意大利IRCCS Neuromed研究所Marialaura Bonaccio团队分析了包装前标签营养评分和超加工食品摄入与死亡率的相关性。2022年8月31日出版的《英国医学杂志》发表了这项成果。

为了联合分析两个食品维度（用于推导包装标签前Nutri评分的食品标准局营养分析系统[FSAm NPS]和NOVA分类）与死亡率的相关性，2005-2010年，研究组在意大利进行了一项前瞻性群组研究，共招募了22895名参与者（平均年龄55岁；48%为男性）。主要结局是饮食暴露与死亡风险之间的相关性，使用已知风险因素控制的多变量原因特异性Cox比例风险模型进行评估。

在272960人年的随访中，共发生2205例死亡。FSAm NPS指数的最高季度与最低季度相比，全因死亡和心血管死亡的多变量校正危险比分别为1.19和1.32。比较两种极端类型的超加工食品摄入时，全因死亡和心血管死亡的风险比分别为1.19和1.27。当联合分析这两个指数时，FSAm NPS饮食指数与全因死亡和心血管死亡的相关程度分别降低了22.3%和15.4%，而与高超加工食品摄入相关的死亡风险没有改变。

研究结果表明，使用FSAm NPS饮食指数（支撑Nutri评分）测量的饮食质量最低的成年人，以及超加工食品消费量最高的成年人（NOVA分类），其全因和心血管死亡的风险最高。与营养不良食物摄入增加有关的较高死亡风险很大一部分原因是高度食品加工。相比之下，超加工食品高摄入量与死亡率之间的关系并不能用这些食品的质量差来解释。

附：英文原文

Title: Joint association of food nutritional profile by Nutri-Score front-of-pack label and ultra-processed food intake with mortality: Moli-sani prospective cohort study

Author: Marialaura Bonaccio, Augusto Di Castelnuovo, Emilia Ruggiero, Simona Costanzo, Giuseppe Grosso, Amalia De Curtis, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello

Issue&Volume: 2022/08/31

Abstract:

Objective To jointly analyse two food dimensions, the Food Standards Agency Nutrient Profiling System (FSAm-NPS), used to derive the Nutri-Score front-of-pack label, and the NOVA classification in relation to mortality.

Design Prospective cohort study.

Setting Moli-sani Study, Italy 2005-10.

Participants 22895 participants (mean age 55 (SD 12) years; 48% men).

Main outcomes measures Associations between dietary exposures and mortality risk, assessed using multivariable cause specific Cox proportional hazard models controlled for known risk factors.

Results A total of 2205 deaths occurred during 272960 person years of follow-up. In the highest quarter of the FSAm-NPS index compared with the lowest quarter, multivariable adjusted hazard ratios for all cause and cardiovascular mortality were 1.19 (95% confidence interval 1.04 to 1.35; absolute risk difference 4.3%, 95% confidence interval 1.4% to 7.2%) and 1.32 (1.06 to 1.64; 2.6%, 0.3% to 4.9%), respectively. The hazard ratios were 1.19 (1.05 to 1.36; absolute risk difference 9.7%, 5.0% to 14.3%) and 1.27 (1.02 to 1.58; 5.0%, 1.2% to 8.8%), respectively, for all cause and cardiovascular mortality when the two extreme categories of ultra-processed food intake were compared. When these two indices were analysed jointly, the magnitude of the association of the FSAm-NPS dietary index with all cause and cardiovascular mortality was attenuated by 22.3% and 15.4%, respectively, whereas mortality risks associated with high ultra-processed food intake were not altered.

Conclusions Adults with the lowest quality diet, as measured using the FSAm-NPS dietary index (underpinning the Nutri-Score), and the highest ultra-processed food consumption (NOVA classification) were at the highest risk for all cause and cardiovascular mortality. A significant proportion of the higher mortality risk associated with an elevated intake of nutrient poor foods was explained by a high degree of food processing. In contrast, the relation between a high ultra-processed food intake and mortality was not explained by the poor quality of these foods.

DOI: 10.1136/bmj-2022-070688

Source: https://www.bmj.com/content/378/bmj-2022-070688