ArticleBMJ (Clinical research ed.)2022
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.
Article in BMJ (Clinical research ed.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers.
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Who cites it
51 citing papers in PubMed.
- "Warning: ultra-processed": an online experiment examining the impact of ultra-processed warning labels on consumers' product perceptions and behavioral intentions.The international journal of behavioral nutrition and physical activity · 2024Trial
- Review
- A Nutrient Ratio-Based, Web-Enabled Food Quality Score Is Associated With Weight and Blood Pressure Compared With Leading Nutrient Profiling Systems.Current developments in nutrition · 2026Article
- Ultraprocessed Food Versus Diet Quality in Relation to Cardiometabolic Health and All-Cause Mortality: NHANES 1999-2018.American journal of public health · 2026Article
- Article
- Understandings of ultra-processed foods among adults with responsibility for household food activities in the United Kingdom: a qualitative study.BMC global and public health · 2026Article
- Associations of the updated nutrient profiling system underlying the Nutri-Score label with weight gain, overweight and obesity risk in the French NutriNet-Santé cohort.European journal of nutrition · 2026Article
- Mortality risk in relation to diet quality assessed by the 2023 nutri-score nutrient profiling model: a prospective analysis.European journal of nutrition · 2026Article
- Validation of the food compass score through 24 h recalls and measurement of erythrocyte fatty acids in a mediterranean population.European journal of nutrition · 2026Article
- Cardiovascular disease risk and the balance between animal-based and plant-based foods, nutritional quality, and food processing level in the French NutriNet-Santé cohort: a longitudinal observational study.The Lancet regional health. Europe · 2025Article
- Article
- Consumption of ultra-processed foods and risk of all-cause and cause-specific mortality: the Singapore Chinese health study.Nutrition journal · 2025Article
- Ultra-processed foods, plant and animal sources, and all-cause, cardiovascular, and cancer mortality in older adults in the United States: results from the Cardiovascular Health Study.The American journal of clinical nutrition · 2025Article
- Toward Multidimensional Front-of-Pack Labels: Integrating Nutritional, Environmental, and Processing Information.Nutrients · 2025Review
- Updated nutrient profiling system underlying nutri-score (Uns-Nps) and colorectal cancer risk.European journal of clinical nutrition · 2025Article
- Ultra-processed food consumption and overweight in children, adolescents and young adults: Long-term data from the Kiel Obesity Prevention Study (KOPS).Pediatric obesity · 2025Article
- Fifteen Years of NOVA Food-Processing Classification: "Friend or Foe" Among Sustainable Diet Indicators? A Scoping Review.Nutrition reviews · 2025Article
- Modifying the Health Star Rating nutrient profiling algorithm to account for ultra-processing.Nutrition & dietetics : the journal of the Dietitians Association of Australia · 2025Article
- Editorial: The Impact of Ultra-Processed Food Consumption on Health in Low- and Middle-Income Countries.International journal of public health · 2025Article
- Associations between ultra-processed food consumption and duration of exercise with psychological symptoms in Chinese adolescents: a nationwide cross-sectional survey.Frontiers in nutrition · 2025Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo 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.
designProspective cohort study.
settingMoli-sani Study, Italy 2005-10.
participants22 895 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.
resultsA total of 2205 deaths occurred during 272 960 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.
conclusionsAdults 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.
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