Dietary indices underpinning front-of-pack nutrition labels and health outcomes : a systematic review and meta-analysis of prospective cohort studies

Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved..

BACKGROUND: Nutrient profiling systems are increasingly used to characterize the healthfulness of foods for front-of-package (FOP) labeling, which have been proposed as an effective public health strategy to help people make healthier food choices.

OBJECTIVE: This study aimed to review available evidence from cohort studies that evaluated the association of dietary indices underpinning FOP nutrition labels with all-cause mortality and incidence of cardiovascular diseases (CVDs) or cancer.

METHODS: PubMed, Web of Science, and Scopus were systematically searched up to October 2023. We included articles if they were prospective cohort studies, if the exposure was any dietary index underpinning FOP nutrition labels [e.g., the modified Food Standard Agency-Nutrient Profiling System (FSAm-NPS) and the Health Star Rating System], and if outcomes were all-cause mortality or incidence of or mortality due to CVD and cancer. Random-effects models were used to calculate the pooled hazard ratios (HRs) and 95% CIs.

RESULTS: We identified 11 records (7 unique prospective studies), which were included in the systematic review. The meta-analysis comprised 8 studies analyzing the FSAm-NPS dietary index (DI) as exposure. The pooled HRs associated with a 2-unit increase in the FSAm-NPS DI of all-cause mortality, CVD, and cancer risk were 1.06 (95% confidence interval [CI]: 0.99, 1.13; I2: 80%), 1.08 (95% CI: 1.00, 1.18; I2: 70%), and 1.09 (95% CI: 1.00, 1.19; I2: 77%), respectively. The Chilean Warning Label score and the Health Star Rating systems were examined by 1 study each and were significantly associated with the outcomes.

CONCLUSIONS: DIs underpinning most common FOP nutrition labels and reflecting nutrient-poor diets show a tendency toward an increased incidence of CVD and cancer, but the observed effects are quite modest in magnitude. Further studies at the population level are needed to support the widely shared hypothesis that FOP labels, possibly in conjunction with other interventions, may contribute to reduce noncommunicable disease risk. This meta-analysis was registered at PROSPERO as CRD42021292625.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:119

Enthalten in:

The American journal of clinical nutrition - 119(2024), 3 vom: 01. März, Seite 756-768

Sprache:

Englisch

Beteiligte Personen:

Montericcio, Alberto [VerfasserIn]
Bonaccio, Marialaura [VerfasserIn]
Ghulam, Anwal [VerfasserIn]
Di Castelnuovo, Augusto [VerfasserIn]
Gianfagna, Francesco [VerfasserIn]
de Gaetano, Giovanni [VerfasserIn]
Iacoviello, Licia [VerfasserIn]

Links:

Volltext

Themen:

Cancer risk
Cardiovascular disease
Chilean warning labels
Food Standard Agency-Nutrient Profiling System
Front-of-pack nutrition labels
Health Star Rating
Journal Article
Meta-Analysis
Nutri-Score
Survival
Systematic Review
Ultraprocessed food

Anmerkungen:

Date Completed 05.03.2024

Date Revised 12.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.ajcnut.2023.12.017

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366363727