Associations Between the Modified Food Standard Agency Nutrient Profiling System Dietary Index and Cardiovascular Risk Factors in an Elderly Population
Authors: Khoury Nadine , Gómez-Donoso Clara , Martínez María Ángeles , Martínez-González Miguel Ángel , Corella Dolores , Fitó Montserrat , Martínez J. Alfredo , Alonso-Gómez Ángel M. , Wärnberg Julia , Vioque Jesús , Romaguera Dora , León-Acuña Ana , Tinahones Francisco J. , Santos-Lozano José M. , Serra-Majem Luís , Massó Guijarro Paloma , Tur Josep A. , Martín Sánchez Vicente , Pintó Xavier , Delgado-Rodríguez Miguel , Matía-Martín Pilar , Vidal Josep , Vázquez Clotilde , Daimiel Lidia , Ros Emili , Bes-Rastrollo Maira , Barragan Rocio , Castañer Olga , Torres-Peña Jose D. , Notario-Barandiaran Leyre , Muñoz-Bravo Carlos , Abete Itziar , Prohens Lara , Cano-Ibáñez Naomi , Tojal Sierra Lucas , Fernández-García José Carlos , Sayon-Orea Carmen , Pascual Maria , Sorli Jose V. , Zomeño Dolores , Peña-Orihuela Patricia J. , Signes-Pastor Antonio J. , Basterra-Gortari F. Javier , Schröeder Helmut , Salas Salvadó Jordi , Babio Nancy 
Published: July 2022

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]; &lt;0.001; 6.27 [2.46, 10.09]; &lt;0.001; 0.56 [0.08, 1.05]; 0.001; 0.51 [0.41, 0.60]; &lt;0.001; 1.19 [0.89, 1.50]; &lt;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.