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Accepted manuscript

Validation of a screener to assess ultra-processed food consumption in the adult Indian population: The Nova-UPF Screener (for India)

Published online by Cambridge University Press:  26 September 2025

Suparna Ghosh-Jerath*
Affiliation:
The George Institute for Global Health, New Delhi, India Email: SGhosh-Jerath@georgeinstitute.org.in
Srishti Mediratta
Affiliation:
Lady Irwin College, University of Delhi, New Delhi, India Email: srishti.mediratta@lic.du.ac.in
Gaurika Kumar
Affiliation:
The George Institute for Global Health, New Delhi, India Email: gaurika.kumar12@gmail.com
Sahiba Kohli
Affiliation:
The George Institute for Global Health, New Delhi, India Email: SKohli@georgeinstitute.org.in
Fernanda H Marrocos-Leite
Affiliation:
Center for Epidemiological Research in Nutrition and Health, Faculty of Public Health, University of Sao Paulo, Sao Paulo, Brazil Email: fernandahml@gmail.com
Neha Khandpur
Affiliation:
Wageningen University, Wageningen, the Netherlands Email: neha.khandpur@wur.nl
K Srinath Reddy
Affiliation:
Public Health Foundation of India, Haryana, India Email: ksrinath.reddy@phfi.org
*
Corresponding author: Suparna Ghosh-Jerath: The George Institute for Global Health, 308, Third Floor, Elegance Tower, Plot No. 8, Jasola District Centre, New Delhi 110025, India; Email: SGhosh-Jerath@georgeinstitute.org.in; Phone: +91-9711311910.
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Abstract

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Increasing prevalence of diet-related non-communicable diseases in India is attributed to overconsumption of energy-dense, nutrient-poor diets and ultra processed foods (UPFs) may potentially contribute to this consumption pattern. Applying standard UPF definition and developing appropriate tools can better capture its consumption among Indians. This cross-sectional study aimed to validate the ‘Nova-UPF Screener (for India)’ and explore its potential to objectively capture UPF consumption among Indian adults. The screener, adapted in prior formative research study from a tool for Brazilian population, was subjected to content, face, and concurrent criterion validation. Subject matter experts (n=74) participated in online consultations to determine its content validity. Adults (18-60 years) from different geographical regions of India were included for face (n=70) and concurrent criterion (n=304) validations. The screener comprised 24 UPF categories specific to Indian food environment. Critical inputs from experts on screener’s appropriateness were incorporated to enhance its content. For face validation, overall percentage agreement of 99.4% for all questions indicated a strong agreement for retaining screener attributes in each question. Half the participants (49.4%) who were administered the finalized screener had Nova-UPF scores between 2 to 4 out of 24. There was almost perfect agreement (Pabak index = 0.85) between distribution of participants based on Nova-UPF scores and fifths of dietary share of UPFs (as energy %) assessed by 24-hour dietary recall. Nova-UPF Screener (for India) is a valid tool to capture UPF consumption in India that can be used for rapid assessment of UPF consumption and informing policies to improve Indian diets.

Information

Type
Research Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society