Research articleThe Association Between a Nutritional Quality Index and Risk of Chronic Disease
Section snippets
Background
Nutrient profiling is an effort to rank or classify foods based on nutrient composition.1 Dozens of nutrient profiling schemes have been developed,2, 3 and the potential applications of these profiles include consumer education and dietary guidance, regulation of health claims, and evaluation of the nutritional quality of food products. A rapidly growing application for these profiles is front-of-package food product labeling. Front-of-package labeling has emerged recently from many sources,4
Study Population
The Nurses' Health Study was established in 1976, when 121,700 female registered nurses aged 30–55 years were enrolled.15 The Health Professionals Follow-up Study (HPFS) is a prospective cohort of 51,529 U.S. men, aged 40–75 years, who returned a mailed questionnaire about diet and medical history in 1986.16 In both cohorts, detailed information on lifestyle habits, medical history and newly diagnosed disease is updated biennially. Dietary data were collected with a 138- and 135-item food
Results
The median (10th–90th percentile) of the ONQI-f score was 32.2 (23.1, 42.4) in the women and 30.1 (21.4, 40.9) in the men. The baseline characteristics and mean values for the nutrients included in the ONQI algorithm are presented by quintiles of ONQI-f score in Table 2. As expected, the intake of nutrients in the numerator was higher, and nutrients in the denominator were lower, with greater ONQI-f scores. Women and men who consumed a diet with a higher average ONQI-f score were less likely to
Discussion
In these two prospective cohorts, consumption of foods with higher ratings based on the ONQI algorithm was associated with lower risk of chronic disease and total mortality over 20 years of follow-up. Higher ONQI-f scores were associated with a 9%–12% lower risk of chronic disease and a 10%–11% lower risk of all-cause mortality. These associations were driven by strong associations with risk of CVD and diabetes. The ONQI-f score was not significantly associated with risk of cancer. The ONQI
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