Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study
Background and aimsFront-of-Pack (FoP) nutrition labelling has been established as a policy, empowering consumers to choose healthy food options for preventing diet-related non-communicable diseases. This study aimed to evaluate the association between the nutrient profile underlying the Chilean war...
| Main Authors: | , , , , , |
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| Format: | info:eu-repo/semantics/article |
| Language: | English |
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2023
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| Online Access: | https://hdl.handle.net/10171/65698 |
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| author | Bullón-Vela, M. V. (María Vanessa) Sayon-Orea, C. (Carmen) Gómez-Donoso, C. (Clara) Martínez-Hernández, J.A. (J. Alfredo) Martinez-Gonzalez, M.A. (Miguel Ángel) Bes-Rastrollo, M. (Maira) |
| author_facet | Bullón-Vela, M. V. (María Vanessa) Sayon-Orea, C. (Carmen) Gómez-Donoso, C. (Clara) Martínez-Hernández, J.A. (J. Alfredo) Martinez-Gonzalez, M.A. (Miguel Ángel) Bes-Rastrollo, M. (Maira) |
| author_sort | Bullón-Vela, M. V. (María Vanessa) |
| collection | DSpace |
| description | Background and aimsFront-of-Pack (FoP) nutrition labelling has been established as a policy, empowering consumers to choose healthy food options for preventing diet-related non-communicable diseases. This study aimed to evaluate the association between the nutrient profile underlying the Chilean warning label score and all-cause mortality and to conduct a calibration with the Nutri-Score in a large cohort of Spanish university graduates. Materials and methodsThis prospective cohort study analysed 20,666 participants (8,068 men and 12,598 women) with a mean (standard deviation) age of 38 years (+/- 12.4) from the SUN cohort. Dietary food intake was assessed by a validated semi-quantitative food-frequency questionnaire at baseline and after 10 years of follow-up. The warning label score was calculated by considering the threshold of nutrients (sugar, saturated fat, and sodium) and energy density per 100 g/ml of product, as established by Chilean Legislation. Participants were classified according to quartiles of consumption of daily label score: Q1 (<= 5.0), Q2 (>5.0-7.1), Q3 (>7.1-9.8), and Q4 (>9.8). Time-dependent, multivariable-adjusted Cox models were applied. To compare the performance of the warning label score and Nutri-Score to predict mortality, we used the Akaike information criterion (AIC) and Bayesian information criterion (BIC) methods. ResultsDuring a median of 12.2 years of follow-up, 467 deaths were identified. A higher score in the warning label values (lower nutritional quality) was associated with an increased risk of all-cause mortality [HR (95% CI) Q4 vs. Q1: 1.51 (1.07-2.13); p-trend = 0.010] and cancer mortality [HR (95% CI) Q4 vs. Q1: 1.91 (1.18-3.10); p-trend = 0.006]. However, no statistically significant association was found for cardiovascular mortality. Furthermore, the warning label score and Nutri-Score exhibited comparable AIC and BIC values, showing similar power of prediction for mortality. ConclusionA diet with a higher warning label score (>9.8 per day) was a good predictor of all cases and cancer mortality in a large Spanish cohort of university graduates. Also, the warning label score was capable to predict mortality as well as the Nutri-Score. Our findings support the validity of the warning label score as a FoP nutrition labelling policy since it can highlight less healthy food products. |
| format | info:eu-repo/semantics/article |
| id | oai:dadun.unav.edu:10171-65698 |
| institution | Universidad de Navarra |
| language | English |
| publishDate | 2023 |
| record_format | dspace |
| spelling | oai:dadun.unav.edu:10171-656982023-05-03T11:04:48Z Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study Bullón-Vela, M. V. (María Vanessa) Sayon-Orea, C. (Carmen) Gómez-Donoso, C. (Clara) Martínez-Hernández, J.A. (J. Alfredo) Martinez-Gonzalez, M.A. (Miguel Ángel) Bes-Rastrollo, M. (Maira) All-cause mortality Cancer CVD Front-of-pack nutrition labels Warning label Nutri-Score Background and aimsFront-of-Pack (FoP) nutrition labelling has been established as a policy, empowering consumers to choose healthy food options for preventing diet-related non-communicable diseases. This study aimed to evaluate the association between the nutrient profile underlying the Chilean warning label score and all-cause mortality and to conduct a calibration with the Nutri-Score in a large cohort of Spanish university graduates. Materials and methodsThis prospective cohort study analysed 20,666 participants (8,068 men and 12,598 women) with a mean (standard deviation) age of 38 years (+/- 12.4) from the SUN cohort. Dietary food intake was assessed by a validated semi-quantitative food-frequency questionnaire at baseline and after 10 years of follow-up. The warning label score was calculated by considering the threshold of nutrients (sugar, saturated fat, and sodium) and energy density per 100 g/ml of product, as established by Chilean Legislation. Participants were classified according to quartiles of consumption of daily label score: Q1 (<= 5.0), Q2 (>5.0-7.1), Q3 (>7.1-9.8), and Q4 (>9.8). Time-dependent, multivariable-adjusted Cox models were applied. To compare the performance of the warning label score and Nutri-Score to predict mortality, we used the Akaike information criterion (AIC) and Bayesian information criterion (BIC) methods. ResultsDuring a median of 12.2 years of follow-up, 467 deaths were identified. A higher score in the warning label values (lower nutritional quality) was associated with an increased risk of all-cause mortality [HR (95% CI) Q4 vs. Q1: 1.51 (1.07-2.13); p-trend = 0.010] and cancer mortality [HR (95% CI) Q4 vs. Q1: 1.91 (1.18-3.10); p-trend = 0.006]. However, no statistically significant association was found for cardiovascular mortality. Furthermore, the warning label score and Nutri-Score exhibited comparable AIC and BIC values, showing similar power of prediction for mortality. ConclusionA diet with a higher warning label score (>9.8 per day) was a good predictor of all cases and cancer mortality in a large Spanish cohort of university graduates. Also, the warning label score was capable to predict mortality as well as the Nutri-Score. Our findings support the validity of the warning label score as a FoP nutrition labelling policy since it can highlight less healthy food products. 2023-03-16T15:56:41Z 2023-03-16T15:56:41Z 2022 info:eu-repo/semantics/article https://hdl.handle.net/10171/65698 en info:eu-repo/grantAgreement/EC/FP7/340918/EU info:eu-repo/grantAgreement/MSC/Redes Temáticas de Investigación Cooperativa en Salud (RETICS)/RD06%2F0045/ES/ALIMENTACIÓN SALUDABLE EN LA PREVENCIÓN PRIMARIA DE ENFERMEDADES CRÓNICAS: LA RED PREDIMED info:eu-repo/grantAgreement/MINECO/Proyectos de investigación en salud (AE en Salud)/ PI13%2F00615/ES/ESTILOS DE VIDA Y RIESGO DE DIABETES MELLITUS GESTACIONAL: LA COHORTE SUN info:eu-repo/grantAgreement/MINECO/Proyectos de investigación en salud (AE Salud 2014)/ PI14%2F01668/ES/Dieta y estilos de vida en la prevención de la diabetes mellitus gestacional: un proyecto coordinado de casos y controles y análisis prospectivo de un estudio de cohortes info:eu-repo/grantAgreement/MINECO/Proyectos de investigación en salud (AE Salud 2014)/ PI14%2F01798/ES/Patrones de dieta, de actividad física y de consumo de alcohol y riesgo de depresión en la cohorte SUN info:eu-repo/grantAgreement/MINECO/Proyectos de investigación en salud (AE Salud 2014)/ PI14%2F01764/ES/Prevención eficiente de la demencia en sujetos con alto riesgo info:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016 (ISCIII)/ PI17%2F01795/ES/ESTUDIO DE LA OBESIDAD COMO FACTOR DE RIESGO DE MORTALIDAD Y SU PREVENCION MEDIANTE RECOMENDACIONES DIETETICAS: ANALISIS LONGITUDINAL DE LA COHORTE SUN info:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI20%2F00564/ES/EMPODERAMIENTO INTEGRAL PARA GANAR SALUD: ANALISIS LONGITUDINAL DE LA COHORTE SUN info:eu-repo/semantics/openAccess application/pdf |
| spellingShingle | All-cause mortality Cancer CVD Front-of-pack nutrition labels Warning label Nutri-Score Bullón-Vela, M. V. (María Vanessa) Sayon-Orea, C. (Carmen) Gómez-Donoso, C. (Clara) Martínez-Hernández, J.A. (J. Alfredo) Martinez-Gonzalez, M.A. (Miguel Ángel) Bes-Rastrollo, M. (Maira) Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study |
| title | Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study |
| title_full | Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study |
| title_fullStr | Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study |
| title_full_unstemmed | Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study |
| title_short | Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study |
| title_sort | mortality prediction of the nutrient profile of the chilean front-of-pack warning labels: results from the seguimiento universidad de navarra prospective cohort study |
| topic | All-cause mortality Cancer CVD Front-of-pack nutrition labels Warning label Nutri-Score |
| url | https://hdl.handle.net/10171/65698 |
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