Joint association of food nutritional profile by Nutri-Score front-of-pack label and ultra-processed food intake with mortality: Moli-sani prospective cohort study

OBJECTIVE: To jointly analyse two food dimensions, the Food Standards Agency Nutrient Profiling System (FSAm-NPS), used to derive the Nutri-Score front-of-pack label, and the NOVA classification in relation to mortality. DESIGN: Prospective cohort study. SETTING: Moli-sani Study, Italy 2005-10. PART...

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Detalles Bibliográficos
Autores principales: Bonaccio, Marialaura, Di Castelnuovo, Augusto, Ruggiero, Emilia, Costanzo, Simona, Grosso, Giuseppe, De Curtis, Amalia, Cerletti, Chiara, Donati, Maria Benedetta, de Gaetano, Giovanni, Iacoviello, Licia, Bonanni, Americo, Gianfagna, Francesco, Persichillo, Mariarosaria, Di Prospero, Teresa, Olivieri, Marco, Panzera, Teresa, Esposito, Simona, Gialluisi, Alessandro, Magnacca, Sara, Izzi, Benedetta, Marotta, Annalisa, Noro, Fabrizia, Parisi, Roberta, Tirozzi, Alfonsina, Bracone, Francesca, De Lucia, Francesca, Mignogna, Cristiana, Rago, Livia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2022
Materias:
Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9430377/
https://www.ncbi.nlm.nih.gov/pubmed/36450651
http://dx.doi.org/10.1136/bmj-2022-070688
Descripción
Sumario:OBJECTIVE: To jointly analyse two food dimensions, the Food Standards Agency Nutrient Profiling System (FSAm-NPS), used to derive the Nutri-Score front-of-pack label, and the NOVA classification in relation to mortality. DESIGN: Prospective cohort study. SETTING: Moli-sani Study, Italy 2005-10. PARTICIPANTS: 22 895 participants (mean age 55 (SD 12) years; 48% men). MAIN OUTCOMES MEASURES: Associations between dietary exposures and mortality risk, assessed using multivariable cause specific Cox proportional hazard models controlled for known risk factors. RESULTS: A total of 2205 deaths occurred during 272 960 person years of follow-up. In the highest quarter of the FSAm-NPS index compared with the lowest quarter, multivariable adjusted hazard ratios for all cause and cardiovascular mortality were 1.19 (95% confidence interval 1.04 to 1.35; absolute risk difference 4.3%, 95% confidence interval 1.4% to 7.2%) and 1.32 (1.06 to 1.64; 2.6%, 0.3% to 4.9%), respectively. The hazard ratios were 1.19 (1.05 to 1.36; absolute risk difference 9.7%, 5.0% to 14.3%) and 1.27 (1.02 to 1.58; 5.0%, 1.2% to 8.8%), respectively, for all cause and cardiovascular mortality when the two extreme categories of ultra-processed food intake were compared. When these two indices were analysed jointly, the magnitude of the association of the FSAm-NPS dietary index with all cause and cardiovascular mortality was attenuated by 22.3% and 15.4%, respectively, whereas mortality risks associated with high ultra-processed food intake were not altered. CONCLUSIONS: Adults with the lowest quality diet, as measured using the FSAm-NPS dietary index (underpinning the Nutri-Score), and the highest ultra-processed food consumption (NOVA classification) were at the highest risk for all cause and cardiovascular mortality. A significant proportion of the higher mortality risk associated with an elevated intake of nutrient poor foods was explained by a high degree of food processing. In contrast, the relation between a high ultra-processed food intake and mortality was not explained by the poor quality of these foods.

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