Diet quality and risk of using medication for hypertension up to 11 years after delivery: Testing the predictive validity of a proposed revision of the Nutri-Score and the current Nutri-Score in the NewTools project

Abstract The aim of this study was to investigate the predictive validity of a proposed revision of the Nutri-Score and the current Nutri-Score by investigating associations between the diet quality scores measured in mid-pregnancy and the risk of dispended prescription of medications for hypertension up to 11 years following delivery, and blood pressure mid-pregnancy. The study population (N=70,730) were participants in the Norwegian Mother, Father and Child Cohort Study. Food intake was assessed mid-pregnancy using a food frequency questionnaire. Nutritional scores for each food item were calculated based on content of energy, sugars, saturated fat, salt, fibre, protein, fruit, vegetables, and legumes. Diet quality scores were derived using energy-weighted means of nutritional scores. Anti-hypertensive medications were registered in the national prescription database. We estimated hazard ratios (HR) with 95% confidence intervals (95% CI) using Cox regression models. During a mean follow-up of 6 years, 4,736 (6.7%) women got dispended prescription of medications for hypertension. There was a non-linear association between diet quality and hypertension medication. Compared with the median diet quality score, poorer diet quality (90 th percentile of the score) was associated with higher risk of medications for hypertension (HR=1.08, 95% CI 1.02-1.14) and cross-sectional high diastolic blood pressure (odds ratio=1.18, 95% CI 1.03-1.32). Both diet quality scores yielded similar results overall. Poorer diet quality during pregnancy, assessed with a proposed version, and the current Nutri-Score, were associated with a higher risk of medications for hypertension, indicating its usefulness as a valuable tool for guiding consumers and improving public health.