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...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.951738/full |
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| author | Vanessa Bullón-Vela Vanessa Bullón-Vela Carmen Sayón-Orea Carmen Sayón-Orea Carmen Sayón-Orea Clara Gómez-Donoso Clara Gómez-Donoso J. A. Martínez J. A. Martínez J. A. Martínez Miguel A. Martínez-González Miguel A. Martínez-González Miguel A. Martínez-González Miguel A. Martínez-González Maira Bes-Rastrollo Maira Bes-Rastrollo Maira Bes-Rastrollo |
| author_facet | Vanessa Bullón-Vela Vanessa Bullón-Vela Carmen Sayón-Orea Carmen Sayón-Orea Carmen Sayón-Orea Clara Gómez-Donoso Clara Gómez-Donoso J. A. Martínez J. A. Martínez J. A. Martínez Miguel A. Martínez-González Miguel A. Martínez-González Miguel A. Martínez-González Miguel A. Martínez-González Maira Bes-Rastrollo Maira Bes-Rastrollo Maira Bes-Rastrollo |
| author_sort | Vanessa Bullón-Vela |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-11T19:18:14Z |
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| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-11T19:18:14Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-c803456a93f6485abd38dcccbcead9d52022-12-22T04:07:23ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-10-01910.3389/fnut.2022.951738951738Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort studyVanessa Bullón-Vela0Vanessa Bullón-Vela1Carmen Sayón-Orea2Carmen Sayón-Orea3Carmen Sayón-Orea4Clara Gómez-Donoso5Clara Gómez-Donoso6J. A. Martínez7J. A. Martínez8J. A. Martínez9Miguel A. Martínez-González10Miguel A. Martínez-González11Miguel A. Martínez-González12Miguel A. Martínez-González13Maira Bes-Rastrollo14Maira Bes-Rastrollo15Maira Bes-Rastrollo16Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, SpainNavarra Institute for Health Research, Pamplona, SpainDepartment of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, SpainNavarra Institute for Health Research, Pamplona, SpainBiomedical Research Centre Network on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, SpainNavarra Institute for Health Research, Pamplona, SpainGlobal Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, VIC, AustraliaBiomedical Research Centre Network on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, SpainDepartment of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Pamplona, SpainMadrid Institute for Advanced Studies in Food, Madrid, SpainDepartment of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, SpainNavarra Institute for Health Research, Pamplona, SpainBiomedical Research Centre Network on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, SpainDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United StatesDepartment of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, SpainNavarra Institute for Health Research, Pamplona, SpainBiomedical Research Centre Network on Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, SpainBackground 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.https://www.frontiersin.org/articles/10.3389/fnut.2022.951738/fullall-cause mortalitycancerCVDfront-of-pack nutrition labelswarning labelNutri-Score |
| spellingShingle | Vanessa Bullón-Vela Vanessa Bullón-Vela Carmen Sayón-Orea Carmen Sayón-Orea Carmen Sayón-Orea Clara Gómez-Donoso Clara Gómez-Donoso J. A. Martínez J. A. Martínez J. A. Martínez Miguel A. Martínez-González Miguel A. Martínez-González Miguel A. Martínez-González Miguel A. Martínez-González Maira Bes-Rastrollo Maira Bes-Rastrollo Maira Bes-Rastrollo Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study Frontiers in Nutrition all-cause mortality cancer CVD front-of-pack nutrition labels warning label Nutri-Score |
| 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://www.frontiersin.org/articles/10.3389/fnut.2022.951738/full |
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