title: Consuming a diet complying with front-of-pack label criteria may reduce cholesterol levels: a modeling study.
abstract: OBJECTIVE
  Front-of-pack nutrition labels can help consumers to make healthier choices and stimulate healthier product development. This is the first modeling study to investigate the potential impact on cholesterol levels of consuming a diet consisting of products that comply with the criteria for a 'healthier choice logo'.
  
  
  METHODS
  National food consumption and food composition data were used to estimate the nutrient intake of the Dutch adult population (18-70 years) before and after replacing foods that did not comply with the choices front-of-pack label criteria. Different scenarios were established. The difference in cholesterol levels in the Dutch population was assessed before and after replacement by means of equations from meta-analyses that calculate how blood lipids change when diet composition changes.
  
  
  RESULTS
  After replacing non-complying products with products, which comply with the label's criteria (maximum scenario), saturated fatty acids median intake reduced from 14.5 to 9.8 en%. Trans-fatty acids reduced from 0.95 to 0.57 en%. The average predicted changes in low-density lipoprotein and total cholesterol levels were -0.25 and -0.31 mmol/l, respectively. Because high-density lipoprotein (HDL) cholesterol levels reduced as well (-0.05 mmol/l), overall, the result was a slightly positive change in the total cholesterol/HDL ratio (-0.03).
  
  
  CONCLUSIONS
  Our findings suggest that the consumption of foods complying with the criteria for a front-of-pack label could contribute moderately to cardiovascular risk reduction via influencing blood lipids. These findings were independent of other potential effects on related health outcomes.
authors.affiliation: Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands. ellis.vyth@falw.vu.nl
authors.forename: E L
authors.initials: EL
authors.lastname: Vyth
authors.forename: M A H
authors.initials: MA
authors.lastname: Hendriksen
authors.forename: A J C
authors.initials: AJ
authors.lastname: Roodenburg
authors.forename: I H M
authors.initials: IH
authors.lastname: Steenhuis
authors.forename: J M A
authors.initials: JM
authors.lastname: van Raaij
authors.forename: H
authors.initials: H
authors.lastname: Verhagen
authors.forename: J
authors.initials: J
authors.lastname: Brug
authors.forename: J C
authors.initials: JC
authors.lastname: Seidell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000008:administration & dosage / Q000097:blood*; D008078:Cholesterol, LDL / Q000008:administration & dosage / Q000097:blood*; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage*; D002149:Energy Intake; D005227:Fatty Acids / Q000032:analysis; D005515:Food Labeling; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D012307:Risk Factors; D044242:Trans Fatty Acids / Q000008:administration & dosage; D014280:Triglycerides / Q000097:blood; D044465:White People; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004041:Dietary Fats; D005227:Fatty Acids; D044242:Trans Fatty Acids; D014280:Triglycerides