The updated 2023 Nutri-Score model demonstrated strong predictive power for mortality risk in 7,212 Spanish adults aged 55-80 with high cardiovascular risk. Those with the poorest diet quality scores faced 64% higher all-cause mortality and a striking 221% increased risk of cardiovascular death over six years of follow-up, with 425 total deaths recorded. This validates a significant refinement to one of Europe's most visible nutrition labeling systems. The updated algorithm appears more sensitive to mortality prediction than previous versions, particularly for cardiovascular outcomes. However, this validation occurs in a specific high-risk Mediterranean population already enrolled in a dietary intervention study, potentially limiting broader applicability. The lack of association with cancer mortality suggests the scoring system may be more attuned to metabolic and cardiovascular pathways than oncological risk factors. For public health policy, this represents confirmatory evidence that front-of-package nutrition labels can meaningfully stratify mortality risk. Yet the real-world impact depends on consumer behavior changes, which remain poorly studied. The 2023 updates to Nutri-Score appear scientifically sound, though implementation effectiveness across diverse European populations requires further investigation.