Prospective association between cancer risk and an individual dietary index based on the British Food Standards Agency Nutrient Profiling System

Abstract

The Food Standards Agency Nutrient Profiling System (FSA-NPS) constitutes the basis for the Five-Colour Nutrition Label suggested in France to be put on the front-of-pack of food products. At the individual level, a dietary index (FSA-NPS DI) has been derived and validated and corresponds to a weighted mean of all FSA-NPS scores of foods usually consumed by the individual, reflecting the nutritional quality of his/her diet. Our aim was to investigate the association between the FSA-NPS DI and cancer risk in a large cohort. This prospective study included 6435 participants to the SUpplémentation en VItamines et Minéraux AntioXydants cohort (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)) who completed at least six 24 h dietary records during the first 2 years of follow-up. FSA-NPS DI was computed for each subject (higher values representing lower nutritional quality of the diet). After a median follow-up of 12·6 years, 453 incident cancers were diagnosed. Associations were characterised by multivariate Cox proportional hazards models. The FSA-NPS DI was directly associated with overall cancer risk (hazard ratio (HR) for a 1-point increment = 1·08 (95 % CI 1·01, 1·15), P trend = 0·02; HR Q5 v. Q1 = 1·34 (95 % CI 1·00, 1·81), P trend = 0·03). This association tended to be more specifically observed in subjects with moderate energy intake (≤ median, HR for a 1-point increment = 1·10 (95 % CI 1·01-1·20), P trend = 0·03). No association was observed in subjects with higher energy intake (P trend = 0·3). Results were not statistically significant for breast and prostate cancer risks. For the first time, this study investigated the prospective association between the FSA-NPS individual score and cancer risk. The results suggest that unhealthy food choices may be associated with a 34 % increase in overall cancer risk, supporting the public health relevance of developing front-of-pack nutrition labels based on this score.

The performance and potential of the Australasian Health Star Rating system: a four‐year review using the RE‐AIM framework

“…The most frequently validated of these is the United Kingdom (UK) Ofcom model, from which HSR originated 55,58 . Results of studies assessing its performance in UK and French cohorts have found prospective associations with health outcomes in most, 98–103 but not all studies 104 . While recognising the significant commonalities between both algorithms, further high‐level validation could usefully assess any prospective association between HSR, healthier diets and health outcomes in Australasian populations.…”

Effects of front-of-pack labels on the nutritional quality of supermarket food purchases: evidence from a large-scale randomized controlled trial

“…The main advantage of the basket measure is that it summarizes the effects of the label on shoppers' buying of high-, medium-, and low-nutritional-quality products into one number, while considering the quantity bought. For this reason, it is the measure of choice in epidemiological studies of the effects of the nutritional quality of food purchased on health (e.g., Donnenfeld et al 2015). The drawback is that it can only be computed for consumers who bought labeled products in the category both before and during the intervention.…”

Nutrient profiling for regulatory purposes

“…There was a clearer relationship when the variety in individuals' diets was taken into account (18) . A group of French researchers have taken these analyses forward and shown that a higher diet quality score (based on the average UK FSA/Ofcom scores of the foods of which diets are composed) is associated with a lower prospective risk of weight gain, metabolic syndrome, cancer and CVD (19)(20)(21)(22) .…”