Ultra-Processed Foods in the Mediterranean Diet according to the NOVA Classification System; A Food Level Analysis of Branded Foods in Greece

• Published in: Foods 2023-04, Vol.12 (7), p.1520
• Main Authors: Katidi, Alexandra, Vlassopoulos, Antonis, Noutsos, Stamoulis, Kapsokefalou, Maria
• Format: Article
• Language: English
• Subjects: Beverages; branded food composition databases; Cellulose; Classification; Diet; Food; Food availability; Food composition; Food processing; Food research; Food science; Fruits; Health aspects; Identification and classification; Ingredients; Mediterranean diet; Missing data; NOVA; Nutrient content; Nutrients; Nutrition research; Nutritive value; Packaged food; Plant-based foods; Processed foods; Pyramids; Sodium; Supermarkets; Sustainability; ultra-processed foods; Vegetables
• ISSN: 2304-8158; 2304-8158
• DOI: 10.3390/foods12071520

While the Mediterranean diet (MD) is championed as a healthy and sustainable dietary pattern, the NOVA classification is discussed as a tool to identify ultra-processed foods and further specify healthy food choices. We tested whether the NOVA System aligns with the MD recommendations as presented in the MD pyramids. Foods from the Greek branded food composition database, HelTH, (n = 4581) were scored according to NOVA and assigned to the tiers of the traditional and/or sustainable MD pyramids. Nutritional quality was measured as nutrient content and Nutri-Score grades. NOVA identified 70.2% of all foods as UPFs, and 58.7% or 41.0% of foods included in the sustainable and the traditional MD, respectively. Although foods at the top of the pyramids were mostly (>80%) UPFs, NOVA identified > 50% of foods in the MD base as UPFs. Only 22-39% of foods in the MD base were not UPFs and of high nutritional quality (Nutri-Score A-B). NOVA has low discriminatory capacity across the MD tiers, and it restricts food choices to