INSERM, Centre for Research in Epidemiology and Population Health, U1018, Team 9, Institut Gustave Roussy, Université Paris Saclay, Paris, France.
Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique-Hôpitaux de Paris and Université Paris-Saclay, Paris, France.
Aliment Pharmacol Ther. 2024 Feb;59(4):558-568. doi: 10.1111/apt.17835. Epub 2023 Dec 15.
Nutri-score is now widely available in food packages in Europe.
To study the overall nutritional quality of the diet in relation to risks of Crohn's disease (CD) and ulcerative colitis (UC), in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort METHODS: We collected dietary data at baseline from validated food frequency questionnaires. We used a dietary index based on the UK Food Standards Agency modified nutrient profiling system (FSAm-NPS-DI) underlying the Nutri-Score label, to measure the nutritional quality of the diet. We estimated the association between FSAm-NPS-DI score, and CD and UC risks using Cox models stratified by centre, sex and age; and adjusted for smoking status, BMI, physical activity, energy intake, educational level and alcohol intake.
We included 394,255 participants (68.1% women; mean age at recruitment 52.1 years). After a mean follow-up of 13.6 years, there were 184 incident cases of CD and 459 incident cases of UC. Risk of CD was higher in those with a lower nutritional quality, that is higher FSAm-NPS-DI Score (fourth vs. first quartile: aHR: 2.04, 95% CI: 1.24-3.36; p-trend: <0.01). Among items of the FSAm-NPS-DI Score, low intakes of dietary fibre and fruits/vegetables/legumes/nuts were associated with higher risk of CD. Nutritional quality was not associated with risk of UC (fourth vs. first quartile of the FSAm-NPS-DI Score: aHR: 0.91, 95% CI: 0.69-1.21; p-trend: 0.76).
A diet with low nutritional quality as measured by the FSAm-NPS-DI Score is associated with a higher risk of CD but not UC.
Nutri-score 现已在欧洲的食品包装上广泛使用。
在欧洲癌症与营养前瞻性调查（EPIC）队列中，研究饮食的整体营养质量与克罗恩病（CD）和溃疡性结肠炎（UC）风险之间的关系。
我们从经过验证的食物频率问卷中收集了基线时的饮食数据。我们使用基于英国食品标准局改良营养成分分类系统（FSAm-NPS-DI）的饮食指数来衡量饮食的营养质量，该系统是 Nutri-Score 标签的基础。我们使用 Cox 模型，根据中心、性别和年龄对 FSAm-NPS-DI 评分与 CD 和 UC 风险之间的关系进行分层估计，并根据吸烟状况、BMI、身体活动、能量摄入、教育水平和酒精摄入进行调整。
我们纳入了 394255 名参与者（68.1%为女性；招募时的平均年龄为 52.1 岁）。在平均 13.6 年的随访后，有 184 例 CD 新发病例和 459 例 UC 新发病例。营养质量较低（即 FSAm-NPS-DI 评分较高）的患者发生 CD 的风险更高，例如第四四分位与第一四分位相比（aHR：2.04，95%CI：1.24-3.36；p 趋势：<0.01）。在 FSAm-NPS-DI 评分的各项指标中，膳食纤维和水果/蔬菜/豆类/坚果摄入量低与 CD 风险增加有关。营养质量与 UC 风险无关（第四四分位与第一四分位的 FSAm-NPS-DI 评分：aHR：0.91，95%CI：0.69-1.21；p 趋势：0.76）。
用 FSAm-NPS-DI 评分衡量的低营养质量饮食与 CD 风险增加有关，但与 UC 无关。
