Prospective association between a dietary quality index based on a nutrient profiling system and cardiovascular disease risk

Eur J Prev Cardiol. 2016 Oct;23(15):1669-76. doi: 10.1177/2047487316640659. Epub 2016 Mar 21.

Abstract

Background: Public health strategies are essential to guide consumers' choices and produce a substantial population impact on cardiovascular disease risk prevention through nutrition. Our aim was to investigate the prospective association between the Food Standards Agency nutrient profiling system dietary index (FSA-NPS DI) and cardiovascular disease risk. The FSA-NPS has been proposed to serve as a basis for a five-colour nutrition label suggested in France to be put on the front of pack of food products.

Methods and results: A total of 6515 participants to the SU.VI.MAX cohort (1994-2007), who completed at least six 24-hour dietary records during the first two years of the study, were followed for a median of 12.4 years (25th-75th percentiles: 11.0-12.6). Multivariable Cox proportional hazards models were used to characterise the associations between FSA-NPS DI (continuous and sex-specific quartiles) and the incidence of cardiovascular diseases. Interactions with individual characteristics were tested; 181 major cardiovascular events were reported (59 myocardial infarctions, 43 strokes, 79 anginas). A higher FSA-NPS DI, characterising poorer food choices, was associated with an overall increase in cardiovascular disease risk (HRfor a 1-point increment = 1.14 (1.03-1.27); HRQ4vs.Q1 = 1.61 (1.05-2.47), Ptrend Q4-Q1 = 0.03). This association tended to be stronger in smokers (HRfor a 1-point increment = 1.39 (1.11-1.73); Pinteraction = 0.01) and those less physically active (HRfor a 1-point increment = 1.26 (1.08-1.46); Pinteraction = 0.04).

Conclusions: Our results suggest that poorer food choices, as reflected by a higher FSA-NPS DI, may be associated with a significant increase in cardiovascular risk, especially in at-risk individuals (smokers and physically inactive persons). This score could be a useful tool for public health prevention strategies.

Clinical trial registration: ClinicalTrials.gov identifier: NCT00272428.

Keywords: Cardiovascular risk; FSA-NPS; nutrient profiling system; nutrition policy; prospective study.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / prevention & control
  • Diet / standards*
  • Diet Records
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Food Preferences
  • Forecasting*
  • France / epidemiology
  • Humans
  • Incidence
  • Life Style*
  • Male
  • Middle Aged
  • Nutrition Policy
  • Nutritional Status*
  • Nutritive Value*
  • Prospective Studies
  • Risk Factors
  • Survival Rate / trends

Associated data

  • ClinicalTrials.gov/NCT00272428