Adaptation and Validation of the Nova-UPF Screener for the Assessment of Ultra-Processed Food Intake in Portuguese Adults

Q: What was the purpose of adapting the Nova-UPF screener in this study?

To adapt and validate the Nova-UPF screener, a brief food-based questionnaire, for assessing ultra-processed food intake among Portuguese adults.

Q: How was validity assessed for the Portuguese Nova-UPF screener?

Criterion validity evaluated the relationship between the Nova-UPF score and the percentage of energy intake from UPFs, while construct validity tested predefined hypotheses and agreement using PABAK.

Q: What key results were reported about the performance of the Portuguese Nova-UPF screener?

The final version included 25 subgroups, showed a positive association with UPF energy contribution, and demonstrated near-perfect agreement between quintiles of UPF intake and Nova-UPF score (PABAK = 0.86).

Sep 30, 2026

Uploaded by SANS

Urgent demand exists for practical, standardized methods to measure ultra-processed food (UPF) intake as diet-related diseases rise. This study adapted and validated the Nova-UPF screener, originally developed in Brazil, for Portuguese adults. Adaptation used data from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015–2016) and refined it through DELPHI. Validation with 304 adults used an electronic questionnaire and a 24 h dietary recall, testing criterion and construct validity.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Abstract

Introduction

Dietary patterns and UPF growth

Health impacts associated with UPFs

UPFs and poor dietary quality

UPF availability in Portugal

Article Adaptation and Validation of the Nova-UPF Screener for the Assessment of Ultra-Processed Food Intake in Portuguese Adults Sandra Abreu 1,2,3,4, *, Caroline dos Santos Costa 5 and Margarida Liz Martins 6,7,8,9 Academic Editor: Antonio Cepeda-Benito Received: 30 November 2025 Revised: 23 December 2025 Accepted: 24 December 2025 Published: 27 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 School of Life and Environment Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5001-801 Vila Real, Portugal 2 RISE-Health, Department of Genetics and Biotechnology, School of Life and Environmental Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal 3 Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4050-313 Porto, Portugal 4 Laboratory for Integrative and Translational Research in Population Health, 4050-600 Porto, Portugal 5 Centre for Epidemiological Studies in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; [carolinercosta@gmail.com](carolinercosta@gmail.com) 6 Coimbra Health School, Polytechnic University of Coimbra, 3045-093 Coimbra, Portugal; [margarida.liz@estesc.ipc.pt](margarida.liz@estesc.ipc.pt) 7 H&TRC—Health & Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, 3045-093 Coimbra, Portugal 8 Sports and Physical Activity Research Center, University of Coimbra, 3040-248 Coimbra, Portugal 9 Research Centre for Anthropology and Health, University of Coimbra, 3000-456 Coimbra, Portugal * Correspondence: [sandraabreu@utad.pt](sandraabreu@utad.pt) Abstract Background/Objectives: With the increasing global concern about diet-related diseases associated with the consumption of ultra-processed foods (UPFs), there is an urgent need for practical and standardized tools to evaluate and monitor UPF intake. This study aimed to adapt and validate the Nova-UPF screener, a brief, food-based questionnaire originally developed in Brazil, for use among Portuguese adults. Methods: The adaptation process relied on data from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015–2016) and was refined using the DELPHI methodology. A validation study was carried out with a convenience sample of 304 adults through an electronic questionnaire. Dietary intake was evaluated using a 24 h dietary recall. Criterion validity was assessed by examining the relationship between the Nova-UPF score and the percentage of total energy intake (TEI) from UPFs, while construct validity was evaluated based on predefined hypotheses. Agreement between quintiles of Nova-UPF score and quintiles of UPF contribution to TEI was tested using the prevalence and bias-adjusted kappa (PABAK) index. Results: The final Portuguese version of the Nova-UPF screener includes 25 subgroups. The Nova-UPF score was positively associated with the percentage of UPF contribution to TEI (B = 6.224, p < 0.001) . Participants in the highest quintiles of the Nova-UPF score had higher TEI but lower consumption of monounsaturated and polyunsaturated fats, potassium, and dietary fibre. There was a near-perfect agreement between quintile classifications of UPF and Nova-UPF score (PABAK = 0.86) . Conclusions: The Portuguese Nova-UPF screener is a valid, simple, and quick tool for evaluating UPF consumption and dietary quality in adults. Keywords: food classification systems; NOVA classification; ultra-processed foods; validation study 1. Introduction Changes in the dietary patterns of populations in recent decades has determined an increase in consumption of “convenience” foods and beverages, ready-to-eat products and packaged food that replaced traditional dietary patterns b

FAQs

What was the purpose of adapting the Nova-UPF screener in this study?

To adapt and validate the Nova-UPF screener, a brief food-based questionnaire, for assessing ultra-processed food intake among Portuguese adults.

How was validity assessed for the Portuguese Nova-UPF screener?

Criterion validity evaluated the relationship between the Nova-UPF score and the percentage of energy intake from UPFs, while construct validity tested predefined hypotheses and agreement using PABAK.

What key results were reported about the performance of the Portuguese Nova-UPF screener?

The final version included 25 subgroups, showed a positive association with UPF energy contribution, and demonstrated near-perfect agreement between quintiles of UPF intake and Nova-UPF score (PABAK = 0.86).

Sep 30, 2026

Uploaded by SANS