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

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.