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Cross-sectional comparisons of dietary indexes underlying nutrition labels: nutri-score, Canadian ‘high in’ labels and Diabetes Canada Clinical Practices (DCCP)

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Abstract

Purpose

To assess the cross-sectional association between dietary indexes (DI) that underlie, respectively, the Nutri-score (NS), the proposed Canadian ‘High In’ Symbol (CHIL) and the Diabetes Canada Clinical Practice Guidelines (DCCP) with food consumption, nutrient intakes and metabolic markers.

Methods

1836 adults (18–74 years) participating in the representative ESTEBAN study, conducted in mainland France in 2014–2016, were included in the analysis. Food consumption was assessed with three repeated 24 h dietary recalls. Anthropometric measurements and biomarkers of metabolic risk (cholesterol—total, LDL (Low Density Lipoprotein), HDL (High Density Lipoprotein)—triglycerides, glucose) were obtained through a clinical examination and fasting blood draw. The DI were assessed for their association with food consumption, dietary intakes and metabolic biomarkers as quintiles and continuous variables using multi-adjusted linear regression. Heathier diets were assigned to lower scores.

Results

Correlations between scores ranged from + 0.62 between CHIL-DI and NS-DI to + 0.75 between NS-DI and DCCP-DI. All DIs discriminated individuals according to the nutritional quality of their diets through food consumption and nutrient intakes (healthier diets were associated with lower intakes of energy, added sugars and saturated fat; and with higher intakes of fiber, vitamins and minerals). NS-DI was associated with blood glucose (adjusted mean in Q1 = 5 vs. Q5 = 5.46 mmol/dl, ptrend = 0.001) and DCCP-DI was associated with BMI (Q1 = 24.8 kg/m2 vs. Q5 = 25.8 kg/m2, ptrend = 0.025), while CHIL showed no significant association with any anthropometric measures or biomarkers.

Conclusions

This study provides elements supporting the validity of the nutrient profiling systems underlying front-of-package nutrition labellings (FOPLs) to characterize the healthiness of diets.

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Acknowledgements

The authors gratefully acknowledge the dieticians who collected the data, the participants to the study. and “Santé Publique France”, as the main promoter and supporter, for access to the Esteban database and support documentation.

Funding

This investigation within the ESTEBAN cross-sectional study was funded by the Sanofi-Pasteur-University of Toronto-Université Paris-Descartes International Collaborative Research Pilot and Feasibility Program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Valérie Deschamps and Chantal Julia are co-last authors and have contributed equally to this work.

Authors and Affiliations

  1. Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 93017, Bobigny, France

    Laura Paper, Emmanuelle Kesse-Guyot, Mathilde Touvier, Serge Hercberg, Pilar Galan & Chantal Julia

  2. Nutritional Epidemiology Surveillance Team (ESEN), Santé Publique France, The French Public Health Agency, Bobigny, France

    Laura Paper, Benoît Salanave, Charlotte Verdot & Valérie Deschamps

  3. Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Mavra Ahmed, Jennifer J. Lee & Mary R. L’Abbé

  4. Joannah & Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, Canada

    Mavra Ahmed

  5. Public Health Department, Avicenne Hospital, AP-HP, Bobigny, France

    Serge Hercberg & Chantal Julia

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  1. Laura Paper
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Correspondence to Laura Paper.

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Paper, L., Ahmed, M., Lee, J.J. et al. Cross-sectional comparisons of dietary indexes underlying nutrition labels: nutri-score, Canadian ‘high in’ labels and Diabetes Canada Clinical Practices (DCCP). Eur J Nutr 62, 261–274 (2023). https://doi.org/10.1007/s00394-022-02978-w

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