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This study aimed to adapt and validate the NOVA 27 ultra-processed food (UPF) Screener for use in Ecuador by identifying commonly consumed foods, classifying them using the NOVA system and testing the screener’s validity in an urban sample and a national food survey.
Design:
A cross-sectional study was conducted in two phases: screener validation with a convenience sample of 327 adults in Quito through an online questionnaire (2021) and assessment of its applicability using data from the 2012 Ecuadorian National Health and Nutrition Survey (ENSANUT-Ecu). The method, adapted from a similar study in Brazil, compared NOVA UPF scores to the 24 h-Recall (24-HR) automated multiple-pass method, used as the gold standard.
Setting:
The study included Quito’s urban population for validation and secondary data from ENSANUT-Ecu.
Participants:
Three hundred and twenty-seven adults aged 18–64 from Quito were included in the validation phase, and 3510 adults from the ENSANUT-Ecu dataset were analysed in the secondary analysis.
Results:
The screener adaptation identified twenty-seven subgroups of commonly consumed UPF, summarising 90 % of UPF energy intake. Validation results indicated significant agreement between the NOVA-UPF score and UPF intake, with PABAK indices above 0·8 for most socio-demographic groups. Higher NOVA-UPF scores corresponded to increased UPF dietary shares, mirroring patterns observed in the ENSANUT-Ecu dataset.
Conclusions:
The adapted NOVA 27 UPF Screener is a valid tool for assessing UPF intake in Ecuador, offering a practical resource for future dietary surveys to monitor and address UPF intake among Ecuadorian adults.
To update the estimate of mean salt intake for the Australian population made by the Australian Health Survey (AHS).
Design
A secondary analysis of the data collected in a cross-sectional survey was conducted. Estimates of salt intake were made in Lithgow using the 24 h diet recall methodology employed by the AHS as well as using 24 h urine collections. The data from the Lithgow sample were age- and sex-weighted, to provide estimates of daily salt intake for the Australian population based upon (i) the diet recall data and (ii) the 24 h urine samples.
Setting
Lithgow, New South Wales, Australia.
Subjects
Individuals aged ≥20 years residing in Lithgow and listed on the 2009 federal electoral roll.
Results
Mean (95 % CI) salt intake estimated from the 24 h diet recalls was 6·4 (6·2, 6·7) g/d for the Lithgow population compared with a corresponding figure of 6·2 g/d for the Australian population derived from the AHS. The corresponding estimate of salt intake for Lithgow adults based upon the 24 h urine collections was 9·0 (8·6, 9·4) g/d. When the age- and sex-specific estimates of salt intake obtained from the 24 h urine collections in the Lithgow sample were weighted using Australian census data, estimated salt intake for the Australian population was 9·0 (8·6, 9·5) g/d. Further adjustment for non-urinary Na excretion made the best estimate of daily salt intake for both Lithgow and Australia about 9·9 g/d.
Conclusions
The dietary recall method used by the AHS likely substantially underestimated mean population salt consumption in Australia.
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