{"doi":"10.1016/j.ajcnut.2024.02.017","title":"Excluding whole grain-containing foods from the Nova ultraprocessed food category: a cross-sectional analysis of the impact on associations with cardiometabolic risk measures","abstract":null,"journal":"The American Journal of Clinical Nutrition","year":2024,"id":619759,"datarank":0.4566783656585135,"base_score":3.044522437723423,"endowment":3.044522437723423,"self_citation_contribution":0.4566783656585135,"citation_network_contribution":0.0,"self_endowment_contribution":0.4566783656585135,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":314769,"name":"Mengxi Du","orcid":"0000-0002-6406-7250","position":1,"is_corresponding":false},{"id":1599585,"name":"Nicola M McKeown","orcid":null,"position":2,"is_corresponding":false},{"id":1599586,"name":"Marijka J Batterham","orcid":null,"position":3,"is_corresponding":false},{"id":1041633,"name":"Eleanor J. Beck","orcid":"0000-0002-3448-6534","position":4,"is_corresponding":false},{"id":1599584,"name":"Elissa J Price","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Excluding whole grain-containing foods from the Nova ultraprocessed food category: a cross-sectional analysis of the impact on associations with cardiometabolic risk measures","abstract":"<h4>Background</h4>Whole grain (WG) consumption is linked with a reduced risk of chronic disease. However, the recommendations of the Nova classification system tend to contradict this evidence as high WG-containing foods, such as bread and cereals, are considered ultraprocessed, and intake is discouraged.<h4>Objectives</h4>This study aimed to explore associations of cardiometabolic risk measures with ultraprocessed food (UPF) intake as classified by Nova compared with when foods with ≥25% and ≥50% WG are removed from the Nova UPF category.<h4>Methods</h4>A cross-sectional analysis of the 2015-18 National Health and Nutrition Examination Survey. Nova was used to identify UPFs, and the WG Initiative's definition of a WG food and front-of-pack labeling requirements was used to identify high WG foods. Regression models were used to explore impacts on the association of UPF intake (quintiles) and cardiometabolic risk measures when high WG foods were excluded from the Nova UPF category.<h4>Results</h4>Participants in the highest quintile of UPF intake had significantly higher weight [83.6 kg (0.8)], BMI (in kg/m<sup>2</sup>) [30.6 (0.3)], waist circumference [103.1 cm (0.6)], and weight-to-height ratio [0.63 (0.003)] compared to those in the lowest quintile (P < 0.0001 for all). The same was found when foods with ≥25% and ≥50% WG were removed. Positive associations for C-reactive protein were found when ≥25% and ≥50% WG-containing foods were removed only [2.32 mg/L (0.1), P = 0.0209; 2.37 mg/L (0.1), P = 0.0179, respectively]. Participants in the highest quintile had significantly lower total cholesterol after adjustment when foods with ≥50% WG were removed [4.98 mmol/L (0.04), P = 0.0292]. Adjusted R<sup>2</sup> values remained relatively unchanged across each approach for all outcomes.<h4>Conclusions</h4>Foods high in WG may not significantly contribute to the deleterious associations previously observed between UPF intake and cardiometabolic risk factors. Consideration of their contribution to healthful dietary patterns and diet quality in the United States population should be made prior to the endorsement of Nova.","is_dataset_classified":null,"base_score":2.995732273553991,"endowment":2.995732273553991,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38417577","pmcid":null,"openalex_id":"https://openalex.org/W4392245144","authors":[],"funders":[{"funder_name":"Institute for the Advancement of Food and Nutrition Sciences","grant_id":"","title":null}],"total_grants":1,"fwci":7.7966,"citation_percentile":0.97970158,"influential_citations":0,"citation_trend":[{"year":2024,"count":4},{"year":2025,"count":7},{"year":2026,"count":8}],"oa_status":"closed","license":"http://www.elsevier.com/open-access/userlicense/1.0/","oa_locations":[{"url":"https://api.elsevier.com/content/article/PII:S0002916524001631?httpAccept=text/xml","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S0002916524001631?httpAccept=text/plain","host_type":"publisher"},{"url":"https://doi.org/10.1016/j.ajcnut.2024.02.017","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38417577","host_type":"repository"},{"url":"https://ro.uow.edu.au/test2021/11199","host_type":"repository"}],"fields_of_study":["Consumer Attitudes and Food Labeling","Food composition and properties","Nutritional Studies and Diet","Humans","Cross-Sectional Studies","Male","Female","Cardiometabolic Risk Factors","Adult","Middle Aged","Whole Grains","Nutrition Surveys","Food Handling","Diet","Cardiovascular Diseases","Fast Foods","Body Mass Index"],"mesh_terms":["Whole Grains","Cardiometabolic Risk Factors","Adult","Cardiovascular Diseases","Cross-Sectional Studies","Diet","Female","Food Handling","Humans","Male","Middle Aged","Nutrition Surveys","Body Mass Index","Fast Foods"],"keywords":["Cross-sectional study","Environmental health","Whole grains","Food science","Nova (rocket)","Medicine","Mathematics","Statistics","Engineering","Chemistry","Whole Grain","Nhanes","Nova","Cardiometabolic Risk","Ultraprocessed Food"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Zero hunger"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T08:24:12.460407Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}