A Semi-quantitative Food Frequency Questionnaire Has Relative Validity to Identify Groups of NOVA Food Classification System Among Mexican Adults

Abstract

BackgroundUltra-processed foods are recognized as indicators of an unhealthy diet in epidemiological studies. In addition to ultra-processed foods, the NOVA food classification system identifies three other groups with less processing. Unprocessed foods that, together with minimally processed foods (MPF), make NOVA group 1, NOVA group 2 is processed culinary ingredients, and NOVA group 3 is processed foods.ObjectiveTo assess the relative validity of the semi-quantitative food frequency questionnaire (SFFQ) to estimate the energy intake for each group NOVA classification system by comparing it with two 24 h-dietary-recall (24DRs) Mexican adults.MethodsWe analyzed dietary information from 226 adults included <60 and ≥60 years with complete SFFQ and two 24DRs from the National Health and Nutrition Survey 2012. We reported mean differences, Spearman correlation coefficients, intra-class correlations coefficients, Bland–Altman plots, and weighted kappa between measures.ResultsThe percentage energy intake from unprocessed and minimally processed foods group, Spearman correlation coefficients was 0.54 in adults <60 years and 0.42 in adults ≥60 years, while ultra-processed foods group was 0.67 and 0.48, respectively. The intra-class correlation coefficients in the unprocessed and minimally processed foods group was 0.51 in adults <60 years and 0.46 in adults ≥60 years, and for the ultra-processed foods group were 0.71 and 0.50, respectively. Bland–Altman plots indicated reasonably consistent agreement for unprocessed and minimally processed foods group and ultra-processed foods group in adults <60 years and adults in the ≥60 age group. Weighted kappa was 0.45 in the ultra-processed foods group to adults <60 years and was 0.36–≥60 years.ConclusionThe SFFQ had acceptable validity to rank the percentage of energy intake from unprocessed and minimally processed foods group and ultra-processed foods group in Mexican adults, both in adults under 60 years and who were 60 years old or older.

Are dietary patterns becoming more processed? The effects of different dietary patterns on cognition: A review

“…It is well established that the high intake of fresh fruit and vegetable, wholegrains, and fish is positively associated with cognitive function (Loughrey et al, 2017; Opie et al, 2013; McEvoy et al, 2017; Tangney, 2014); however, relatively few studies (Gardener et al, 2015; Parrott et al, 2013) have investigated the combination of whole dietary patterns and UPF in combination. Recently, several studies have started to develop and use food frequency questionnaires and classification methods specifically designed to evaluate UPF (Oviedo-Solis et al, 2022; Martinez-Perez et al, 2022; Khandpur et al, 2021). While these methods are being used within existing large epidemiological studies, new longitudinal studies are needed that aim to understand the associations between UPF and cognitive function.…”

Ultra-processed Food and Obesity: What Is the Evidence?

“…However, observational studies rank participants to compare disease risk across quantiles of an exposure, rather than identifying exact exposures. Compared with recalls or diet records, FFQs show good agreement in ranking participants into quantiles of UPF intake [ 100 – 105 ]. Furthermore, several diet assessments including generic and NOVA-specific FFQs have been validated for classifying according to NOVA [ 100 – 104 ].…”

Who consumes ultra-processed food? A systematic review of sociodemographic determinants of ultra-processed food consumption from nationally representative samples

“…One paper from Brazil was excluded on the basis of the use of a crude FFQ, reporting the frequency of consumption of ten items to determine UPF intake (26) . One paper from Mexico was included as participants were randomly selected from a nationally representative cohort, despite the small sample size (27) .…”

“…In one study of adults only from ENSANUT, adults younger than 60 consumed 21•4% of total energy from UPF (95% CI: 18•8, 24•0), compared with 14•2% (95% CI: 10•7, 17•6) in adults 60 or older, a 50% relative increase (27) . In the adjusted model across all age groups, pre-school-aged children (þ12•5% (95% CI: 10•9, 14•1)), school-aged children (þ3•8% (95% CI: 2•2, 5•4)) and adolescents (þ3% (95% CI: 1•1, 4•9)) all consumed greater amounts of UPF than adults.…”