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Accepted manuscript

Whole grain modified Nova ultra-processed food (UPF) definitions: a cross-sectional analysis of the impact on cardiometabolic risk measures when excluding high whole-grain foods from the UPF category in Australia

Published online by Cambridge University Press:  23 December 2024

Elissa J. Price Open the ORCID record for Elissa J. Price [Opens in a new window] ,
Katrina R. Kissock Open the ORCID record for Katrina R. Kissock [Opens in a new window] ,
Eden M. Barrett ,
Marijka J. Batterham  and
Eleanor J. Beck Open the ORCID record for Eleanor J. Beck [Opens in a new window]
Elissa J. Price
Affiliation:
School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
Katrina R. Kissock
Affiliation:
School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
Eden M. Barrett
Affiliation:
School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
Marijka J. Batterham
Affiliation:
National Institute for Applied Statistics Research Australia and Statistical Consulting Centre, School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia
Eleanor J. Beck*
Affiliation:
School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia School of Medical, Indigenous, and Health Sciences, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, NSW, Australia
*
*Corresponding author: Eleanor J. Beck (e.beck@unsw.edu.au)
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Abstract

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Ultra-processed foods (UPF), defined using the Nova classification system, are associated with increased chronic disease risk. More recently, evidence suggests the UPF subgroup of whole-grain breads and cereals is in fact linked with reduced chronic disease risk. This study aimed to explore associations of cardiometabolic risk measures with Nova UPF intake versus when foods with ≥25% or ≥50% whole grain are excluded from the definition. We considered dietary data from the Australian National Nutrition and Physical Activity Survey (NNPAS) 2011-12. Impacts on associations of UPF intake (quintiles) and cardiometabolic risk measures were analysed using regression models. The median proportion of UPF intake from high whole-grain foods was zero for all quintiles. Participants in the highest Nova UPF intake quintile had significantly higher weight (78.1kg [0.6]), BMI (27.2kg/m2 [0.2]), waist circumference (92.7cm [0.5]), and weight-to-height ratio (0.55 [0.003]) compared to the lowest quintile (p<0.05). Associations were the same when foods with ≥25% and ≥50% whole grain were excluded. Adjusted R-squared values remained similar across all approaches for all outcomes. In Australia, high whole-grain foods considered UPF may not significantly contribute to deleterious cardiometabolic risk associations. Until conclusive evidence on Nova UPF is available, prioritisation should be given to the nutrient density of high whole-grain foods and their potential contribution to improving whole-grain intakes and healthful dietary patterns in Australia.

Keywords

NNPASwhole grainNovaultra-processed foodcardiometabolic risk
Type
Research Article
Information
British Journal of Nutrition , Accepted manuscript , pp. 1 - 25
Copyright
© The Authors 2024