The updated nutrient profile underlying the Nutri-Score label and adult weight gain: A cohort study

Abstract Introduction Nutrient profiling systems are key tools in the development of nutrition-related policies. Their prospective associations with health outcomes are a crucial step in assessing their validity as public health measures. In 2023, the nutrient profiling system underlying the Nutri-Score -a nutrition front-of-pack label used in the European Union- was updated. The present study aims to investigate the updated nutrient profile’s association with weight gain, overweight and obesity. Methods The dietary and anthropometric data of 75,775 participants of the Nutrinet-Santé cohort study was retrieved for this study. Standardized dietary indices derived from both nutrient profiling systems (the 2015 NS-NPM DI (initial profile) and 2023 NS-NPM DI (updated profile)) were computed based on at least 3 24-hour dietary records upon the first two years of inclusion in the cohort. The associations between these indices and the risk of developing overweight and obesity were assessed using Cox proportional hazard models and weight gain using mixed models. Results Participants with a higher 2023 NS-NPM DI (i.e. a poorer nutritional quality of diet) were more likely to gain BMI over time (T3 vs. T1: +0.23% points of BMI/year, p < 0.0001), had a higher risk of developing overweight (HR T3 vs. T1: 1.33 [95% CI: 1.24-1.43]) and obesity (HR T3 vs. T1: 1.29 [95% CI: 1.14-1.45]). Overall, the 2015 NS-NPM DI displayed similar associations and effect sizes with the outcomes and the predictive ability of the two indices on overweight and obesity risk was not significantly different (p = 0.32 for overweight risk, p = 0.09 for obesity risk). Conclusions These results constitute a step in the validation of the recently updated nutrient profiling system and help support its use in public policies for non-communicable diseases prevention. Key messages • The 2023 updated nutrient profiling system underlying the Nutri-Score was associated with weight gain and obesity, two important risk factors in the development of non-communicable diseases. • The 2015 and 2023 NS-NPM DI showed similar prospective associations with overweight and obesity risk.