Dietary Guidelines Meet NOVA: Developing a Menu for A Healthy Dietary Pattern Using Ultra-Processed Foods

• Published in: The Journal of nutrition Vol. 153; no. 8; p. 2472
• Main Authors: Hess, Julie M, Comeau, Madeline E, Casperson, Shanon, Slavin, Joanne L, Johnson, Guy H, Messina, Mark, Raatz, Susan, Scheett, Angela J, Bodensteiner, Anne, Palmer, Daniel G
• Format: Journal Article
• Language: English
• Published: United States 01-08-2023
• Subjects: Diet; Energy Intake; Fast Foods; Food Handling; Food, Processed; Humans; Micronutrients; Nutrition Policy; Vitamins; NOVA; ultra-processed food; dietary guidelines; food processing; diet quality
• ISSN: 1541-6100
• DOI: 10.1016/j.tjnut.2023.06.028

A proposed topic for the 2025 Dietary Guidelines for Americans (DGA) Scientific Advisory Committee to address is the relationship between dietary patterns with ultra-processed foods (UPF) and body composition and weight status. Implementing the NOVA system, the most commonly applied framework for determining whether a food is "ultra-processed," in dietary guidance could omit several nutrient-dense foods from recommended healthy diets in the DGA.
The purpose of this proof-of-concept study was to determine the feasibility of building a menu that aligns with recommendations for a healthy dietary pattern from the 2020 DGA and includes ≥80% kcal from UPF as defined by NOVA.
To accomplish this objective, we first developed a list of foods that fit NOVA criteria for UPF, fit within dietary patterns in the 2020 DGA, and are commonly consumed by Americans. We then used these foods to develop a 7-d, 2000 kcal menu modeled on MyPyramid sample menus and assessed this menu for nutrient content as well as for diet quality using the Healthy Eating Index-2015 (HEI-2015).
In the ultra-processed DGA menu that was created, 91% of kcal were from UPF, or NOVA category 4. The HEI-2015 score was 86 out of a possible 100 points. This sample menu did not achieve a perfect score due primarily to excess sodium and an insufficient amount of whole grains. This menu provided adequate amounts of all macro- and micronutrients except vitamin D, vitamin E, and choline.
Healthy dietary patterns can include most of their energy from UPF, still receive a high diet quality score, and contain adequate amounts of most macro- and micronutrients.