Energy Contribution of the Nova Food Groups & Their Association with Nutritional Status of Urban Dwellers in Accra, Ghana.

Abstract

Background: NOVA is a food classification system that is based on the type, extent, and purpose of processing of the food. A primary reason for its establishment was to help consumers understand the difference between unprocessed or minimally processed foods and highly processed foods, sensitize them, and guide the development of dietary food guidelines. According to research, Obesity and other associated health conditions have been linked to an increase in the consumption of ultra-processed foods (UPF). Aim: To estimate the energy and macronutrient contribution of the NOVA food groups consumed in the diet of urban dwellers in Accra and their association with their nutritional status. Methods: The study employed secondary analysis of a descriptive cross-sectional food consumption survey conducted as part of a research project to develop a photographic food atlas with the portion sizes of commonly consumed animal and plant protein source foods in the Greater Accra Metropolitan Area. The study drew on the information of 700 of the 834 original study participants whose available data satisfied the inclusion criteria for this present study (i.e., age, sex, religion, occupation, educational level, marital status, ethnicity, waist-to-hip circumference, and 3-day 24-hour-dietary recall). The pattern of NOVA food groups consumption was described as frequencies and proportions. and the estimated energy and macronutrient (i.e., Protein, carbohydrate, and fat) contribution of each NOVA food group to the intakes of study participants was also calculated. Additionally, logistic regression models were applied to evaluate the relationship between participants’ characteristics and the commonly consumed NOVA food. Lastly, the relationship between the type of NOVA foodgroups and the nutritional status (Body Mass Index and Waist-to-Hip ratio) of study participants was assessed using multiple linear regression techniques. Statistical analysis was performed with STATA and level of significance was set at p-value ≤ 0.05. Results: Ultra-processed food was the most frequently consumed by 40.97% of the study population, followed by unprocessed or minimally processed food (35.89%), processed food (20.18%), and processed culinary ingredients (2.96%). However, minimally processed food contributed the most calories (59.9%). This was followed by processed foods which accounted for 38.3% of calorie intake, ultra-processed foods (1.4%) and processed culinary (0.5%). A statistically significant (p value < 0.05) association was found between educational level (p value =0.04) as well as occupation (p value <0.001) and consumption of ultra processed food. No significant association (p > 0.05) ) was found between NOVA food types consumed and nutritional status (BMI and WHR) of study participants after controlling for demographic and socio-economic characteristics of study participant. However, age and sex were found to be predictors of nutritional status (BMI and WHR). Conclusion: Ultra-processed foods were frequently consumed although they contributed only 1.4% of the total caloric intake. Furthermore, educational level and occupation were associated with consumption of ultra-processed food.