目的:澳大利亚膳食指南目前正在修订中,超加工食品已被确定为高度优先行动领域。为了更好地了解当前的膳食指南与加工分类水平的一致性,这项研究的目的是评估澳大利亚膳食指南和NOVA分类系统在包装食品健康分类方面的一致性.
方法:数据来自澳大利亚FoodSwitch数据集,其中包括2022年澳大利亚主要超市提供的28071种包装食品和饮料产品。产品分为(i)核心或可自由支配的(澳大利亚饮食指南)和(ii)非超加工或超加工(NOVA)。两个系统之间的协议(核心与非超处理和自由裁量vs.超处理)使用卡帕统计量进行评估。
结果:澳大利亚膳食指南和NOVA系统之间存在“中度”协议(κ=0.41,95%CI:0.40-0.42),69.8%的产品在两个系统中保持一致。与核心食品(59.9%的对齐未经超加工)相比,可自由支配食品(80.6%的对齐未经超加工)更为常见。表现出最强一致性的食品类别包括糖果,特定饮食用途的食物,鸡蛋和蛋制品。不协调是最常见的方便食品,糖,糖蜂蜜及相关产品,谷物和谷物产品。
结论:尽管澳大利亚膳食指南和NOVA之间有适度的一致性,在近三分之一的产品中观察到的不一致现象凸显了在指南中制定超加工食品建议的机会,以建议澳大利亚人如何将这些食品视为健康饮食的一部分.
OBJECTIVE: The Australian Dietary
Guidelines are currently being revised and ultra-processed foods have been identified as a high priority action area. To better understand how well the current Dietary
Guidelines align with level of processing classifications, the aim of this study was to assess the alignment between the Australian Dietary
Guidelines and the NOVA classification system for classifying the healthiness of packaged foods.
METHODS: Data were sourced from the Australian FoodSwitch dataset, which included 28 071 packaged food and beverage products available in major Australian supermarkets in 2022. Products were classified as (i) core or discretionary (Australian Dietary Guidelines) and (ii) non-ultra-processed or ultra-processed (NOVA). Agreement between the two systems (core vs. non-ultra-processed and discretionary vs. ultra-processed) was evaluated using the kappa statistic.
RESULTS: There was \'moderate\' agreement (κ = 0.41, 95% CI: 0.40-0.42) between the Australian Dietary
Guidelines and the NOVA system, with 69.8% of products aligned across the two systems. Alignment was more common for discretionary foods (80.6% were ultra-processed) than core foods (59.9% aligned were not-ultra-processed). Food categories exhibiting the strongest levels of alignment included confectionary, foods for specific dietary use, and egg and egg products. Discordance was most common for convenience foods, sugars, honey and related products, and cereal and grain products.
CONCLUSIONS: Despite moderate alignment between the Australian Dietary
Guidelines and NOVA, the discordance observed for almost one-third of products highlights the opportunity to develop recommendations for ultra-processed foods within the guidelines to advise Australians how these foods should be considered as part of a healthy diet.