Deschasaux Mélanie, Julia Chantal, Kesse-Guyot Emmanuelle, Lécuyer Lucie, Adriouch Solia, Méjean Caroline, Ducrot Pauline, Péneau Sandrine, Latino-Martel Paule, Fezeu Léopold K, Fassier Philippine, Hercberg Serge, Touvier Mathilde
Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France.
French network for Nutrition And Cancer Research (NACRe network), www.inra.fr/nacre.
BMJ Open. 2017 Jun 8;7(6):e013718. doi: 10.1136/bmjopen-2016-013718.
French authorities are considering the implementation of a simplified nutrition labelling system on food products to help consumers make healthier food choices. One of the most documented candidates (Five-Colour Nutrition Label/Nutri-score) is based on the British Food Standards Agency Nutrient Profiling System (FSA-NPS), a score calculated for each food/beverage using the 100 g amount of energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits and vegetables. To assess its potential public health relevance, studies were conducted on the association between the nutritional quality of the diet, measured at the individual level by an energy-weighted mean of all FSA-NPS scores of foods usually consumed (FSA-NPS dietary index (FSA-NPS DI)), and the risk of chronic diseases. The present study aimed at investigating the relationship between the FSA-NPS DI and breast cancer risk.
Prospective study.
Population based, NutriNet-Santé cohort, France.
46 864 women aged ≥35 years who completed ≥3 24-hour dietary records during their first 2 year of follow-up.
Associations between FSA-NPS DI and breast cancer risk (555 incident breast cancers diagnosed between 2009 and 2015) were characterised by multivariable-adjusted Cox proportional hazard models.
A higher FSA-NPS DI (lower nutritional quality of the diet) was associated with an increased breast cancer risk (HR=1.06 (1.02-1.11), p=0.005; HR=1.52 (1.11-2.08), p trend=0.002). Similar trends were observed in premenopausal and postmenopausal women (HR=1.09 (1.01-1.18) and 1.05 (1.00-1.11), respectively).This study was based on an observational cohort using self-reported dietary data, thus residual confounding cannot be entirely ruled out. Finally, this holistic approach does not allow investigating which factors in the diet most specifically influence breast cancer risk.
These results suggested that unhealthy food choices, as characterised by the FSA-NPS, may be associated with an increase in breast cancer risk, supporting the potential public health relevance of using this profiling system in the framework of public health nutritional measures.
法国当局正在考虑在食品上实施简化的营养标签系统，以帮助消费者做出更健康的食品选择。记录最完善的候选方案之一（五色营养标签/营养评分）基于英国食品标准局营养成分分析系统（FSA-NPS），该评分是根据每100克食品/饮料中的能量、糖、饱和脂肪酸、钠、纤维、蛋白质以及水果和蔬菜的含量计算得出的。为评估其潜在的公共卫生相关性，开展了多项研究，探讨通过通常食用的所有食品的FSA-NPS评分的能量加权平均值在个体水平上衡量的饮食营养质量与慢性病风险之间的关联。本研究旨在调查FSA-NPS饮食指数与乳腺癌风险之间的关系。
前瞻性研究。
基于法国NutriNet-Santé队列的人群研究。
46864名年龄≥35岁的女性，她们在随访的前两年中完成了≥3次24小时饮食记录。
采用多变量调整的Cox比例风险模型来描述FSA-NPS饮食指数与乳腺癌风险（2009年至2015年期间诊断出555例乳腺癌病例）之间的关联。
较高的FSA-NPS饮食指数（较低的饮食营养质量）与乳腺癌风险增加相关（风险比=1.06（1.02 - 1.11），p = 0.005；风险比=1.52（1.11 - 2.08），p趋势=0.002）。在绝经前和绝经后女性中观察到类似趋势（分别为风险比=1.09（1.01 - 1.18）和1.05（1.00 - 1.11））。本研究基于使用自我报告饮食数据的观察性队列，因此无法完全排除残余混杂因素。最后，这种整体方法无法探究饮食中的哪些因素最具体地影响乳腺癌风险。
这些结果表明，以FSA-NPS为特征的不健康食品选择可能与乳腺癌风险增加有关，这支持了在公共卫生营养措施框架内使用该成分分析系统的潜在公共卫生相关性。
