Abstract
Background/objectives:
For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes.
Subjects/methods:
Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50−64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models.
Results:
In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5−6 points (highest scores) had significantly lower MI risk (men: HR=0.77, 95% CI=0.62, 0.97; women: HR=0.55, 95% CI=0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR=0.95, 95% CI=0.92, 0.99) and women (HR=0.93, 95% CI=0.88, 0.98).
Conclusions:
A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health.
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
Sustainability of K-Food: focused on the change in the health values of K-Food
Journal of Ethnic Foods Open Access 21 July 2023
-
Nordic dietary patterns and cardiometabolic outcomes: a systematic review and meta-analysis of prospective cohort studies and randomised controlled trials
Diabetologia Open Access 26 August 2022
-
Is body mass index (BMI) or body adiposity index (BAI) a better indicator to estimate body fat and selected cardiometabolic risk factors in adults with intellectual disabilities?
BMC Cardiovascular Disorders Open Access 02 March 2021
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
References
World Health Organization. Fact sheet no. 317: Cardiovascular diseases (CVDs) 2015: http://www.who.int/mediacentre/factsheets/fs317/en/# (accessed 5 November 2015).
Sofi F, Abbate R, Gensini GF, Casini A . Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr 2010; 92: 1189–1196.
Bere E, Brug J . Towards health-promoting and environmentally friendly regional diets - a Nordic example. Public Health Nutr 2009; 12: 91–96.
Olsen A, Egeberg R, Halkjær J, Christensen J, Overvad K, Tjønneland A . Healthy aspects of the Nordic diet are related to lower total mortality. J Nutr 2011; 141: 639–644.
Kyrø C, Skeie G, Loft S, Overvad K, Christensen J, Tjønneland A et al. Adherence to a healthy Nordic food index is associated with a lower incidence of colorectal cancer in women: the Diet, Cancer and Health cohort study. Br J Nutr 2013; 109: 920–927.
Kanerva N, Kaartinen NE, Rissanen H, Knekt P, Eriksson JG, Sääksjärvi K et al. Associations of the Baltic Sea diet with cardiometabolic risk factors—a meta-analysis of three Finnish studies. Br J Nutr 2014; 112: 616–626.
Adamsson V, Reumark A, Fredriksson I-B, Hammarström E, Vessby B, Johansson G et al. Effects of a healthy Nordic diet on cardiovascular risk factors in hypercholesterolaemic subjects: a randomized controlled trial (NORDIET). J Intern Med 2011; 269: 150–159.
Brader L, Uusitupa M, Dragsted LO, Hermansen K . Effects of an isocaloric healthy Nordic diet on ambulatory blood pressure in metabolic syndrome: a randomized SYSDIET sub-study. Eur J Clin Nutr 2014; 68: 57–63.
Kanerva N, Kaartinen NE, Schwab U, Lahti-Koski M, Männistö S . Adherence to the Baltic Sea diet consumed in the Nordic countries is associated with lower abdominal obesity. Br J Nutr 2013; 109: 520–528.
Uusitupa M, Hermansen K, Savolainen MJ, Schwab U, Kolehmainen M, Brader L et al. Effects of an isocaloric healthy Nordic diet on insulin sensitivity, lipid profile and inflammation markers in metabolic syndrome — a randomized study (SYSDIET). J Intern Med 2013; 274: 52–66.
Poulsen SK, Due A, Jordy AB, Kiens B, Stark KD, Stender S et al. Health effect of the New Nordic Diet in adults with increased waist circumference: a 6-mo randomized controlled trial. Am J Clin Nutr 2014; 99: 35–45.
Roswall N, Sandin S, Scragg R, Löf M, Skeie G, Olsen A et al. No association between adherence to the healthy Nordic food index and cardiovascular disease amongst Swedish women: a cohort study. J Intern Med 2015; 278: 531–541.
Slimani N, Fahey M, Welch AA, Wirfält E, Stripp C, Bergström E et al. Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project. Public Health Nutr 2002; 5: 1311–1328.
Tjønneland A, Olsen A, Boll K, Stripp C, Christensen J, Engholm G et al. Study design, exposure variables, and socioeconomic determinants of participation in Diet, Cancer and Health: a population-based prospective cohort study of 57053 men and women in Denmark. Scand J Public Health 2007; 35: 432–441.
Tjønneland A, Overvad K, Haraldsdóttir J, Bang S, Ewertz M, Jensen OM . Validation of a semiquantitative food frequency questionnaire developed in Denmark. Int J Epidemiol 1991; 20: 906–912.
Lauritzen J, FoodCalc. Unknown 2009: http://www.ibt.ku.dk/jesper/foodcalc/default.htm (accessed 25 January 2015).
Roswall N, Olsen A, Boll K, Christensen J, Halkjær J, Sørensen TI et al. Consumption of predefined ‘Nordic’ dietary items in ten European countries – an investigation in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Public Health Nutr 2014; 17: 2650–2659.
Trichopoulou A, Costacou T, Bamia C, Trichopoulos D . Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003; 348: 2599–2608.
Joensen AM, Jensen MK, Overvad K, Dethlefsen C, Schmidt E, Rasmussen L et al. Predictive values of acute coronary syndrome discharge diagnoses differed in the Danish National Patient Registry. J Clin Epidemiol 2009; 62: 188–194.
Hvidtfeldt UA, Tolstrup JS, Jakobsen MU, Heitmann BL, Grønbaek M, O’Reilly E et al. Alcohol intake and risk of coronary heart disease in younger, middle-aged, and older adults. Circulation 2010; 121: 1589–1597.
Hu FB, Willett WC . Optimal diets for prevention of coronary heart disease. JAMA 2002; 288: 2569–2578.
Harris KA, Kris-Etherton PM . Effects of whole grains on coronary heart disease risk. Curr Atheroscler Rep 2010; 12: 368–376.
Hansen L, Dragsted LO, Olsen A, Christensen J, Tjønneland A, Schmidt EB et al. Fruit and vegetable intake and risk of acute coronary syndrome. Br J Nutr 2010; 104: 248–255.
Voutilainen S, Nurmi T, Mursu J, Rissanen TH . Carotenoids and cardiovascular health. Am J Clin Nutr 2006; 83: 1265–1271.
Acknowledgements
The study was funded by The Danish Cancer Society Research Centre and NordForsk (Centre of Excellence Programme HELGA). None of them has had any impact on study design, data collection, analysis, or interpretation of the data.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Gunge, V., Andersen, I., Kyrø, C. et al. Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes: the diet, cancer and health cohort study. Eur J Clin Nutr 71, 652–658 (2017). https://doi.org/10.1038/ejcn.2017.1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ejcn.2017.1
This article is cited by
-
Sustainability of K-Food: focused on the change in the health values of K-Food
Journal of Ethnic Foods (2023)
-
Adherence to a modified nordic diet and the risk of cardiovascular events in a non-nordic population: a prospective cohort study
European Journal of Clinical Nutrition (2023)
-
Association of the Healthy Nordic Food Index with risk of bladder cancer: a case–control study
European Journal of Clinical Nutrition (2022)
-
Adherence to Nordic dietary patterns and risk of first-trimester spontaneous abortion
European Journal of Nutrition (2022)
-
Nordic dietary patterns and cardiometabolic outcomes: a systematic review and meta-analysis of prospective cohort studies and randomised controlled trials
Diabetologia (2022)