Linking Nutri-Score dietary profiles to metabolic biomarkers in a cross-sectional study within the multinational EPIC cohort.

The front-of-pack label Nutri-Score has been implemented in several European countries since 2017 to guide consumers towards foods of higher nutritional value. A few studies reported associations between Nutri-Score dietary profiles reflecting a lower nutritional quality, however not using the 2023-updated version of the algorithm, and profiles of biomarkers consistent with increased metabolic risk. Our study therefore investigated cross-sectional associations between 2023-Nutri-Score dietary profiles and 13 biomarkers of metabolic risk (inflammation, insulin resistance, dyslipidemia, oxidative stress and intestinal permeability) in 1,103 participants from the multinational EPIC cohort study with available biomarker data. Food intakes were assessed through country-specific questionnaires (mostly food frequency questionnaires) and the 2023-Nutri-Score nutrient profile was calculated for each food based on its 100 g content of energy, sugars, saturated fats, salt, fibre, protein, fruit, vegetables and pulses. Multivariable ANCOVA models were computed. Associations were observed between 2023-Nutri-Score dietary profiles reflecting a lower nutritional quality and higher concentrations of C-peptide (N = 788, β (SE) for Q5 vs. Q1 = 0.13 (0.06), P-trend = 0.047) and C-reactive protein (N = 899, β (SE) = 0.20 (0.13), P-trend = 0.034). Thus, our results suggested cross-sectional associations between the consumption of foods with less favourable 2023-Nutri-Score rating and biomarkers of chronic inflammation (C-reactive protein) and insulin resistance (C-peptide), providing support for the 2023-Nutri-Score algorithm to reflect the nutritional quality of food, within the context of chronic disease prevention.