Development and Validation of a New Tool for Assessing the Intake of Ultra-Processed Foods in Adult Population: GR-UPFAST.

BACKGROUND AND AIMS: One of the most widely used classification systems for ultra-processed foods is NOVA. However, it lacks adaptability to the Greek dietary context and market. Thus, the aim was to develop a valid and easy-to-use tool, friendly to health professionals, which, in combination with the existing nutritional assessment tools, will be able to determine the level of UPF consumption and dietary habits of young Greek adults. METHODS: For the GR-UPFAST (GReek Ultra Processed Food intake ASsessment Tool) design, a multi-station procedure was followed; literature review, field visits in food markets, classification, and definition of food types and portions. Four experienced nutritionists conducted content and face validity. Then, a cross-sectional study in 220 young adults, aged 18-30, both males and females was performed. Internal consistency of the GR-UPFAST was assessed using Cronbach's alpha. Criterion and predictive validity were evaluated through Spearman's correlations with MedDietScore and body weight. Construct validity was assessed with confirmatory factor analysis. RESULTS: Total Cronbach's α value was 0.766. Cronbach's α values if an item deleted ranged from 0.720 to 0.770, indicating overall good and stable internal consistency. Confirmatory factor analysis confirmed the one-dimension GR-UPFAST's structure, and the very good model fit (x2/df = 0.61). GR-UPFAST score was negatively correlated with the MedDietScore (rho = -0.162, p = 0.016) and positively with body weight (rho = 0.140, p = 0.039). CONCLUSIONS: GR-UPFAST appears to be a practical and valid tool for assessing UPF consumption among Greek younger adults. It may enhance comprehension of nutrition in younger adults and probably in other Greek and Mediterranean populations.