ArticleEuropean journal of clinical nutrition2022
Ultra-processed foods: how functional is the NOVA system?
Article in European journal of clinical nutrition, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 137 papers, 5 of them syntheses that pooled it.
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The trial behind it
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Who cites it
137 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Ultra-processed food consumption and risk of infertility in adults: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- A meta-analysis of epigenome-wide association studies of ultra-processed food consumption with DNA methylation in European children.Clinical epigenetics · 2025Pooled it
- Ultra-Processed Food Intake and Risk of Insomnia: A Systematic Review and Meta-Analysis.Nutrients · 2024Pooled it
- Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses.BMJ (Clinical research ed.) · 2024Pooled it
- Ultra-processed foods consumption and health-related outcomes: a systematic review of randomized controlled trials.Frontiers in nutrition · 2024Pooled it
- Identification and validation of poly-metabolite scores for diets high in ultra-processed food: An observational study and post-hoc randomized controlled crossover-feeding trial.PLoS medicine · 2025Trial
- Trial
- Metabolomic Profiling of an Ultraprocessed Dietary Pattern in a Domiciled Randomized Controlled Crossover Feeding Trial.The Journal of nutrition · 2023Trial
- Review
- When Ultra-Processed Foods are Eaten: The Missing Dimension in Exposure Measurement for Obesity Research.Current obesity reports · 2026Review
- Ultra-processed Foods and Athletes: Current Insights on Classification, Use, Awareness, and Impact-A Narrative Review.Sports medicine - open · 2026Review
- The Gut-brain-adipose Axis in Ultra-processed Food and Obesity: A Mechanistic Synthesis and Its Implications for Food Classification.Current obesity reports · 2026Review
- Are All Ultra-Processed Foods Created Equal? Descriptive Analysis of Nutritional Composition, Nutritional Quality, Energy Density and Hyperpalatability in Relation to Non-Communicable Disease Risk.Foods (Basel, Switzerland) · 2026Article
- Before we tell people to avoid ultra-processed foods, can they identify them? The case for cognitive validity criteria in food classification.Public health nutrition · 2026Article
- A call for methodological rigour: suspending systematic reviews and meta-analyses of observational studies on ultra-processed foods.European journal of clinical nutrition · 2026Review
- Meal-based nutrient profiling models for the away-from-home food environment in Southeast Asia.Asia Pacific journal of clinical nutrition · 2026Article
- Article
- Enhancing Practical Utility and Policy Integration of Ultra-Processed Food Screeners.Public health nutrition · 2026Article
- Ultra-processed foods and cardiometabolic risk: from evidence to policy.npj metabolic health and disease · 2026Article
- The validity and utility of Nova and the concept of ultra-processed foods for science and policy.Nature food · 2026Review
77 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the NOVA classification system, descriptive criteria are used to assign foods to one of four groups based on processing-related criteria. Although NOVA is widely used, its robustness and functionality remain largely unexplored. We determined whether this system leads to consistent food assignments by users.
methodsFrench food and nutrition specialists completed an online survey in which they assigned foods to NOVA groups. The survey comprised two lists: one with 120 marketed food products with ingredient information and one with 111 generic food items without ingredient information. We quantified assignment consistency among evaluators using Fleiss' κ (range: 0-1, where 1 = 100% agreement). Hierarchical clustering on principal components identified clusters of foods with similar distributions of NOVA assignments.
resultsFleiss' κ was 0.32 and 0.34 for the marketed foods (n = 159 evaluators) and generic foods (n = 177 evaluators), respectively. There were three clusters within the marketed foods: one contained 90 foods largely assigned to NOVA4 (91% of assignments), while the two others displayed greater assignment heterogeneity. There were four clusters within the generic foods: three clusters contained foods mostly assigned to a single NOVA group (69-79% of assignments), and the fourth cluster comprised 28 foods whose assignments were more evenly distributed across the four NOVA groups.
conclusionsAlthough assignments were more consistent for some foods than others, overall consistency among evaluators was low, even when ingredient information was available. These results suggest current NOVA criteria do not allow for robust and functional food assignments.
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