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000163216 1001_ $$00000-0002-3359-420X$$aDeschasaux, Mélanie$$b0
000163216 245__ $$aAssociation between nutritional profiles of foods underlying Nutri-Score front-of-pack labels and mortality: EPIC cohort study in 10 European countries.
000163216 260__ $$aLondon$$bBritish Medical Association56099$$c2020
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000163216 520__ $$aTo determine if the Food Standards Agency nutrient profiling system (FSAm-NPS), which grades the nutritional quality of food products and is used to derive the Nutri-Score front-of-packet label to guide consumers towards healthier food choices, is associated with mortality.Population based cohort study.European Prospective Investigation into Cancer and Nutrition (EPIC) cohort from 23 centres in 10 European countries.521 324 adults; at recruitment, country specific and validated dietary questionnaires were used to assess their usual dietary intakes. A FSAm-NPS score was calculated for each food item per 100 g content of energy, sugars, saturated fatty acids, sodium, fibre, and protein, and of fruit, vegetables, legumes, and nuts. The FSAm-NPS dietary index was calculated for each participant as an energy weighted mean of the FSAm-NPS score of all foods consumed. The higher the score the lower the overall nutritional quality of the diet.Associations between the FSAm-NPS dietary index score and mortality, assessed using multivariable adjusted Cox proportional hazards regression models.After exclusions, 501 594 adults (median follow-up 17.2 years, 8 162 730 person years) were included in the analyses. Those with a higher FSAm-NPS dietary index score (highest versus lowest fifth) showed an increased risk of all cause mortality (n=53 112 events from non-external causes; hazard ratio 1.07, 95% confidence interval 1.03 to 1.10, P<0.001 for trend) and mortality from cancer (1.08, 1.03 to 1.13, P<0.001 for trend) and diseases of the circulatory (1.04, 0.98 to 1.11, P=0.06 for trend), respiratory (1.39, 1.22 to 1.59, P<0.001), and digestive (1.22, 1.02 to 1.45, P=0.03 for trend) systems. The age standardised absolute rates for all cause mortality per 10 000 persons over 10 years were 760 (men=1237; women=563) for those in the highest fifth of the FSAm-NPS dietary index score and 661 (men=1008; women=518) for those in the lowest fifth.In this large multinational European cohort, consuming foods with a higher FSAm-NPS score (lower nutritional quality) was associated with a higher mortality for all causes and for cancer and diseases of the circulatory, respiratory, and digestive systems, supporting the relevance of FSAm-NPS to characterise healthier food choices in the context of public health policies (eg, the Nutri-Score) for European populations. This is important considering ongoing discussions about the potential implementation of a unique nutrition labelling system at the European Union level.
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000163216 7001_ $$aHercberg, Serge$$b3
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000163216 7001_ $$aMurphy, Neil$$b10
000163216 7001_ $$aJenab, Mazda$$b11
000163216 7001_ $$aWard, Heather A$$b12
000163216 7001_ $$aWeiderpass, Elisabete$$b13
000163216 7001_ $$aOvervad, Kim$$b14
000163216 7001_ $$aTjønneland, Anne$$b15
000163216 7001_ $$aRostgaard-Hansen, Agnetha Linn$$b16
000163216 7001_ $$aBoutron-Ruault, Marie-Christine$$b17
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000163216 7001_ $$aPeppa, Eleni$$b26
000163216 7001_ $$aMasala, Giovanna$$b27
000163216 7001_ $$aAgnoli, Claudia$$b28
000163216 7001_ $$aDe Magistris, Maria Santucci$$b29
000163216 7001_ $$aTumino, Rosario$$b30
000163216 7001_ $$aSacerdote, Carlotta$$b31
000163216 7001_ $$aBoer, Jolanda Ma$$b32
000163216 7001_ $$aVerschuren, Wm Monique$$b33
000163216 7001_ $$avan der Schouw, Yvonne T$$b34
000163216 7001_ $$aSkeie, Guri$$b35
000163216 7001_ $$aBraaten, Tonje$$b36
000163216 7001_ $$aRedondo, M Luisa$$b37
000163216 7001_ $$aAgudo, Antonio$$b38
000163216 7001_ $$aPetrova, Dafina$$b39
000163216 7001_ $$aColorado-Yohar, Sandra M$$b40
000163216 7001_ $$aBarricarte, Aurelio$$b41
000163216 7001_ $$aAmiano, Pilar$$b42
000163216 7001_ $$aSonestedt, Emily$$b43
000163216 7001_ $$aEricson, Ulrika$$b44
000163216 7001_ $$aOtten, Julia$$b45
000163216 7001_ $$aSundström, Björn$$b46
000163216 7001_ $$aWareham, Nicholas J$$b47
000163216 7001_ $$aForouhi, Nita G$$b48
000163216 7001_ $$aVineis, Paolo$$b49
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000163216 7001_ $$aPapier, Keren$$b52
000163216 7001_ $$aFerrari, Pietro$$b53
000163216 7001_ $$aRiboli, Elio$$b54
000163216 7001_ $$aGunter, Marc J$$b55
000163216 7001_ $$aTouvier, Mathilde$$b56
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