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Accepted manuscript

Validation of NOVA 27 Ultra-Processed Food Screener: adaptation and performance in Ecuador

Published online by Cambridge University Press:  04 June 2025

Wilma B Freire ,
Betzabé Tello Open the ORCID record for Betzabé Tello [Opens in a new window]  and
Philippe Belmont Guerrón Open the ORCID record for Philippe Belmont Guerrón [Opens in a new window]
Wilma B Freire
Affiliation:
Universidad San Francisco de Quito, Quito, Ecuador
Betzabé Tello
Affiliation:
Center for Research on Health in Latin America (CISeAL), Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
Philippe Belmont Guerrón*
Affiliation:
Center for Research on Health in Latin America (CISeAL), Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
*
Corresponding author: Belmont Guerrón Philippe, Avenida 12 de Octubre 1076 y Vicente Ramón Roca, philippebelmont@gmail.com.
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Abstract

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Objective:

This study aimed to adapt and validate the NOVA 27 Ultra-Processed Food (UPF) Screener for use in Ecuador by identifying commonly consumed foods, classifying them using the NOVA system, and testing the screener’s validity in an urban sample and a national food survey.

Design:

A cross-sectional study was conducted in two phases: screener validation with a convenience sample of 327 adults in Quito through an online questionnaire (2021), and assessment of its applicability using data from the 2012 Ecuadorian National Health and Nutrition Survey (ENSANUT-Ecu). The method, adapted from a similar study in Brazil, compared NOVA UPF scores to the 24 Hour-Recall (24-HR) Automated Multiple-Pass Method (AMPM), used as the gold standard.

Setting:

The study included Quito’s urban population for validation and secondary data from ENSANUT-Ecu.

Participants:

327 adults aged 18 to 64 from Quito were included in the validation phase, and 3510 adults from the ENSANUT-Ecu dataset were analyzed in the secondary analysis.

Results:

The screener adaptation identified 27 subgroups of commonly consumed UPFs, summarizing 90% of UPF caloric intake. Validation results indicated significant agreement between the NOVA-UPF score and UPF intake, with PABAK indices above 0·8 for most socio-demographic groups. Higher NOVA-UPF scores corresponded to increased UPF dietary shares, mirroring patterns observed in the ENSANUT-Ecu dataset.

Conclusions:

The adapted NOVA 27 UPFs Screener is a valid tool for assessing UPF intake in Ecuador, offering a practical resource for future dietary surveys to monitor and address UPF intake among Ecuadorian adults.

Type
Research Paper
Information
Public Health Nutrition , Accepted manuscript , pp. 1 - 24
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Authors 2025