1. Association between nutritional profiles of foods underlying Nutri-Score front-of-pack labels and mortality: EPIC cohort study in 10 European countries
- Author
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Deschasaux, Mélanie, Huybrechts, Inge, Julia, Chantal, Hercberg, Serge, Egnell, Manon, Srour, Bernard, Kesse-Guyot, Emmanuelle, Latino-Martel, Paule, Biessy, Carine, Casagrande, Corinne, Murphy, Neil, Jenab, Mazda, Ward, Heather A, Weiderpass, Elisabete, Overvad, Kim, Tjønneland, Anne, Rostgaard-Hansen, Agnetha Linn, Boutron-Ruault, Marie-Christine, Mancini, Francesca Romana, Mahamat-Saleh, Yahya, Kühn, Tilman, Katzke, Verena, Bergmann, Manuela M, Schulze, Matthias B, Trichopoulou, Antonia, Karakatsani, Anna, Peppa, Eleni, Masala, Giovanna, Agnoli, Claudia, De Magistris, Maria Santucci, Tumino, Rosario, Sacerdote, Carlotta, Boer, Jolanda MA, Verschuren, WM Monique, van der Schouw, Yvonne T, Skeie, Guri, Braaten, Tonje, Redondo, M Luisa, Agudo, Antonio, Petrova, Dafina, Colorado-Yohar, Sandra M, Barricarte, Aurelio, Amiano, Pilar, Sonestedt, Emily, Ericson, Ulrika, Otten, Julia, Sundström, Björn, Wareham, Nicholas J, Forouhi, Nita G, Vineis, Paolo, Tsilidis, Konstantinos K, Knuppel, Anika, Papier, Keren, Ferrari, Pietro, Riboli, Elio, Gunter, Marc J, Touvier, Mathilde, Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Sorbonne Paris Nord-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Réseau National Alimentation Cancer Recherche (réseau NACRe), Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Département de Santé Publique [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), School of Public Health, Imperial College London, Aarhus University [Aarhus], Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), Danish Cancer Society Research Center, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut Gustave Roussy (IGR), German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Institute of Nutrition Science, University of Potsdam, Hellenic Health Foundation, 'Attikon' University Hospital, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan], AOU Federico II, Partenaires INRAE, Provincial Health Services Authority, Center for Cancer Prevention (CPO-Piemonte), National Institute for Public Health and the Environment [Bilthoven] (RIVM), Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], The Arctic University of Norway (UiT), Public Health Directorate, Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL), Andalusian School of Public Health [Granada], Escuela Andaluza de Salud Publica, Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain, parent, CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia Regional Health Council [Murcia], Universidad de Antioquia = University of Antioquia [Medellín, Colombia], Navarra Public Health Institute, Navarra Institute for Health Research, Biodonostia Health Research Institute, Department of Clinical Sciences [Malmö, Suède], Lund University [Malmö, Suède], Department of Public Health and Clinical Medicine [Umeå, Sweden] (Environmental and Occupational Medicine), Umeå University, University of Cambridge School of Clinical Medicine, University of Ioannina School of Medicine, Nuffield Department of Population Health [Oxford], University of Oxford [Oxford], French National Cancer Institute (INCa)-Canceropole Ile-de-France 2017-1-PL SHS-01-INSERM ADR 5-1Fondation Recherche Medicale ARF201809007046European CommissionEuropean Commission Joint Research CentreInternational Agency for Research on CancerDanish Cancer SocietyLigue nationale contre le cancerInstitut Gustave RoussyMutuelle Generale de l'Education NationaleInstitut National de la Sante et de la Recherche Medicale (Inserm)Deutsche KrebshilfeFederal Ministry of Education & Research (BMBF)Hellenic Health Foundation (Greece)Associazione Italiana per la Ricerca sul Cancro (AIRC)Italian National Research CouncilDutch Ministry of Public Health, Welfare, and Sports (the Netherlands)Netherlands Cancer Registry (the Netherlands)Netherlands GovernmentHealth Research Fund (Spain)Instituto de Salud Carlos IIIJunta de Andalucia Regional government of Asturias (Spain) Regional government of Basque Country (Spain) Regional government of Murcia (Spain) Regional government of Navarra (Spain) Catalan Institute of Oncology (Spain)Swedish Cancer Society Swedish Scientific Council (Sweden) County councils of Skane and Vasterbotten (Sweden)Cancer Research UK C864/A14136 C8221/A19170Medical Research Council UK (MRC) MR/N003284/1 - MC-UU_12015/1 - MR/M012190/1 - MC_UU_12015/1 - MC_UU_12015/5 - National Institute for Health Research Biomedical Research Centre, Cambridge: Nutrition, Diet, and Lifestyle Research Theme IS-BRC-1215-20014, Deschasaux, Mélanie [0000-0002-3359-420X], and Apollo - University of Cambridge Repository
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Adult ,Male ,1117 Public Health and Health Services ,Cohort Studies ,Food Preferences ,Food Labeling ,General & Internal Medicine ,Surveys and Questionnaires ,Mortalitat ,Humans ,Mortality ,Nutrició ,ComputingMilieux_MISCELLANEOUS ,Nutrition ,Proportional Hazards Models ,Research ,Klinisk medicin ,1103 Clinical Sciences ,Middle Aged ,Europe ,Nutrition Assessment ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Clinical Medicine ,Nutritive Value ,[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition - Abstract
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, PConclusions: 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.
- Published
- 2020