An Overlap between "ultraprocessed" Foods and the Preexisting Nutrient Rich Foods Index?

Abstract

The category of "ultraprocessed"foods in the NOVA food classification scheme is ostensibly based on industrial processing. We compared NOVA category assignments with the preexisting family of Nutrient Rich Food (NRF) indices, first developed in 2004. The NRF indices are composed of 2 subscores: the positive NR based on protein, fiber, and vitamins and minerals, and the negative LIM subscore based on saturated fat, added sugars, and sodium. The 378 foods that were components of the widely used Fred Hutchinson Cancer Center food frequency questionnaire were assigned to NOVA categories and scored using multiple NRF indices. Contrary to published claims, NOVA was largely based on the foods' content of saturated fat, added sugars, and sodium. There were strong similarities between NOVA categories and NRF scores that were largely driven by the nutrients to limit. Nutrient density led to higher increased NRF scores but had less impact on NOVA categories. As a result, the NOVA scheme misclassified some nutrient-rich foods. We conclude that the NOVA classification scheme adds little to the preexisting nutrient profiling models. The purported links between NOVA categories and health outcomes could have been obtained using preexisting NRFn.3 nutrient density metrics.