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Accepted manuscript

A novel food frequency questionnaire for Brazilian adults based on the Nova classification system: development, reproducibility and validation

Published online by Cambridge University Press:  27 March 2025

Evelyn Oliveira da Silva Frade Open the ORCID record for Evelyn Oliveira da Silva Frade [Opens in a new window] ,
Kamila Tiemann Gabe Open the ORCID record for Kamila Tiemann Gabe [Opens in a new window] ,
Caroline dos Santos Costa Open the ORCID record for Caroline dos Santos Costa [Opens in a new window] ,
Daniela Neri ,
Euridice Martinez Steele ,
Fernanda Rauber Open the ORCID record for Fernanda Rauber [Opens in a new window] ,
Josiane Steluti ,
Renata Bertazzi Levy  and
Maria Laura da Costa Louzada
Evelyn Oliveira da Silva Frade*
Affiliation:
Postgraduate Program in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, Brazil Centre for Epidemiological Studies in Nutrition and Health, School of Public Health, University of São Paulo
Kamila Tiemann Gabe
Affiliation:
Centre for Epidemiological Studies in Nutrition and Health, School of Public Health, University of São Paulo
Caroline dos Santos Costa
Affiliation:
Centre for Epidemiological Studies in Nutrition and Health, School of Public Health, University of São Paulo
Daniela Neri
Affiliation:
Centre for Epidemiological Studies in Nutrition and Health, School of Public Health, University of São Paulo
Euridice Martinez Steele
Affiliation:
Centre for Epidemiological Studies in Nutrition and Health, School of Public Health, University of São Paulo
Fernanda Rauber
Affiliation:
Centre for Epidemiological Studies in Nutrition and Health, School of Public Health, University of São Paulo Department of Preventive Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
Josiane Steluti
Affiliation:
Public Policies and Collective Health Department, Health and Society Institute, Federal University of Sao Paulo, Santos, Brazil
Renata Bertazzi Levy
Affiliation:
Centre for Epidemiological Studies in Nutrition and Health, School of Public Health, University of São Paulo Department of Preventive Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
Maria Laura da Costa Louzada
Affiliation:
Centre for Epidemiological Studies in Nutrition and Health, School of Public Health, University of São Paulo Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
*
Corresponding author: Evelyn Oliveira da Silva Frade | E-mail: [email protected] | Centre for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo
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Abstract

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Objective:

To describe the development and validation of the Nova Food-Frequency Questionnaire (NovaFFQ) for Brazilian adults.

Design:

The NovaFFQ is a self-administered, semi-quantitative questionnaire. The food list includes the most consumed foods and drinks based on 2017-2018 National Food Intake Survey data. We identified and differentiated foods that could be classified into multiple Nova groups. We assessed reproducibility and criterion validity using the percent energy contribution of each Nova group. Reproducibility was assessed by comparing NovaFFQ estimates on two occasions. Criterion validity was assessed by comparing the first NovaFFQ estimate against the mean of two Nova24h recalls. We estimated the intraclass correlation coefficients for both analyses and assessed the agreement of classification into quintiles using the prevalence-and-bias-adjusted kappa coefficients for criterion validity analysis.

Setting:

Nationwide Brazilian study, the NutriNet-Brasil cohort.

Participants:

There were 243 participants in the reproducibility analysis and 377 in the criterion validity analysis.

Results:

Strong reproducibility was observed, with an intraclass correlation coefficient of 0.91 for all the Nova groups. Criterion validity showed a moderate intraclass correlation coefficient, ranging from 0.61 for processed and ultra-processed foods to 0.65 for unprocessed and minimally processed foods. Substantial agreement in ranking individuals across quintiles was found, as indicated by the prevalence-and-bias-adjusted kappa (PABAKs= 0.74, 0.72, 0.70 and 0.73 for unprocessed and minimally processed foods, culinary ingredients, and processed and ultra-processed foods, respectively).

Conclusions:

The NovaFFQ is a valid instrument for assessing food consumption by processing level, especially for discriminating individuals according to the magnitude of consumption in all Nova groups.

Keywords

dietary intakeNova systemsurveys and questionnairesnutritional epidemiology
Type
Research Paper
Information
Public Health Nutrition , Accepted manuscript , pp. 1 - 28
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society