Background The updated Nutri-Score nutrient profiling model (uNS-NPM), revised in 2023, aims to better align with dietary guidelines and improve health outcomes prediction. However, evidence assessing its validity and applicability remains limited, particularly in Spanish populations. Objective To investigate the prospective association between diet quality, assessed using the uNS-NPM dietary index (DI), and the risk of all-cause and cause-specific mortality in older adults at high cardiovascular risk. Methods A prospective analysis within the PREDIMED cohort, with 7,212 participants aged 55–80 years at high cardiovascular risk was conducted. Diet was assessed by validated food frequency questionnaires, and the uNS-NPM DI was computed to quantify overall dietary quality. Time-dependent Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cardiovascular, cancer, and other-cause mortality across quintiles of the average cumulative uNS-NPM DI, adjusting for relevant confounders. Results Over a median follow-up of 6 years, 425 deaths occurred (103 cardiovascular, 169 cancers, 153 other causes). Participants in the highest quintile of the uNS-NPM DI (reflecting poorer diet quality) had a higher risk of all-cause mortality (HR: 1.64; 95% CI: 1.19–2.28; p-trend = 0.007) and a higher risk of cardiovascular mortality (HR: 3.21; 95% CI: 1.29–7.95; p-trend = 0.002) compared to those participants in the lowest quintile. Participants in the highest quintile of uNS-NPM DI had also an increased risk of death from other causes (HR: 1.84; 95% CI: 1.11–3.07), although the trend was not statistically significant p-trend = 169). For cancer mortality, no significant association was observed (HR for highest vs. lowest quintile: 1.16; 95% CI: 0.69–1.92 p-trend = 0.695). Conclusions In this Mediterranean cohort of older adults at high cardiovascular risk, lower dietary quality, assessed with the uNS-NPM DI, was prospectively associated with higher risks of all-cause, cardiovascular, and other-cause mortality. These findings support the uNS-NPM DI as a valuable tool for diet quality assessment.
Background Mandatory front-of-pack warning labels on food and beverages assist consumers in making informed consumption and purchase choices. There has been limited research into adolescents’ responses to warning label options for sugar-sweetened beverages (SSBs), despite being the highest consumers of these products globally. Methods Twelve focus groups of 6–8 adolescents were undertaken (ntotal = 89), stratified by gender, location (metropolitan/regional), and school type (public/private). After initial discussions of beverage consumption and preferences, the main label discussion was based on 15 potential SSB warning labels across 4 label categories: sugar content, nutrient content (calories, % daily energy intake), exercise equivalent information and health effects. Graphic warning labels were also shown separately at the end of group discussions to explore preliminary reactions to a novel contrasting approach. Results It was apparent from Theme 1, Drivers of consumption, that participants’ consumption was driven by a range of individual (e.g., taste, functional benefit) and situational (school, work and home environments, social settings) factors. Within Theme 2, Perceptions of label effectiveness, labels needed to command attention and be perceived as serious, and the word ‘warning’ and shape of the label contributed to participants’ perceptions of the label as serious. Theme 2 also related to providing information that was clear and informative, relevant, resistant to self-exemption, and perceived as prompting reconsideration of consumption and purchase of SSBs. Labels depicting teaspoons of sugar content (text and pictogram) were perceived most strongly across these criteria, with responses indicating potential for behaviour change. In Theme 3, Consideration of potential unintended consequences, responses to some labels ranged from perceptions relating to potential switching to artificially sweetened beverages, to more serious issues such as the potential for stigma and encouraging negative eating behaviours among some adolescents. Conclusions This study adds valuable in-depth insights into the potential effects of warning labels on SSBs among adolescents, a group with high consumption levels with the teaspoons of sugar label a standout in potential effectiveness. These findings highlight the importance of testing messaging among specific consumer groups, to assist in determining approaches perceived as effective while limiting stigma and other unintended consequences.
Lancé en France en 2017, le Nutri-Score est l’étiquetage nutritionnel soutenu par les pouvoirs publics. Affiché en face avant des emballages alimentaires, l’objectif de ce logo est double : d’une part, mieux infor...
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