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. 2022 Jul 14:9:897089.
doi: 10.3389/fnut.2022.897089. eCollection 2022.

Associations Between the Modified Food Standard Agency Nutrient Profiling System Dietary Index and Cardiovascular Risk Factors in an Elderly Population

Nadine Khoury  1   2 , Clara Gómez-Donoso  1   2 , María Ángeles Martínez  1   2   3 , Miguel Ángel Martínez-González  3   4   5 , Dolores Corella  3   6 , Montserrat Fitó  3   7 , J Alfredo Martínez  3   8   9 , Ángel M Alonso-Gómez  3   10 , Julia Wärnberg  3   11 , Jesús Vioque  12   13 , Dora Romaguera  3   14 , Ana León-Acuña  3   15 , Francisco J Tinahones  3   16 , José M Santos-Lozano  3   17 , Luís Serra-Majem  3   18 , Paloma Massó Guijarro  19   20   21 , Josep A Tur  3   22 , Vicente Martín Sánchez  12   23 , Xavier Pintó  3   24 , Miguel Delgado-Rodríguez  9   25 , Pilar Matía-Martín  26 , Josep Vidal  27   28 , Clotilde Vázquez  3   29 , Lidia Daimiel  30 , Emili Ros  3   31 , Maira Bes-Rastrollo  3   4 , Rocio Barragan  3   6 , Olga Castañer  3   7 , Jose D Torres-Peña  3   15 , Leyre Notario-Barandiaran  13 , Carlos Muñoz-Bravo  11 , Itziar Abete  3   8   9 , Lara Prohens  3   14 , Naomi Cano-Ibáñez  12   19   21 , Lucas Tojal Sierra  3   10 , José Carlos Fernández-García  3   16 , Carmen Sayon-Orea  3   4 , Maria Pascual  1   2 , Jose V Sorli  3   6 , Dolores Zomeño  3   7   32 , Patricia J Peña-Orihuela  3   15 , Antonio J Signes-Pastor  12   13 , F Javier Basterra-Gortari  4   33 , Helmut Schröeder  3   7 , Jordi Salas Salvadó  1   2   3 , Nancy Babio  1   2   3
Affiliations

Associations Between the Modified Food Standard Agency Nutrient Profiling System Dietary Index and Cardiovascular Risk Factors in an Elderly Population

Nadine Khoury et al. Front Nutr. .

Abstract

Background: Helping consumers to improve the nutritional quality of their diet is a key public health action to prevent cardiovascular diseases (CVDs). The modified version of the Food Standard Agency Nutrient Profiling System Dietary Index (FSAm-NPS DI) underpinning the Nutri-Score front-of-pack label has been used in public health strategies to address the deleterious consequences of poor diets. This study aimed to assess the association between the FSAm-NPS DI and some CVD risk factors including body mass index (BMI), waist circumference, plasma glucose levels, triglyceride levels, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and diastolic and systolic blood pressure.

Materials and methods: Dietary intake was assessed at baseline and after 1 year of follow-up using a 143-item validated semi-quantitative food-frequency questionnaire. Dietary indices based on FSAm-NPS applied at an individual level were computed to characterize the diet quality of 5,921 participants aged 55-75 years with overweight/obesity and metabolic syndrome from the PREDIMED-plus cohort. Associations between the FSAm-NPS DI and CVD risk factors were assessed using linear regression models.

Results: Compared to participants with a higher nutritional quality of diet (measured by a lower FSAm-NPS DI at baseline or a decrease in FSAm-NPS DI after 1 year), those participants with a lower nutritional quality of diet (higher FSAm-NPS DI or an increase in score) showed a significant increase in the levels of plasma glucose, triglycerides, diastolic blood pressure, BMI, and waist circumference (β coefficient [95% confidence interval]; P for trend) (1.67 [0.43, 2.90]; <0.001; 6.27 [2.46, 10.09]; <0.001; 0.56 [0.08, 1.05]; 0.001; 0.51 [0.41, 0.60]; <0.001; 1.19 [0.89, 1.50]; <0.001, respectively). No significant associations in relation to changes in HDL and LDL-cholesterol nor with systolic blood pressure were shown.

Conclusion: This prospective cohort study suggests that the consumption of food items with a higher FSAm-NPS DI is associated with increased levels of several major risk factors for CVD including adiposity, fasting plasma glucose, triglycerides, and diastolic blood pressure. However, results must be cautiously interpreted because no significant prospective associations were identified for critical CVD risk factors, such as HDL and LDL-cholesterol, and systolic blood pressure.

Keywords: FSAm-NPS dietary index; PREDIMED-Plus study; body weight; cardiovascular risk factor; front of pack food labeling.

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Conflict of interest statement

JSS served on the board of the International Nut and Dried Fruit Council and receives grant support through this institution. He also served in the Executive Committee of the Instituto Danone, Spain, and on the Scientific Committee of the Danone International Institute. He received research support from the Patrimonio Comunal Olivarero, Spain, and Borges S.A., Spain. He received consulting fees or travel expenses from Eroski Foundation, the Instituto Danone, Spain, Mundipharma and Abbot Laboratories. ER reports grants, personal fees, non-financial support, and others from California Walnut Commission and Alexion, personal fees, non-financial support, and others from Ferrer International and Danone, and personal fees from Amarin, other than the submitted study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of participant’s inclusion.
FIGURE 2
FIGURE 2
Prospective associations between dietary index based on the French context, the modified FSA-NPS (FSAm-NPS DI) and cardiovascular diseases (CVD) risk factors changes after 1 year of follow-up.
See this image and copyright information in PMC

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