4.6 Article

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


Volume 23, Issue 15, Pages 1669-1676


DOI: 10.1177/2047487316640659


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


  1. CORDDIM - Paris region
  2. French Ministry of Research and Higher Education
  3. Canceropole Ile-de-France - Paris region
  4. Fondation Le Roch - Les Mousquetaires

Ask authors/readers for more resources

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); P-interaction=0.01) and those less physically active (HRfor a 1-point increment=1.26 (1.08-1.46); P-interaction=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.


I am an author on this paper
Click your name to claim this paper and add it to your profile.


Primary Rating

Not enough ratings

Secondary Ratings

Scientific rigor
Rate this paper


No Data Available
No Data Available