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
Bonaccio M, Di Castelnuovo A, Ruggiero E, Costanzo S, Grosso G, De Curtis A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Moli-sani Study Investigators
BMJ (Clinical research ed.) · 63 citas
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Cómo se estudió
- Diseño
- Estudio de cohortes (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Posiblemente financiado por la industria
- Gobierno
- Ministero della Salute
- Organización sin fines de lucro
- Associazione Italiana per la Ricerca sul Cancro
Según 2 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2022-08-31 · BMJ · vol. 378 · pág. e070688
- Citado
- 88 citas · más que el 100% de estudios similares · 15.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 67 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY-NC
- Áreas de investigación
- Consumer Attitudes and Food Labeling · Nutritional Studies and Diet · Food composition and properties
- Palabras clave
- Medicine, Hazard ratio, Confidence interval, Proportional hazards model, Prospective cohort study, Cohort, Demography, Cohort study, Internal medicine
- MeSH
- humans, cardiovascular diseases, prospective studies, eating, adult, middle aged, female, male, fast foods, nutrients
10 autores
- Marialaura Bonaccio🇮🇹 · autor de correspondenciaIstituto Neurologico Mediterraneo
- Augusto Filippo Di Castelnuovo🇮🇹Clinica Mediterranea
- Emilia Ruggiero🇮🇹Istituto Neurologico Mediterraneo
- Simona Costanzo🇮🇹Istituto Neurologico Mediterraneo
- Giuseppe Grosso🇮🇹University of Catania
- Amalia De Curtis🇮🇹Istituto Neurologico Mediterraneo
- Chiara Cerletti🇮🇹Istituto Neurologico Mediterraneo
- Maria Benedetta Donati🇮🇹Istituto Neurologico Mediterraneo
- Giovanni de Gaetano🇮🇹Istituto Neurologico Mediterraneo
- Licia Iacoviello🇮🇹University of Insubria; Istituto Neurologico Mediterraneo
Resumen
El texto original del estudio, en el idioma en que se publicó.
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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