ArticleJournal of nutritional science2021
Categorising ultra-processed foods in large-scale cohort studies: evidence from the Nurses' Health Studies, the Health Professionals Follow-up Study, and the Growing Up Today Study.
Article in Journal of nutritional science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 1 of them a synthesis that pooled it.
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Who cites it
73 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses.BMJ (Clinical research ed.) · 2024Pooled it
- Beyond Nutrients: NOVA-Defined Dietary Patterns in Crohn's Disease and Healthy Adults.Nutrients · 2026Trial
- Processed foods in the context of a vegan diet, and changes in body weight and severe hot flashes in postmenopausal women: a secondary analysis of a randomized clinical trial.Menopause (New York, N.Y.) · 2025Trial
- Isocaloric replacement of ultraprocessed foods was associated with greater weight loss in the POUNDS Lost trial.Obesity (Silver Spring, Md.) · 2024Trial
- Metabolomic Profiling of an Ultraprocessed Dietary Pattern in a Domiciled Randomized Controlled Crossover Feeding Trial.The Journal of nutrition · 2023Trial
- Intake of ultra-processed foods in Sweden and its association with diet quality and weight status: cross-sectional analyses from three national dietary surveys.Nutrition journal · 2026Article
- Longitudinal Changes in Healthy Eating Index-2020 Score and Impacts on Body Mass Index among Adolescents in the Growing Up Today Study: A Prospective Cohort Study.The Journal of nutrition · 2026Article
- The association between ultra-processed food exposure and cognition in older adults.GeroScience · 2026Article
- Reproducibility of an 85-item Child Food Frequency Questionnaire (85-item Child-FFQ) and diet quality scores among Polish children: The cross-sectional PITNUTS 2024 study.BMC pediatrics · 2026Observational
- Ultraprocessed Foods and the Risk of Cognitive Impairment and Dementia in Older US Adults: 2013-2020 Health and Retirement Study.American journal of public health · 2026Article
- The validity and utility of Nova and the concept of ultra-processed foods for science and policy.Nature food · 2026Review
- Foods of concern, cardiopreventive medication use and risk of cardiovascular diseases: a prospective study in the CARTaGENE cohort.The American journal of clinical nutrition · 2026Article
- Multilevel predictors of ultra-processed food intake in Canadian preschoolers.Communications medicine · 2026Article
- Ultraprocessed Food Consumption and Behavioral Outcomes in Canadian Children.JAMA network open · 2026Article
- The Future of Food Processing-A Food Science and Technology Perspective. Proceedings of a Roundtable Event.Nutrition bulletin · 2026Article
- Blood pressure is associated with ultra-processed food intake in a sex- and age-specific manner during the transition to adulthood in Cebu, Philippines.The British journal of nutrition · 2026Article
- Associations Between Consumption of Ultra-Processed Foods and Diet Quality Among Children and Adolescents.Nutrients · 2026Article
- When ultra-processing obscures sustainable dietary transitions.Frontiers in nutrition · 2026Article
- Does the definition of human ultra-processed foods apply to dog and cat foods? A review of pet food processing techniques, their impact on health, and a call for pet food processing classification.Frontiers in veterinary science · 2026Article
- Ultra-processed food exposure and health outcomes: Current evidence, controversies, and future perspectives.EXCLI journal · 2026Review
13 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This manuscript details the strategy employed for categorising food items based on their processing levels into the four NOVA groups. Semi-quantitative food frequency questionnaires (FFQs) from the Nurses' Health Studies (NHS) I and II, the Health Professionals Follow-up Study (HPFS) and the Growing Up Today Studies (GUTS) I and II cohorts were used. The four-stage approach included: (i) the creation of a complete food list from the FFQs; (ii) assignment of food items to a NOVA group by three researchers; (iii) checking for consensus in categorisation and shortlisting discordant food items; (iv) discussions with experts and use of additional resources (research dieticians, cohort-specific documents, online grocery store scans) to guide the final categorisation of the short-listed items. At stage 1, 205 and 315 food items were compiled from the NHS and HPFS, and the GUTS FFQs, respectively. Over 70 % of food items from all cohorts were assigned to a NOVA group after stage 2. The remainder were shortlisted for further discussion (stage 3). After two rounds of reviews at stage 4, 95⋅6 % of food items (NHS + HPFS) and 90⋅7 % items (GUTS) were categorised. The remaining products were assigned to a non-ultra-processed food group (primary categorisation) and flagged for sensitivity analyses at which point they would be categorised as ultra-processed. Of all items in the food lists, 36⋅1 % in the NHS and HPFS cohorts and 43⋅5 % in the GUTS cohorts were identified as ultra-processed. Future work is needed to validate this approach. Documentation and discussions of alternative approaches for categorisation are encouraged.
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