====== Ultra-processed food categorization according to the NOVA classification ====== Researchers from the [[https://www.rug.nl/staff/m.duan/|University Medical Center Groningen]] developed the Ultra-processed food (UPF) categorization for adults according to the NOVA classification using the [[ffq_sum_scores|Food Frequency Questionnaire Sum scores]] from the heart of the FFQ flower ([[1a_questionnaire_2|1A Questionnaire 2]]). ([[sections]]: [[Nutrition]] and [[secondary & linked variables]]).\\ The UPF food categorization can be requested in the Lifelines catalogue or by mail (data@lifelines.nl). When this data has been used in your research, you will have to include a reference to the the following paper: * [[https://doi.org/10.1186/s12916-021-02200-4|Duan, M. J., Vinke, P. C., Navis, G., Corpeleijn, E., & Dekker, L. H. (2022). Ultra-processed food and incident type 2 diabetes: studying the underlying consumption patterns to unravel the health effects of this heterogeneous food category in the prospective Lifelines cohort. BMC medicine, 20(1), 1-11.]] ===== Background information ===== //From the paper of [[https://doi.org/10.1186/s12916-021-02200-4|Duan et al. (2022)]]//\\ Research on UPF has been facilitated by the development of the NOVA classification. The NOVA classification is a frequently used method to categorize food and drinks based on the nature, extent, and purpose of food processing. The NOVA classification comprises four categories, ranging from un-processed/minimally processed food to UPF. According to the NOVA classification, UPF is mostly formulated from food substances and industrial ingredients that undergo a series of chemical and physical manufacturing processes. The resulting food products are often pre-packed, contain little or no intact (un-processed) food, and are considered microbiologically safe, convenient, and palatable.\\ \\ ===== Calculation of UPF categorization ===== Using the NOVA classification, the 110 food items from the [[ffq|FFQ heart]] were categorized in four proposed categories: - **Unprocessed or minimally processed food:** for example fresh vegetables or fruits and unprocessed meat - **Processed culinary ingredient:** for example butter or oil for cooking, sugar, and salt - **Processed food:** for example canned vegetables or fish and fruits in syrup - **Ultra-processed food:** for example processed meat, soft drinks Per category three types of variables have been created: * **Classification variable:** which adds up the intake of all food items that belong to the specific category * **Intake (nova) weight ratio variable:** which indicates the weight proportion (% grams) of a specific category in the total diet of a day * **Intake (nova) energy ratio variable:** which which indicates the energy ratio (grams/1000kcal) of a specific category in the total diet of a day === Remarks from the UMCG researchers === - The current categorization doesn't specifically handle the reliability of energy intake (provided in the [[ffq_sum_scores|Food Frequency Questionnaire Sum scores]]). This could be a decision for other researchers using the UPF classification data. To make this easier, the reliability variable from the [[ffq_sum_scores|FFQ sum scores]] has been added as variable. - According to the NOVA classification, some alcohol products should also be characterized as ultra-processed food. However, we did not do this because alcohol may have separate health effects. Therefore, we analyze alcohol intake always as a separate covariate. This is also practiced by other papers from other cohorts. \\ ===== Variables ===== | **Label English** | **Label Dutch** | **Code** | **Variable** | **Assessment** | **Age** | | food intake (gram per day) / NOVA classification 1: unprocessed or minimally processed food | voedselinname (gram per dag) / NOVA classificatie 1: onbewerkte of minimaal bewerkte voeding | nova_foodintake_adu_c_1 | nova1 | sec * | 18+ | | food intake (gram per day) / NOVA classification 2: processed culinary ingredient | voedselinname (gram per dag) / NOVA classificatie 2: bewerkt culinair ingrediënt | nova_foodintake_adu_c_2 | nova2 | sec * | 18+ | | food intake (gram per day) / NOVA classification 3: processed food | voedselinname (gram per dag) / NOVA classificatie 3: bewerkt voedsel | nova_foodintake_adu_c_3 | nova3 | sec * | 18+ | | food intake (gram per day) / NOVA classification 4: ultra-processed food | voedselinname (gram per dag) / NOVA classificatie 4: ultabewerkt voedsel | nova_foodintake_adu_c_4 | nova4 | sec * | 18+ | | % of the total food intake in gram per day / NOVA classification 1: unprocessed or minimally processed food | % van de totale voedselinname in gram per dag / NOVA classificatie 1: onbewerkte of minimaal bewerkte voeding | nova_weightratio_adu_c_1 | nova1prt | sec * | 18+ | | % of the total food intake in gram per day / NOVA classification 2: processed culinary ingredient | % van de totale voedselinname in gram per dag / NOVA classificatie 2: bewerkt culinair ingrediënt | nova_weightratio_adu_c_2 | nova2prt | sec * | 18+ | | % of the total food intake in gram per day / NOVA classification 3: processed food | % van de totale voedselinname in gram per dag / NOVA classificatie 3: bewerkt voedsel | nova_weightratio_adu_c_3 | nova3prt | sec * | 18+ | | % of the total food intake in gram per day / NOVA classification 4: ultra-processed food | % van de totale voedselinname in gram per dag / NOVA classificatie 4: ultabewerkt voedsel | nova_weightratio_adu_c_4 | nova4prt | sec * | 18+ | | gram per 1000kcal of the total food intake per day / NOVA classification 1: unprocessed or minimally processed food | gram per 1000kcal of de totale voedsellinname per dag / NOVA classificatie 1: onbewerkte of minimaal bewerkte voeding | nova_energyratio_adu_c_1 | nova1kcal | sec * | 18+ | | gram per 1000kcal of the total food intake per day / NOVA classification 2: processed culinary ingredient | gram per 1000kcal of de totale voedsellinname per dag / NOVA classificatie 2: bewerkt culinair ingrediënt | nova_energyratio_adu_c_2 | nova2kcal | sec * | 18+ | | gram per 1000kcal of the total food intake per day / NOVA classification 3: processed food | gram per 1000kcal of de totale voedsellinname per dag / NOVA classificatie 3: bewerkt voedsel | nova_energyratio_adu_c_3 | nova3kcal | sec * | 18+ | | gram per 1000kcal of the total food intake per day / NOVA classification 4: ultra-processed food | gram per 1000kcal of de totale voedsellinname per dag / NOVA classificatie 4: ultabewerkt voedsel | nova_energyratio_adu_c_4 | nova4kcal | sec * | 18+ | | reliability of the ffq heart results that were used to determine the nove scores | betrouwbaarheid van de ffq hart resultaten die zijn gebruikt voor het bepalen van de nova scores | nova_reliabilityffq_adu_c_1 | Betrouwbaarheid__nova | sec * | 18+ | * The UPF categorization according to the NOVA is included as assessment 'sec' because it is based on the FFQ sum scores.