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oai:recercat.cat:2445/2200042025-12-05T12:08:05Zcom_2072_1057col_2072_478916col_2072_478917

Nutritional quality of diet characterized by the Nutri-Score profiling system and cardiovascular disease risk: a prospective study in 7 European countries Deschasaux Tanguy, Mélanie Huybrechts, Inge Julia, Chantal Hercberg, Serge Sarda, Barthélémy Fialon, Morgane Arnault, Nathalie Srour, Bernard Kesse Guyot, Emmanuelle Fezeu, Léopold K. Biessy, Carine Casagrande, Corinne Hemon, Bertrand Weiderpass, Elisabete Pinho, Maria G. M. Murphy, Neil Freisling, Heinz Ferrari, Pietro Tjønneland, Anne Nielsen Petersen, Kristina Elin Katzke, Verena Kaaks, Rudolf Schulze, Matthias B. Masala, Giovanna Pala, Valeria Panico, Salvatore Ricceri, Fulvio Verschuren, W. M. Monique Boer, Jolanda M. A. Schouw, Yvonne T. Van Der Skeie, Guri Agudo, Antonio Molina Montes, Esther Huerta, José María Moreno Iribas, Conchi Ericson, Ulrika Sonestedt, Emily Strid, Anna Oskarsson, Viktor Tong, Tammy Y. N. Heath, Alicia K. Aglago, Elom K. Danesh, John Riboli, Elio Gunter, Marc J. Touvier, Mathilde Etiquetatge Aliments Malalties cardiovasculars Alimentació Labeling Food Cardiovascular diseases Diet Background 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. 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. 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)). 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. Copyright (c) 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/). 2025-03-25T14:31:43Z 2025-03-25T14:31:43Z 2024-11-01 2025-01-22T16:13:45Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.1016/j.lanepe.2024.101006 The Lancet Regional Health - Europe, 2024, vol. 46 https://doi.org/10.1016/j.lanepe.2024.101006 cc-by-nc (c) Deschasaux Tanguy, Mélanie et al., 2024 http://creativecommons.org/licenses/by-nc/3.0/es/ info:eu-repo/semantics/openAccess Elsevier BV Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))