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dc.contributor.authorDeschasaux, Mélanie
dc.contributor.authorHuybrechts, Inge
dc.contributor.authorMurphy, Neil
dc.contributor.authorJulia, Chantal
dc.contributor.authorHercberg, Serge
dc.contributor.authorSrour, Bernard
dc.contributor.authorKesse-Guyot, Emmanuelle
dc.contributor.authorLatino-Martel, Paule
dc.contributor.authorBiessy, Carine
dc.contributor.authorCasagrande, Corinne
dc.contributor.authorJenab, Mazda
dc.contributor.authorWard, Heather
dc.contributor.authorWeiderpass, Elisabete
dc.contributor.authorDahm, Christina C.
dc.contributor.authorOvervad, Kim
dc.contributor.authorKyrø, Cecilie
dc.contributor.authorOlsen, Anja
dc.contributor.authorAffret, Aurélie
dc.contributor.authorBoutron-Ruault, Marie-Christine
dc.contributor.authorMahamat-Saleh, Yahya
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorKühn, Tilman
dc.contributor.authorBoeing, Heiner
dc.contributor.authorSchwingshackl, Lukas
dc.contributor.authorBamia, Christina
dc.contributor.authorPeppa, Eleni
dc.contributor.authorTrichopoulou, Antonia
dc.contributor.authorMasala, Giovanna
dc.contributor.authorKrogh, Vittorio
dc.contributor.authorPanico, Salvatore
dc.contributor.authorTumino, Rosario
dc.contributor.authorSacerdote, Carlotta
dc.contributor.authorBueno-De-Mesquita, Hendrik Bastiaan
dc.contributor.authorPeeters, Petra H.
dc.contributor.authorHjartåker, Anette
dc.contributor.authorRylander, Charlotta
dc.contributor.authorSkeie, Guri
dc.contributor.authorRamõn Quirõs, Jose
dc.contributor.authorJakszyn, Paula
dc.contributor.authorSalamanca-Fernández, Elena
dc.contributor.authorHuerta, José María
dc.contributor.authorArdanaz, Eva
dc.contributor.authorAmiano, Pilar
dc.contributor.authorEricson, Ulrika
dc.contributor.authorSonestedt, Emily
dc.contributor.authorHuseinovic, Ena
dc.contributor.authorJohansson, Ingegerd
dc.contributor.authorKhaw, Kay-Tee
dc.contributor.authorWareham, Nick
dc.contributor.authorBradbury, Kathryn E.
dc.contributor.authorPerez-Cornago, Aurora
dc.contributor.authorTsilidis, Konstantinos K.
dc.contributor.authorFerrari, Pietro
dc.contributor.authorRiboli, Elio
dc.contributor.authorGunter, Mark J.
dc.contributor.authorTouvier, Mathilde
dc.date.accessioned2019-05-21T13:42:33Z
dc.date.available2019-05-21T13:42:33Z
dc.date.issued2018-09-18
dc.description.abstract<p><i>Background - </i>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. <p><i>Methods and findings - </i>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, <i>n</i> = 12,063; prostate, <i>n</i> = 6,745; colon-rectum, <i>n</i> = 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 (HR<sub>Q5</sub> versus <sub>Q1</sub> = 1.07; 95% CI 1.03–1.10, <i>P</i>-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 <i>P</i> < 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. <p><i>Conclusions - </i>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_US
dc.description.sponsorshipFrench National Cancer Institute (INCa)-Cancéropôle Ile-de-France Danish Cancer Society (Denmark) Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (Inserm), (France) Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany) Hellenic Health Foundation (Greece) Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy) Dutch Ministry of Public Health, Welfare, and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (the Netherlands) Health Research Fund (FIS), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII RETIC (Spain) Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden) Cancer Research UK, Medical Research Council (United Kingdomen_US
dc.descriptionSource at <a href=https://doi.org/10.1371/journal.pmed.1002651>https://doi.org/10.1371/journal.pmed.1002651</a>.en_US
dc.identifier.citationDeschasaux, M., Huybrechts, I., Murphy, N., Julia, C., Hercberg, S., Srour,B. ... 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. <i>Nature Methods, 15</i>(9), e1002651. https://doi.org/10.1371/journal.pmed.1002651en_US
dc.identifier.cristinIDFRIDAID 1631683
dc.identifier.doi10.1371/journal.pmed.1002651
dc.identifier.issn1548-7091
dc.identifier.issn1548-7105
dc.identifier.urihttps://hdl.handle.net/10037/15358
dc.language.isoengen_US
dc.publisherSpringer Natureen_US
dc.relation.journalNature Methods
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801en_US
dc.titleNutritional 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 studyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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