Joint association of food nutritional profile by Nutri-Score front-of-pack label and ultra-processed food intake with mortality: Moli-sani prospective cohort study.

A review of the literature analysing the relative effect of adjusting for diet quality/patterns on the reported associations between ultra-processed food intake and health related outcomes in more than 20 prospective cohort studies found that these adjustments did not explain the association between ultra-processed food intake and health related outcomes, with estimates remaining highly significant. 37 On the contrary, none of the large cohort studies evaluating the health impact of the FSAm-NPS dietary index considered the degree of food processing as a potential covariate, 18 38 thereby introducing potential sources of bias in these studies.

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