Dietary index based on the Food Standards Agency nutrient profiling system and risk of Crohn's disease and ulcerative colitis

Antoine Meyer, Catherine Dong, Simon S. M. Chan, Mathilde Touvier, Chantal Julia, Inge Huybrechts, Geneviève Nicolas, Bas Oldenburg, Alicia K. Heath, Tammy Y. N. Tong, Timothy J. Key, Anne Tjønneland, Cecilie Kyrø, Rudolf Kaaks, Verena A. Katzke, Manuela M. Bergman, Domenico Palli, Giovanna Masala, Rosario Tumino, Carlotta SacerdoteSandra M. Colorado-Yohar, Maria-Jose Sánchez, Marcela Guevara, Olof Grip, Johanna Holmgren, Amanda Cross, Pontus Karling, Johan Hultdin, Neil Murphy, Mélanie Deschasaux-Tanguy, Serge Hercberg, Pilar Galan, Yahya Mahamat-Saleh, Aurélien Amiot, Marc J. Gunter, Marie Christine Boutron-Ruault, Franck Carbonnel

Research output: Contribution to journalArticlepeer-review

3 Downloads (Pure)


Background: Nutri-score is now widely available in food packages in Europe. Aim: To study the overall nutritional quality of the diet in relation to risks of Crohn's disease (CD) and ulcerative colitis (UC), in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: We collected dietary data at baseline from validated food frequency questionnaires. We used a dietary index based on the UK Food Standards Agency modified nutrient profiling system (FSAm-NPS-DI) underlying the Nutri-Score label, to measure the nutritional quality of the diet. We estimated the association between FSAm-NPS-DI score, and CD and UC risks using Cox models stratified by centre, sex and age; and adjusted for smoking status, BMI, physical activity, energy intake, educational level and alcohol intake. Results: We included 394,255 participants (68.1% women; mean age at recruitment 52.1 years). After a mean follow-up of 13.6 years, there were 184 incident cases of CD and 459 incident cases of UC. Risk of CD was higher in those with a lower nutritional quality, that is higher FSAm-NPS-DI Score (fourth vs. first quartile: aHR: 2.04, 95% CI: 1.24–3.36; p-trend: <0.01). Among items of the FSAm-NPS-DI Score, low intakes of dietary fibre and fruits/vegetables/legumes/nuts were associated with higher risk of CD. Nutritional quality was not associated with risk of UC (fourth vs. first quartile of the FSAm-NPS-DI Score: aHR: 0.91, 95% CI: 0.69–1.21; p-trend: 0.76). Conclusions: A diet with low nutritional quality as measured by the FSAm-NPS-DI Score is associated with a higher risk of CD but not UC.

Original languageEnglish
Pages (from-to)558-568
Number of pages11
JournalAlimentary Pharmacology and Therapeutics
Issue number4
Early online date15 Dec 2023
Publication statusPublished - Feb 2024


  • dietary
  • EPIC
  • FSAm-NPS DI score
  • inflammatory bowel disease
  • nutri-score

Cite this