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dc.contributor.authorDeschasaux-Tanguy, Mélanie
dc.contributor.authorHuybrechts, Inge
dc.contributor.authorJulia, Chantal
dc.contributor.authorHercberg, Serge
dc.contributor.authorSarda, Barthélémy
dc.contributor.authorFialon, Morgane
dc.contributor.authorArnault, Nathalie
dc.contributor.authorSrour, Bernard
dc.contributor.authorKesse-Guyot, Emmanuelle
dc.contributor.authorFezeu, Léopold K.
dc.contributor.authorBiessy, Carine
dc.contributor.authorCasagrande, Corinne
dc.contributor.authorHemon, Bertrand
dc.contributor.authorWeiderpass Vainio, Elisabete
dc.contributor.authorPinho, Maria G.M.
dc.contributor.authorMurphy, Neil
dc.contributor.authorFreisling, Heinz
dc.contributor.authorFerrari, Pietro
dc.contributor.authorTjønneland, Anne
dc.contributor.authorNielsen Petersen, Kristina Elin
dc.contributor.authorKatzke, Verena
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorSchulze, Matthias B.
dc.contributor.authorMasala, Giovanna
dc.contributor.authorPala, Valeria
dc.contributor.authorPanico, Salvatore
dc.contributor.authorRicceri, Fulvio
dc.contributor.authorVerschuren, W.M.Monique
dc.contributor.authorBoer, Jolanda M.A.
dc.contributor.authorvan der Schouw, Yvonne T.
dc.contributor.authorSkeie, Guri
dc.contributor.authorAgudo, Antonio
dc.contributor.authorMolina-Montes, Esther
dc.contributor.authorHuerta, José María
dc.contributor.authorMoreno-Iribas, Conchi
dc.contributor.authorEricson, Ulrika
dc.contributor.authorSonestedt, Emily
dc.contributor.authorStrid, Anna
dc.contributor.authorOskarsson, Viktor
dc.contributor.authorTong, Tammy Y.N.
dc.contributor.authorHeath, Alicia K.
dc.contributor.authorAglago, Elom K.
dc.contributor.authorDanesh, John
dc.contributor.authorRiboli, Elio
dc.contributor.authorGunter, Marc J.
dc.contributor.authorTouvier, Mathilde
dc.date.accessioned2024-11-14T10:25:34Z
dc.date.available2024-11-14T10:25:34Z
dc.date.issued2024-11
dc.description.abstractBackground - Nutri-Score is a scientifically validated 5-color front-of-pack nutrition label reflecting the nutrient profile of foods. It has been implemented in several European countries on a voluntary basis, pending the revision of the European labeling regulation. Hence, scientific evidence is needed regarding the ability of the nutrient profile underlying the Nutri-Score (uNS-NPS, 2023-updated version) to characterize healthier foods. Our objective was therefore to study the prospective association between the nutritional quality of diet characterized by the uNS-NPS and the risk of cardiovascular diseases in a large European population.<p> <p>Methods - Our analyses included 345,533 participants from the European Prospective Investigation into Cancer and Nutrition study (EPIC, 1992–2010, 7 European countries). Food intakes were assessed at baseline using country-specific dietary questionnaires. The uNS-NPS was calculated as a continuous scale for each food, based on its 100 g content of energy, sugars, saturated fatty acids, salt, fibre, and protein and percentage content of fruit, vegetables, and pulses. A dietary index was derived at the individual level (uNS-NPS DI: energy-weighted mean of uNS-NPS scores of all foods consumed by a participant). Cardiovascular events during follow-up were retrieved using country-specific methods (self-report, registry data). Multi-adjusted Cox models were computed.<p> <p>Findings - Overall, 16,214 first cardiovascular events were reported (median follow-up: 12.3 years; 4,103,133 person-years). The consumption of foods with a higher uNS-NPS score (reflecting a lower overall nutritional quality of diet) was associated with higher risks of total cardiovascular events (Hazards Ratio (HR) for an increment of 1 standard deviation: 1.03 (95% Confidence Interval 1.01–1.05)), especially myocardial infarction (HR = 1.03 (1.01–1.07)), and stroke (HR = 1.04 (1.01–1.07)).<p> <p>Interpretation - In this large prospective study among European adults, a higher risk of cardiovascular diseases (total and several subtypes) was observed in individuals consuming a diet with a lower nutritional value, as graded by the uNS-NPS score. This brings new evidence on the relevance of the updated nutrient profile underlying the Nutri-Score to characterize foods with a healthier nutrient profile.en_US
dc.identifier.citationDeschasaux-Tanguy, Huybrechts, Julia, Hercberg, Sarda, Fialon, Arnault, Srour, Kesse-Guyot, Fezeu, Biessy, Casagrande, Hemon, Weiderpass Vainio, Pinho, Murphy, Freisling, Ferrari, Tjønneland, Nielsen Petersen, Katzke, Kaaks, Schulze, Masala, Pala, Panico, Ricceri, Verschuren, Boer, van der Schouw, Skeie, Agudo, Molina-Montes, Huerta, Moreno-Iribas, Ericson, Sonestedt, Strid, Oskarsson, Tong, Heath, Aglago, Danesh, Riboli, Gunter, Touvier. Nutritional quality of diet characterized by the Nutri-Score profiling system and cardiovascular disease risk: a prospective study in 7 European countries. The Lancet Regional Health - Europe. 2024en_US
dc.identifier.cristinIDFRIDAID 2310751
dc.identifier.doi10.1016/j.lanepe.2024.101006
dc.identifier.issn2666-7762
dc.identifier.urihttps://hdl.handle.net/10037/35718
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalThe Lancet Regional Health - Europe
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7/?/?/?/?/en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2024 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0en_US
dc.rightsAttribution-NonCommercial 4.0 International (CC BY-NC 4.0)en_US
dc.titleNutritional quality of diet characterized by the Nutri-Score profiling system and cardiovascular disease risk: a prospective study in 7 European countriesen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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