Deschasaux, MélanieHuybrechts, IngeMurphy, NeilJulia, ChantalHercberg, SergeSrour, BernardKesse-Guyot, EmmanuelleLatino-Martel, PauleBiessy, CarineCasagrande, CorinneJenab, MazdaWard, HeatherWeiderpass, ElisabeteDahm, Christina COvervad, KimKyrø, CecilieOlsen, AnjaAffret, AurélieBoutron-Ruault, Marie-ChristineMahamat-Saleh, YahyaKaaks, RudolfKühn, TilmanBoeing, HeinerSchwingshackl, LukasBamia, ChristinaPeppa, EleniTrichopoulou, AntoniaMasala, GiovannaKrogh, VittorioPanico, SalvatoreTumino, RosarioSacerdote, CarlottaBueno-de-Mesquita, BasPeeters, Petra HHjartåker, AnetteRylander, CharlottaSkeie, GuriRamón Quirós, JJakszyn, PaulaSalamanca-Fernández, ElenaHuerta, José MaríaArdanaz, EvaAmiano, PilarEricson, UlrikaSonestedt, EmilyHuseinovic, EnaJohansson, IngegerdKhaw, Kay-TeeWareham, NickBradbury, Kathryn EPerez-Cornago, AuroraTsilidis, Konstantinos KFerrari, PietroRiboli, ElioGunter, Marc JTouvier, Mathilde2023-01-252023-01-252018-09-18http://hdl.handle.net/10668/12960Helping consumers make healthier food choices is a key issue for the prevention of cancer and other diseases. In many countries, political authorities are considering the implementation of a simplified labelling system to reflect the nutritional quality of food products. The Nutri-Score, a five-colour nutrition label, is derived from the Nutrient Profiling System of the British Food Standards Agency (modified version) (FSAm-NPS). How the consumption of foods with high/low FSAm-NPS relates to cancer risk has been studied in national/regional cohorts but has not been characterized in diverse European populations. This prospective analysis included 471,495 adults from the European Prospective Investigation into Cancer and Nutrition (EPIC, 1992-2014, median follow-up: 15.3 y), among whom there were 49,794 incident cancer cases (main locations: breast, n = 12,063; prostate, n = 6,745; colon-rectum, n = 5,806). Usual food intakes were assessed with standardized country-specific diet assessment methods. The FSAm-NPS was calculated for each food/beverage using their 100-g content in energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits/vegetables/legumes/nuts. The FSAm-NPS scores of all food items usually consumed by a participant were averaged to obtain the individual FSAm-NPS Dietary Index (DI) scores. Multi-adjusted Cox proportional hazards models were computed. A higher FSAm-NPS DI score, reflecting a lower nutritional quality of the food consumed, was associated with a higher risk of total cancer (HRQ5 versus Q1 = 1.07; 95% CI 1.03-1.10, P-trend In this large multinational European cohort, the consumption of food products with a higher FSAm-NPS score (lower nutritional quality) was associated with a higher risk of cancer. This supports the relevance of the FSAm-NPS as underlying nutrient profiling system for front-of-pack nutrition labels, as well as for other public health nutritional measures.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/AdultCohort StudiesEuropeFemaleFood LabelingFood PreferencesHumansMaleMiddle AgedNeoplasmsNutrition PolicyNutritive ValueProspective StudiesRisk Factorsresearch article30226842open access10.1371/journal.pmed.10026511549-1676PMC6143197https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1002651&type=printablehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6143197/pdf