(P06-006-25) Hess vs Hall: Two Different Approaches to Menu Design Using Ultra-Processed Foods Generate Large Differences in Caloric Density

Objectives: Hess et al (2023) created a diet of primarily NOVA 4 (UPFs or ultra-processed foods) that aligned with the Dietary Guidelines for Americans (DGA). Hall et al (2019) used a different suite of foods in their study of how UPFs impact food intake, without regard for the DGA. We sought to analyze and compare the two diets to better understand key differences and similarities, with a particular focus on the caloric density of the menu.

Methods: Only foods classified as NOVA 4 from the Hess (186 foods) and Hall (80 foods) menus were assessed.  The kcal/serve for each food was obtained from the WISEdata™ database (containing over 650,000 foods and over 5,400 ingredients). The mean kcal/serve of each menu plan were compared.  Additionally, the menu plans were contrasted using WISEcode-UPF™ code (Wc-UPF™), an alternative to NOVA for assessing processed foods, argued to be a more nuanced approach.  Mean kcal/serve in each of five levels were compared between the two menus: minimal, light, moderate, ultra and the highest level, super-ultra.

Results: For NOVA 4 foods, mean caloric density (kcal/serve ± SEM) in the Hess menu was 116.9 ± 4.5, which was significantly lower than 156.9 ± 14.28 in the Hall menu (p < 0.05).  When foods were assessed via Wc-UPF™, mean caloric density (kcal/serve ± SEM) in the levels minimal, light, moderate, ultra and super-ultra from the Hess menu were below 130 at 104.4 ± 7.5, 127.3 ± 8.3, 126.3 ±8.8, 123.0 ±17.5 and 112.1 ±18.5 respectively.  The caloric density profile across the 5 levels was markedly higher in the Hall menu (with the exception of minimal), at 106.5 ± 19.3, 164.5 ± 33.7, 176.7* ± 34.9, 164.4 ± 31.0, 245.8* ± 43.5, respectively (* p < 0.05).  In summary, foods in the Hall menu were significantly more calorie dense than those in the Hess menu, particularly for foods in the highest level of processing.

Conclusions: These results highlight the fact that NOVA 4 fails to differentiate among foods that in reality have large differences in caloric density, making the case for a more nuanced assessment of processed foods in the diet in general, and experimental diets in particular.

Funding Sources: WISEcode LLC funded all work.