Abstract
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.
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Acknowledgements
The authors thank all EPIC participants and staff for their outstanding contribution to the study. We thank Corinne Casagrande and Bertrand Hemon for their technical assistance with the data. We acknowledge the contribution of Bas Bueno-de-Mesquita for the obtention of biomarker data. We acknowledge the use of data from EPIC-Aarhus (Denmark), EPIC-Ragusa (Italy), EPIC-Bilthoven (Netherlands), EPIC-Asturias (Spain), EPIC-Umea (Sweden), EPIC-Cambridge, EPIC-Oxford (UK). This work was performed within the framework of the Nutrition And Cancer Research Network (NACRe, https://www.reseaunacre.eu/).
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Funding
This work was funded by a research grant from the French National Cancer Institute (INCa)-Cancéropôle Ile-de-France (Convention n° 2017-1-PL SHS-01-INSERM ADR 5 − 1, PI: M. Touvier, Co-PI M. Deschasaux). The coordination of EPIC is financially supported by the International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by the Danish Cancer Society (Denmark), Ligue Contre le Cancer (France), Institut Gustave Roussy (France), Mutuelle Générale de l’Education Nationale (France), Institut National de la Santé et de la Recherche Médicale (INSERM, France), German Cancer Aid (Germany), German Cancer Research Center (DKFZ, Germany), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE, Germany), Federal Ministry of Education and Research (BMBF, Germany), Associazione Italiana per la Ricerca sul Cancro (AIRC, Italy), Compagnia di SanPaolo (Italy), National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS, Netherlands), Netherlands Cancer Registry (NKR, Netherlands), LK Research Funds (Netherlands), Dutch Prevention Funds (Netherlands), Dutch ZON (Zorg Onderzoek Nederland, Netherlands), World Cancer Research Fund (WCRF, Netherlands), Statistics Netherlands (Netherlands), Health Research Fund (FIS, Spain), Instituto de Salud Carlos III (ISCIII, Spain), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra (Spain), Catalan Institute of Oncology (ICO, Spain), Swedish Cancer Society (Sweden), Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden), Cancer Research UK (UK), Medical Research Council (UK).
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Deschasaux-Tanguy, M., Meirhaeghe, A., Julia, C. et al. Linking Nutri-Score dietary profiles to metabolic biomarkers in a cross-sectional study within the multinational EPIC cohort. Sci Rep (2026). https://doi.org/10.1038/s41598-026-51357-6
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DOI: https://doi.org/10.1038/s41598-026-51357-6
