Description and performance of two diet quality scores based on the Nova classification

Author(s)

Caroline dos Santos Costa ^[1] ; Francine Silva dos Santos ; Kamila Tiemann Gabe ; Eurídice Martinez Steele ; Fernanda Helena Marrocos-Leite ; Neha Khandpur ; Fernanda Rauber ; Maria Laura da Costa Louzada ; Renata Bertazzi Levy

Affiliation

^[1] Universidade de São Paulo. Faculdade de Saúde Pública. Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde - Brasil

• Document type: Journal article
• Source: Revista de Saúde Pública; v. 58, 2024-11-25.

Abstract

ABSTRACT OBJECTIVE To describe two low-burden diet quality scores and evaluate their performance in reflecting the dietary share of the least and most processed foods defined within the Nova food system classification. METHODS This cross-sectional study included data from the NutriNet-Brasil cohort. Participants answered the Nova24hScreener, a 3-minute self-administered questionnaire measuring the consumption of a set of foods on the day before. Food items included in this tool belong to two main groups of the Nova classification: unprocessed or minimally processed whole plant foods (WPF, 33 items) and ultra-processed foods (UPF, 23 items). Two scores were obtained by summing the number of items checked: the Nova-WPF and the Nova-UPF. We compared the scores, respectively, with the dietary intake (% of total energy) of all unprocessed or minimally processed whole plant foods and all ultra-processed foods obtained from a full self-administered web-based 24-hour recall performed on the same day. RESULTS The approximate quintiles of each score had a direct and linear relationship with the corresponding % of energy intake (p-value for linear trend < 0.001). We found a substantial agreement between the intervals of each score and the corresponding % of energy intake (Nova-WPF score: Prevalence-Adjusted and Bias-Adjusted Kappa (PABAK) 0.72, 95%CI 0.64–0.81; Nova-UPF score: PABAK 0.79, 95%CI 0.69–0.88). CONCLUSIONS These two scores performed well against the dietary share of unprocessed or minimally processed whole plant foods and ultra-processed foods in Brazil and can be used to evaluate and monitor diet quality. (AU)

• FAPESP's process: 22/05636-0 - Program of population studies on the consumption of ultraprocessed foods and health
• Grantee: Carlos Augusto Monteiro
• Support Opportunities: Research Projects - Thematic Grants