Nova score for the consumption of ultra-processed foods: description and performance evaluation in Brazil

Costa, Caroline dos Santos; de Faria, Franciane Rocha; Gabe, Kamila Tiemann; Sattamini, Isabela Fleury; Khandpur, Neha; Leite, Fernanda Helena Marrocos; Steele, Eurídice Martínez; Louzada, Maria Laura da Costa; Levy, Renata Bertazzi; Monteiro, Carlos Augusto

OBJECTIVE: To describe the Nova score for the consumption of ultra-processed foods (UPF) and evaluate its potential in reflecting the dietary share of UPF in Brazil. METHODS: This study was conducted in São Paulo with a convenience sample of 300 adults. Using a tablet, participants answered a 3-minute electronic self-report questionnaire on the consumption of 23 subgroups of UPF commonly consumed in Brazil, regarding the day prior the survey. Each participant score corresponded to the number of subgroups reported. The dietary share of UPF on the day prior to the survey, expressed as a percentage of total energy intake, was calculated based on data collected on a 30-minute complete 24-hour dietary recall administered by trained nutritionists. The association between the score and the dietary share of UPF was evaluated using linear regression models. The Pabak index was used to assess the agreement in participants’ classification according to the fifths of Nova score and the fifths of dietary share of UPF. RESULTS: The average dietary share of UPF increased linearly and significantly with the increase of the Nova score for the consumption of ultra-processed foods. We found a substantial agreement in participants’ classification according to the fifths of the distribution of scores and the fifths of the dietary share of UPF (Pabak index = 0.67). Age was inversely associated with a relatively high frequency of UPF consumption (upper fifth of the distribution) for both score and dietary share of UPF. CONCLUSION: The Nova score for the consumption of ultra-processed foods, obtained in a quick and practical manner, shows a good potential in reflecting the dietary share of UPF in Brazil.