Researchers in Canada created a quick online quiz called CUPS that asks 28 questions to figure out how much ultra-processed food people eat. Ultra-processed foods are things like packaged snacks, sugary drinks, and fast food that have lots of added ingredients. Scientists tested this quiz with 354 Canadian adults to see if it actually works. They found that the CUPS quiz does a pretty good job of measuring processed food intake and gives consistent results. This tool could help doctors and nutritionists understand people’s eating habits better and give them better advice about their diet.
The Quick Take
- What they studied: Does a new online quiz called CUPS accurately measure how much ultra-processed food Canadian adults eat?
- Who participated: 354 Canadian adults between ages 18 and 60 who filled out the online quiz and kept food diaries
- Key finding: The CUPS quiz showed moderate accuracy (correlation scores of 0.33 to 0.44) when compared to detailed food diaries, meaning it’s a useful tool for identifying who eats a lot of processed foods versus who doesn’t
- What it means for you: If your doctor uses CUPS to check your diet, it can give them a quick snapshot of your processed food habits. However, it works best as a screening tool rather than a precise measurement, so it’s most helpful for spotting general patterns in eating habits.
The Research Details
Researchers recruited 354 Canadian adults and had them complete the CUPS quiz three different times over about a month (measuring intake over 1 day, 7 days, and 30 days). At the same time, participants kept detailed food diaries for three separate 24-hour periods, which served as the gold standard for comparison. This allowed researchers to see how well the quiz matched up with actual food records.
The CUPS quiz itself is a 28-question online form available in both English and French that asks people about their consumption of various ultra-processed foods and drinks commonly available in Canada. The researchers then compared the quiz scores to the detailed food diary information to check accuracy and consistency.
This type of study design is called cross-sectional, meaning researchers collected all the information at roughly the same time period rather than following people over years. This approach is efficient for testing whether a new screening tool works well.
Before doctors can recommend using a new screening tool, they need to verify it actually measures what it claims to measure (validity) and gives consistent results (reliability). This study provides that evidence for the CUPS tool, which is important because quick screening tools save time in busy medical offices while still giving useful information.
The study included a reasonable sample size of 354 people, which is adequate for this type of validation research. The researchers used multiple food diaries as a comparison point, which strengthens confidence in the results. However, the study only included Canadian adults aged 18-60, so results may not apply to teenagers, seniors, or people in other countries. The moderate correlation scores (0.33-0.44) suggest the tool is useful but not perfect, which is typical for screening questionnaires.
What the Results Show
The CUPS quiz showed moderate correlation with detailed food diaries, with scores ranging from 0.33 to 0.44. In simple terms, this means the quiz does a decent job of identifying who eats lots of processed foods and who doesn’t, but it’s not perfectly precise. Think of it like a thermometer that’s usually accurate but might be off by a few degrees.
When researchers gave the same quiz twice to the same people, the results were fairly consistent (intraclass correlation of 0.61), meaning if you took the quiz on two different days, you’d likely get similar results. The quiz also showed good internal consistency, meaning the questions work together well to measure the same thing.
Interestingly, people who scored high on the CUPS quiz (meaning they eat more processed foods) also had higher intake of added sugars, saturated fats, and sodium according to their food diaries. This makes sense because ultra-processed foods typically contain these unhealthy ingredients, which validates that the quiz is measuring something real and important.
The study found that the CUPS quiz works well in both English and French versions, suggesting it’s equally useful for both language groups in Canada. The different time-frame versions (1-day, 7-day, and 30-day) all showed acceptable performance, though the 30-day version had slightly better internal consistency (0.86) compared to the 1-day version (0.72). This suggests that asking about longer time periods captures a more reliable picture of eating habits.
This is one of the first validation studies for the CUPS tool, so there’s limited previous research to compare directly. However, the moderate correlation scores and reliability measures are similar to other food screening questionnaires used in nutrition research. The tool appears to perform as well as or better than comparable screening tools used in other countries.
The study only included Canadian adults aged 18-60, so we don’t know if the quiz works as well for teenagers or older adults. All participants were volunteers who completed the study online, which might mean they’re more health-conscious than the general population. The moderate correlation scores (0.33-0.44) indicate the quiz isn’t perfect and works best for identifying general patterns rather than precise measurements. The study was conducted over a specific time period (July-November 2023) and only measured Canadian ultra-processed foods, so results might differ in other countries or seasons.
The Bottom Line
The CUPS quiz appears useful as a quick screening tool to identify people who eat high amounts of ultra-processed foods (moderate confidence). It’s best used as a starting point for conversations about diet rather than as a precise measurement tool. If you’re concerned about your processed food intake, this quiz could be a helpful first step, but detailed food diaries remain the gold standard for accurate assessment (high confidence).
This tool is most relevant for Canadian adults aged 18-60. Healthcare providers, nutritionists, and public health researchers should find this useful for quickly assessing patients’ processed food habits. People trying to improve their diet quality would benefit from knowing their CUPS score. However, the tool may be less useful for teenagers, seniors, or people living outside Canada.
If you use CUPS to identify high processed food intake and then make dietary changes, you might notice improvements in energy levels within 2-4 weeks and measurable health improvements (like blood sugar or cholesterol levels) within 2-3 months. However, the CUPS itself is just a measurement tool—the real benefits come from actually changing your eating habits based on the results.
Want to Apply This Research?
- Complete the CUPS quiz monthly and track your score over time. Record the specific ultra-processed foods you eat most frequently and set a goal to reduce consumption by 10-20% each month.
- Use the CUPS results to identify your top 3 ultra-processed foods. For each one, find a less-processed alternative and swap it out once per week, gradually increasing frequency. For example, if you drink sugary sodas, replace one with flavored water or unsweetened tea.
- Take the CUPS quiz every 4 weeks and compare scores to track progress. Simultaneously log the ultra-processed foods you eat daily in the app to see which categories (sugary drinks, packaged snacks, fast food) are your biggest challenges. Use this data to set personalized reduction goals.
This research describes a screening tool for measuring ultra-processed food intake and should not be used for medical diagnosis or treatment. The CUPS quiz is designed to identify general patterns in eating habits, not to provide precise nutritional analysis. If you have specific health concerns or dietary restrictions, please consult with a registered dietitian or healthcare provider. Results from this validation study apply primarily to Canadian adults aged 18-60 and may not be accurate for other populations. Always discuss any significant dietary changes with your healthcare provider, especially if you have existing health conditions or take medications that interact with diet.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.