Trial reportThe American journal of clinical nutrition2023
Reliability and validity of assigning ultraprocessed food categories to 24-h dietary recall data.
Trial report in The American journal of clinical nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled 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
- Association between ultra-processed foods and risk of cancer: a systematic review and meta-analysis.Frontiers in nutrition · 2023Pooled it
- Beyond Nutrients: NOVA-Defined Dietary Patterns in Crohn's Disease and Healthy Adults.Nutrients · 2026Trial
- Ultra-processed food consumption and BMI-Z among children at risk for obesity from low-income households.Pediatric obesity · 2023Trial
- A call for methodological rigour: suspending systematic reviews and meta-analyses of observational studies on ultra-processed foods.European journal of clinical nutrition · 2026Review
- The validity and utility of Nova and the concept of ultra-processed foods for science and policy.Nature food · 2026Review
- Understandings of ultra-processed foods among adults with responsibility for household food activities in the United Kingdom: a qualitative study.BMC global and public health · 2026Article
- Comparison of food processing classification frameworks in the NHANES 2017-2018.The American journal of clinical nutrition · 2026Article
- Variations of Dietary Intake Across Migraine Phases in Adults with Episodic Migraine: A Prospective Observational Pilot Study.Current developments in nutrition · 2026Article
- Ultra-Processed Foods and the Cardiovascular-Kidney-Metabolic Continuum: Integrating Epidemiological, Multi-Omics, and Translational Evidence.Nutrients · 2026Review
- 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
- Ultra-processed food exposure and health outcomes: Current evidence, controversies, and future perspectives.EXCLI journal · 2026Review
- Nutritional status is linked to muscle strength and perceived function in adults with muscular dystrophy: evidence for targeted nutritional interventions.The British journal of nutrition · 2025Article
- Ultra-Processed Foods and Metabolic Dysfunction: A Narrative Review of Dietary Processing, Behavioral Drivers and Chronic Disease Risk.Metabolites · 2025Review
- Energy contribution from ultra processed foods in peruvian children.Revista peruana de medicina experimental y salud publica · 2025Article
- The role of ultra-processed food in obesity.Nature reviews. Endocrinology · 2025Review
- Federal Nutrition Assistance Programs and UltraProcessed Food Intake among Preschool-Aged Children.Current developments in nutrition · 2025Article
- The Impact of Eating Behaviors on Ultraprocessed Food Consumption Over 12 Months in Children.Obesity (Silver Spring, Md.) · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundThe Nova classification system categorizes foods into 4 processing levels, including ultraprocessed foods (UPFs). Consumption of UPFs is extensive in the United States, and high UPF consumption is associated with chronic disease risk. A reliable and valid method to Nova-categorize foods would advance understanding of UPF consumption and its relationship to health outcomes.
objectivesTest the reliability and validity of training coders and assigning Nova categories to individual foods collected via 24-h dietary recalls.
designA secondary analysis of 24-h dietary recalls from 610 children who participated in a randomized controlled trial and were 3-5 y old at baseline was conducted. The Nutrition Data System for Research (NDSR) software was used to collect 2-3 dietary recalls at baseline and yearly for 3 y. Trained and certified coder pairs independently categorized foods into one of 4 Nova categories (minimally processed, processed culinary ingredients, processed, and ultraprocessed). Interrater reliability was assessed by percent concordance between coder pairs and by Cohen's κ coefficient. Construct validity was evaluated by comparing the average daily macronutrient content of foods between Nova categories.
resultsIn 5546 valid recall days, 3099 unique foods were categorized: minimally processed (18%), processed culinary ingredients (0.4%), processed (15%), and ultraprocessed (67%). Coder concordance = 88.3%, and κ coefficient = 0.75. Descriptive comparisons of macronutrient content across 66,531 diet recall food entries were consistent with expectations. On average, UPFs were 62% (SD 19) of daily calories, and a disproportionally high percentage of daily added sugar (94%; SD 16) and low percentage of daily protein (47%; SD 24). Minimally processed foods were 30% (SD 17) of daily calories, and a disproportionally low percentage of daily added sugar (1%; SD 8) and high percentage of daily protein (43%; SD 24).
conclusionsThis method of Nova classifying NDSR-based 24-h dietary recalls was reliable and valid for identifying individual intake of processed foods, including UPFs.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.