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Association between nutritional profiles of foods underlying Nutri-Score front-of-pack labels and mortality : EPIC cohort study in 10 European countries
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- Deschasaux, Melanie (author)
- Paris-Sorbonne University
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Huybrechts, Inge (author)
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Julia, Chantal (author)
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Hercberg, Serge (author)
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Egnell, Manon (author)
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Srour, Bernard (author)
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Kesse-Guyot, Emmanuelle (author)
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Latino-Martel, Paule (author)
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Biessy, Carine (author)
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Casagrande, Corinne (author)
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Murphy, Neil (author)
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Jenab, Mazda (author)
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Ward, Heather A. (author)
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Weiderpass, Elisabete (author)
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Overvad, Kim (author)
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Tjonneland, Anne (author)
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Rostgaard-Hansen, Agnetha Linn (author)
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Boutron-Ruault, Marie-Christine (author)
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Mancini, Francesca Romana (author)
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Mahamat-Saleh, Yahya (author)
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Kuehn, Tilman (author)
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Katzke, Verena (author)
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Bergmann, Manuela M. (author)
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Schulze, Matthias B. (author)
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Trichopoulou, Antonia (author)
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Karakatsani, Anna (author)
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Peppa, Eleni (author)
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Masala, Giovanna (author)
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Agnoli, Claudia (author)
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De Magistris, Maria Santucci (author)
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Tumino, Rosario (author)
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Sacerdote, Carlotta (author)
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Boer, Jolanda M. A. (author)
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Verschuren, W. M. Monique (author)
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van der Schouw, Yvonne T. (author)
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Skeie, Guri (author)
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Braaten, Tonje (author)
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Luisa Redondo, M. (author)
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Agudo, Antonio (author)
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Petrova, Dafina (author)
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Colorado-Yohar, Sandra M. (author)
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Barricarte, Aurelio (author)
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Amiano, Pilar (author)
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- Sonestedt, Emily (author)
- Lund University,Lunds universitet,Nutritionsepidemiologi,Forskargrupper vid Lunds universitet,Nutrition Epidemiology,Lund University Research Groups
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- Ericson, Ulrika (author)
- Lund University,Lunds universitet,Diabetes - kardiovaskulär sjukdom,Forskargrupper vid Lunds universitet,Diabetes - Cardiovascular Disease,Lund University Research Groups
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- Otten, Julia, 1973- (author)
- Umeå universitet,Avdelningen för medicin
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- Sundström, Björn, 1968- (author)
- Umeå universitet,Reumatologi
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Wareham, Nicholas J. (author)
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Forouhi, Nita G. (author)
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Vineis, Paolo (author)
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Tsilidis, Konstantinos K. (author)
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Knuppel, Anika (author)
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Papier, Keren (author)
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Ferrari, Pietro (author)
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Riboli, Elio (author)
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Gunter, Marc J. (author)
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- Touvier, Mathilde (author)
- Centre of Epidemiology And Biostatistics Sorbonne Paris Cité Center (CRESS)
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(creator_code:org_t)
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et al
- 2020-09-16
- 2020
- English.
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In: The BMJ. - : BMJ Publishing Group Ltd. - 1756-1833. ; 370
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Abstract
Subject headings
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- OBJECTIVE To determine if the Food Standards Agency nutrient profiling system (FSAm-NPS), which grades the nutritional quality of food products and is used to derive the Nutri-Score front-of-packet label to guide consumers towards healthier food choices, is associated with mortality. DESIGN Population based cohort study. SETTING European Prospective Investigation into Cancer and Nutrition (EPIC) cohort from 23 centres in 10 European countries. PARTICIPANTS 521 324 adults; at recruitment, country specific and validated dietary questionnaires were used to assess their usual dietary intakes. A FSAm-NPS score was calculated for each food item per 100 g content of energy, sugars, saturated fatty acids, sodium, fibre, and protein, and of fruit, vegetables, legumes, and nuts. The FSAm-NPS dietary index was calculated for each participant as an energy weighted mean of the FSAm-NPS score of all foods consumed. The higher the score the lower the overall nutritional quality of the diet. MAIN OUTCOME MEASURE Associations between the FSAm-NPS dietary index score and mortality, assessed using multivariable adjusted Cox proportional hazards regression models. RESULTS After exclusions, 501 594 adults (median follow-up 17.2 years, 8 162 730 person years) were included in the analyses. Those with a higher FSAm-NPS dietary index score (highest versus lowest fifth) showed an increased risk of all cause mortality (n=53 112 events from non-external causes; hazard ratio 1.07, 95% confidence interval 1.03 to 1.10, P(0.001 for trend) and mortality from cancer (1.08, 1.03 to 1.13, P(0.001 for trend) and diseases of the circulatory (1.04, 0.98 to 1.11, P=0.06 for trend), respiratory (1.39, 1.22 to 1.59, P(0.001), and digestive (1.22, 1.02 to 1.45, P=0.03 for trend) systems. The age standardised absolute rates for all cause mortality per 10 000 persons over 10 years were 760 (men=1237; women=563) for those in the highest fifth of the FSAm-NPS dietary index score and 661 (men=1008; women=518) for those in the lowest fifth. CONCLUSIONS In this large multinational European cohort, consuming foods with a higher FSAm-NPS score (lower nutritional quality) was associated with a higher mortality for all causes and for cancer and diseases of the circulatory, respiratory, and digestive systems, supporting the relevance of FSAm-NPS to characterise healthier food choices in the context of public health policies (eg, the Nutri-Score) for European populations. This is important considering ongoing discussions about the potential implementation of a unique nutrition labelling system at the European Union level.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Näringslära (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nutrition and Dietetics (hsv//eng)
Keyword
- adult
- cohort analysis
- Europe
- female
- food packaging
- food preference
- human
- male
- middle aged
- mortality
- nutritional assessment
- nutritional value
- proportional hazards model
- questionnaire
- Adult
- Cohort Studies
- Female
- Food Labeling
- Food Preferences
- Humans
- Male
- Middle Aged
- Mortality
- Nutrition Assessment
- Nutritive Value
- Proportional Hazards Models
- Surveys and Questionnaires
Publication and Content Type
- ref (subject category)
- art (subject category)
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Deschasaux, Mela ...
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Huybrechts, Inge
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Julia, Chantal
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Hercberg, Serge
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Egnell, Manon
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Srour, Bernard
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show more...
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Kesse-Guyot, Emm ...
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Latino-Martel, P ...
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Biessy, Carine
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Casagrande, Cori ...
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Murphy, Neil
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Jenab, Mazda
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Ward, Heather A.
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Weiderpass, Elis ...
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Overvad, Kim
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Tjonneland, Anne
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Rostgaard-Hansen ...
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Boutron-Ruault, ...
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Mancini, Frances ...
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Mahamat-Saleh, Y ...
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Kuehn, Tilman
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Katzke, Verena
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Bergmann, Manuel ...
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Schulze, Matthia ...
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Trichopoulou, An ...
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Karakatsani, Ann ...
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Peppa, Eleni
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Masala, Giovanna
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Agnoli, Claudia
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De Magistris, Ma ...
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Tumino, Rosario
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Sacerdote, Carlo ...
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Boer, Jolanda M. ...
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Verschuren, W. M ...
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van der Schouw, ...
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Skeie, Guri
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Braaten, Tonje
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Luisa Redondo, M ...
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Agudo, Antonio
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Petrova, Dafina
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Colorado-Yohar, ...
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Barricarte, Aure ...
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Amiano, Pilar
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Sonestedt, Emily
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Ericson, Ulrika
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Otten, Julia, 19 ...
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Sundström, Björn ...
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Wareham, Nichola ...
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Forouhi, Nita G.
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Vineis, Paolo
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Tsilidis, Konsta ...
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Knuppel, Anika
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Papier, Keren
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Ferrari, Pietro
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Riboli, Elio
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Gunter, Marc J.
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Touvier, Mathild ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Nutrition and Di ...
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The BMJ
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Umeå University
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Lund University