Nutritional quality of food as represented by the FSAm-NPS nutrient profiling system underlying the Nutri-Score label and cancer risk in Europe : Results from the EPIC prospective cohort study

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dc.contributor.author Deschasaux, Melanie
dc.contributor.author Huybrechts, Inge
dc.contributor.author Murphy, Neil
dc.contributor.author Julia, Chantal
dc.contributor.author Hercberg, Serge
dc.contributor.author Srour, Bernard
dc.contributor.author Kesse-Guyot, Emmanuelle
dc.contributor.author Latino-Martel, Paule
dc.contributor.author Biessy, Carine
dc.contributor.author Casagrande, Corinne
dc.contributor.author Jenab, Mazda
dc.contributor.author Ward, Heather
dc.contributor.author Weiderpass, Elisabete
dc.contributor.author Dahm, Christina C.
dc.contributor.author Overvad, Kim
dc.contributor.author Kyro, Cecilie
dc.contributor.author Olsen, Anja
dc.contributor.author Affret, Aurelie
dc.contributor.author Boutron-Ruault, Marie-Christine
dc.contributor.author Mahamat-Saleh, Yahya
dc.contributor.author Kaaks, Rudolf
dc.contributor.author Kuehn, Tilman
dc.contributor.author Boeing, Heiner
dc.contributor.author Schwingshackl, Lukas
dc.contributor.author Bamia, Christina
dc.contributor.author Peppa, Eleni
dc.contributor.author Trichopoulou, Antonia
dc.contributor.author Masala, Giovanna
dc.contributor.author Krogh, Vittorio
dc.contributor.author Panico, Salvatore
dc.contributor.author Tumino, Rosario
dc.contributor.author Sacerdote, Carlotta
dc.contributor.author Buen-de-Mesquita, Bas
dc.contributor.author Peeters, Petra H.
dc.contributor.author Hjartaker, Anette
dc.contributor.author Rylander, Charlotta
dc.contributor.author Skeie, Guri
dc.contributor.author Ramon Quiros, J.
dc.contributor.author Jakszyn, Paula
dc.contributor.author Salamanca-Fernandez, Elena
dc.contributor.author Maria Huerta, Jose
dc.contributor.author Ardanaz, Eva
dc.contributor.author Amiano, Pilar
dc.contributor.author Ericson, Ulrika
dc.contributor.author Sonestedt, Emily
dc.contributor.author Huseinovic, Ena
dc.contributor.author Johansson, Ingegerd
dc.contributor.author Khaw, Kay-Tee
dc.contributor.author Wareham, Nick
dc.contributor.author Bradbury, Kathryn E.
dc.contributor.author Perez-Cornago, Aurora
dc.contributor.author Tsilidis, Konstantinos K.
dc.contributor.author Ferrari, Pietro
dc.contributor.author Riboli, Elio
dc.contributor.author Gunter, Marc J.
dc.contributor.author Touvier, Mathilde
dc.date.accessioned 2018-10-17T08:27:01Z
dc.date.available 2018-10-17T08:27:01Z
dc.date.issued 2018-09
dc.identifier.citation Deschasaux , M , Huybrechts , I , Murphy , N , Julia , C , Hercberg , S , Srour , B , Kesse-Guyot , E , Latino-Martel , P , Biessy , C , Casagrande , C , Jenab , M , Ward , H , Weiderpass , E , Dahm , C C , Overvad , K , Kyro , C , Olsen , A , Affret , A , Boutron-Ruault , M-C , Mahamat-Saleh , Y , Kaaks , R , Kuehn , T , Boeing , H , Schwingshackl , L , Bamia , C , Peppa , E , Trichopoulou , A , Masala , G , Krogh , V , Panico , S , Tumino , R , Sacerdote , C , Buen-de-Mesquita , B , Peeters , P H , Hjartaker , A , Rylander , C , Skeie , G , Ramon Quiros , J , Jakszyn , P , Salamanca-Fernandez , E , Maria Huerta , J , Ardanaz , E , Amiano , P , Ericson , U , Sonestedt , E , Huseinovic , E , Johansson , I , Khaw , K-T , Wareham , N , Bradbury , K E , Perez-Cornago , A , Tsilidis , K K , Ferrari , P , Riboli , E , Gunter , M J & Touvier , M 2018 , ' Nutritional quality of food as represented by the FSAm-NPS nutrient profiling system underlying the Nutri-Score label and cancer risk in Europe : Results from the EPIC prospective cohort study ' , PLoS Medicine , vol. 15 , no. 9 , 1002651 . https://doi.org/10.1371/journal.pmed.1002651
dc.identifier.other PURE: 116976752
dc.identifier.other PURE UUID: 8d4a15aa-6820-4dc0-8d61-4f823d988c16
dc.identifier.other WOS: 000445914900004
dc.identifier.other Scopus: 85054628911
dc.identifier.uri http://hdl.handle.net/10138/250869
dc.description.abstract Background Helping consumers make healthier food choices is a key issue for the prevention of cancer and other diseases. In many countries, political authorities are considering the implementation of a simplified labelling system to reflect the nutritional quality of food products. The Nutri-Score, a five-colour nutrition label, is derived from the Nutrient Profiling System of the British Food Standards Agency (modified version) (FSAm-NPS). How the consumption of foods with high/low FSAm-NPS relates to cancer risk has been studied in national/regional cohorts but has not been characterized in diverse European populations. Methods and findings This prospective analysis included 471,495 adults from the European Prospective Investigation into Cancer and Nutrition (EPIC, 1992-2014, median follow-up: 15.3 y), among whom there were 49,794 incident cancer cases (main locations: breast, n = 12,063; prostate, n = 6,745; colon-rectum, n = 5,806). Usual food intakes were assessed with standardized country-specific diet assessment methods. The FSAm-NPS was calculated for each food/beverage using their 100-g content in energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits/vegetables/legumes/nuts. The FSAm-NPS scores of all food items usually consumed by a participant were averaged to obtain the individual FSAm-NPS Dietary Index (DI) scores. Multi-adjusted Cox proportional hazards models were computed. A higher FSAm-NPS DI score, reflecting a lower nutritional quality of the food consumed, was associated with a higher risk of total cancer (HRQ5 versus (Q1) = 1.07; 95% CI 1.03-1.10, P-trend <0.001). Absolute cancer rates in those with high and low (quintiles 5 and 1) FSAm-NPS DI scores were 81.4 and 69.5 cases/10,000 person-years, respectively. Higher FSAm-NPS DI scores were specifically associated with higher risks of cancers of the colon-rectum, upper aerodigestive tract and stomach, lung for men, and liver and postmenopausal breast for women (all P <0.05). The main study limitation is that it was based on an observational cohort using self-reported dietary data obtained through a single baseline food frequency questionnaire; thus, exposure misclassification and residual confounding cannot be ruled out. Conclusions In this large multinational European cohort, the consumption of food products with a higher FSAm-NPS score (lower nutritional quality) was associated with a higher risk of cancer. This supports the relevance of the FSAm-NPS as underlying nutrient profiling system for front-of-pack nutrition labels, as well as for other public health nutritional measures. en
dc.format.extent 21
dc.language.iso eng
dc.relation.ispartof PLoS Medicine
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject CARDIOVASCULAR-DISEASE RISK
dc.subject FRONT-OF-PACKAGE
dc.subject DIETARY INDEX
dc.subject PROSPECTIVE ASSOCIATION
dc.subject SU.VI.MAX COHORT
dc.subject FRENCH ADULTS
dc.subject VALIDATION
dc.subject DATABASE
dc.subject PROJECT
dc.subject FRANCE
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.title Nutritional quality of food as represented by the FSAm-NPS nutrient profiling system underlying the Nutri-Score label and cancer risk in Europe : Results from the EPIC prospective cohort study en
dc.type Article
dc.contributor.organization Department of Medical and Clinical Genetics
dc.contributor.organization Medicum
dc.contributor.organization University of Helsinki
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1371/journal.pmed.1002651
dc.relation.issn 1549-1676
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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