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oai:recercat.cat:20.500.14342/52682025-05-24T19:14:38Zcom_2072_482405com_2072_183628col_2072_482409

2025-05-24T19:14:38Z urn:hdl:20.500.14342/5268 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 Deschasaux, Mélanie Huybrechts, Inge Murphy, Neil Julia, Chantal Hercberg, Serge Srour, Bernard Kesse-Guyot, Emmanuelle Latino-Martel, Paule Biessy, Carine Casagrande, Corinne Jenab, Mazda Ward, Heather A. Weiderpass, Elisabete Dahm, Christina C. Overvad, Kim Kyrø, Cecilie Olsen, Anja Affret, Aurélie Boutron-Ruault, Marie-Christine Mahamat-Saleh, Yahya Kaaks, Rudolf Kühn, Tilman Boeing, Heiner Schwingshackl, Lukas Bamia, Christina Peppa, Eleni Trichopoulou, Antonia Masala, Giovanna Krogh, Vittorio Panico, Salvatore Tumino, Rosario Sacerdote, Carlotta Bueno de Mesquita, H. Bas Peeters, Petra H. Hjartåker, Anette Rylander, Charlotta Skeie, Guri Quirós, José Ramón Jakszyn, Paula Salamanca-Fernández, Elena Huerta, José María Ardanaz, Eva Amiano, Pilar Ericson, Ulrika Sonestedt, Emily Huseinovic, Ena Johansson, Ingegerd Khaw, Kay-Tee Wareham, Nick Bradbury, Kathryn E. Perez-Cornago, Aurora Tsilidis, Konstantinos K. Ferrari, Pietro Riboli, Elio Gunter, Marc J. Touvier, Mathilde Càncer Aliments Alimentació Factors de risc 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. 2025-05-24T19:14:38Z 2025-05-24T19:14:38Z 2018-04 2018-09 info:eu-repo/semantics/article http://hdl.handle.net/20.500.14342/5268 https://doi.org/10.1371/journal.pmed.1002651 eng PLoS Medicine, 2018, 15(9): e1002651 http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess © L'autor/a Attribution 4.0 International Public Library of Science (PLoS)