title: 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 (1994-2007) 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; HRQ5 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, HRfor 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.
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Donnenfeld
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Julia
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse-Guyot
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Méjean
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Ducrot
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Péneau
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Deschasaux
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Paule
authors.initials: P
authors.lastname: Latino-Martel
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Léopold
authors.initials: L
authors.lastname: Fezeu
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.affiliation: 1Centre de Recherche en Epidémiologie et Statistiques,Equipe de Recherche en Epidémiologie Nutritionnelle (EREN),Université Paris 13,Inserm (U1153),Inra (U1125),Cnam,COMUE Sorbonne Paris Cité,F-93017 Bobigny,France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Touvier
mesh_terms: D004032:Diet; D015930:Diet Records; D004311:Double-Blind Method; D002149:Energy Intake; D005260:Female; D005502:Food / Q000592:standards*; D005515:Food Labeling; D005518:Food Preferences; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D009753:Nutritive Value; D010919:Placebos; D011446:Prospective Studies; D012307:Risk Factors; D006113:United Kingdom
chemical_list: D010919:Placebos
keywords: Cancer risk; FSA-NPS DI Food Standards Agency Nutrient Profiling System Dietary Index; Food Standards Agency Nutrient Profiling System; HR hazard ratio; Nutrient profiling systems; Nutrition policy; Prospective studies; SU.VI.MAX SUpplémentation en VItamines et Minéraux AntioXydants