova twice, four to six weeks apart. We compared the consumption estimates of the following groups of the Nova classification: unprocessed or minimally processed foods (G1), processed culinary ingredients (G2), processed foods (G3), and ultra-processed foods (G4). For reproducibility, we compared the estimates from the two applications of the FFQ-Nova. For criterion validity, we compared the estimates from the first administration of the FFQ-Nova with the mean of two R24h-Nova. We estimated the intraclass correlation coefficients for both analyses. For criterion validation, we also estimated the agreement of the classification into quintiles of consumption of the Nova groups using the kappa coefficient. Results: We included 243 participants in the reproducibility analysis and 377 participants in the criterion validity analysis. The reproducibility analysis demonstrated excellent reproducibility over time, with an intraclass correlation coefficient of 0.91 for all Nova groups. In the criterion validity analysis, there was moderate agreement between the instruments, with intraclass correlation coefficients ranging from 0.61 for processed and ultra-processed foods to 0.65 for unprocessed and minimally processed foods. The classification into quintiles showed substantial agreement, as indicated by the prevalence- and bias-adjusted kappa coefficients (PABAKs= 0.74; 0.72; 0.70 and 0.73 respectively for Nova\'s G1, G2, G3 and G4). Conclusion: The FFQ-Nova is a valid instrument for assessing dietary intake according to food processing. The instrument also showed good ability to discriminate individuals according to the magnitude of consumption in all Nova groups. We expected that the FFQ-Nova will be used in epidemiological studies to investigate the effects of food processing on public health. (AU) | |
| FAPESP's process: | 22/04118-5 - Development and validation of a Food Frequency Questionnaire for Brazilian adults, according to the NOVA classification. |
| Grantee: | Evelyn Oliveira da Silva Frade |
| Support Opportunities: | Scholarships in Brazil - Master |