Reliability and validity of a Hebrew-language short screening questionnaire for highly processed foods (HsQ-HPF)

Background: Ultraprocessed food consumption has been linked to adverse health outcomes and is traditionally assessed through labor-intensive dietary intake methods. To facilitate efficient assessment, the short screening questionnaire of highly processed food consumption (sQHPF) was previously developed and validated in Spanish populations. Objective: To translate, culturally adapt, and validate a Hebrew version of the sQHPF (HsQHPF) for use among Israeli adults. Methods: In this cross-sectional study, adult participants completed a 24-hour dietary recall, the HsQHPF, and the Israel Mediterranean Diet Screener (IMEDAS). A subgroup repeated the HsQHPF after three weeks to evaluate reliability. Associations between HsQHPF scores, NOVA group 4 food items from the dietary recall, and IMEDAS scores were examined. Internal consistency, correlations, and intraclass correlation coefficients (ICC) were calculated. Results: Forty-three adults participated (median age 25 years; 72.7% female). The HsQHPF exhibited excellent internal consistency (Cronbach’s α = 0.74). HsQHPF scores correlated strongly and significantly with the number of NOVA group 4 items from the 24-hour recall (rho = 0.727, p < 0.001), supporting construct validity. No significant associations were found with IMEDAS scores. Test–retest reliability was high (ICC = 0.81; 95% CI 0.58–0.92; p < 0.001). Higher HsQHPF tertiles were associated with significantly greater saturated fat intake and a higher number of NOVA group 4 foods. Conclusion: The HsQHPF is a valid and reliable tool for evaluating ultra-processed food consumption in the Israeli adult population. Its use may streamline data collection in future studies examining associations between ultra-processed food intake and health outcomes. Novelty of the study: The present study is the first to validate a tool for evaluating the intake of ultra-processed foods in adults in the Israeli population.