A healthy Nordic diet score and risk of incident CHD among men: the Kuopio Ischaemic Heart Disease Risk Factor Study

Abstract

Healthy Nordic diet has been beneficially associated with coronary heart disease (CHD) risk factors, but few studies have investigated risk of developing CHD. We investigated the associations of healthy Nordic diet with major CHD risk factors, carotid atherosclerosis, and incident CHD in middle-aged and older men from eastern Finland. A total of 1981 men aged 42-60 years and free of CHD at baseline in 1984-1989 were investigated. Diet was assessed with 4-d food recording and the healthy Nordic diet score was calculated based on the Baltic Sea Diet Score. Carotid atherosclerosis was assessed by ultrasonography of the common carotid artery intima-media thickness in 1053 men. Analysis of covariance and Cox proportional hazards regression analyses were used for analyses. Healthy Nordic diet score associated with lower serum C-reactive protein concentrations (multivariable-adjusted extreme-quartile difference 0.69 mg/L, 95% confidence interval 0.15-1.22 mg/L), but not with serum lipid concentrations, blood pressure, or carotid atherosclerosis. During the average follow-up of 21.6 years (SD 8.3 years), 407 men had a CHD event, of which 277 were fatal. The multivariable-adjusted hazard ratios (95% confidence interval) in the lowest vs. the highest quartile of the healthy Nordic diet score were 1.10 (0.85-1.45) for any CHD event (P-trend 0.429) and 1.38 (0.95-2.00) (P-trend 0.119) for fatal CHD event. We did not find evidence that adherence to a healthy Nordic diet would be associated with a lower risk of CHD or with carotid atherosclerosis or major CHD risk factors, except for an inverse association with serum C-reactive protein concentrations.

Healthy Aging and Dietary Patterns

“…The key messages underlying the NND guidelines are the following: (1) including more calories from plant-based foods and less from meat; (2) use of more foods coming from the lakes and sea (comprising seaweeds and shellfish); and (3) including more wild local foods from the countryside (plants, berries, mushrooms, and aromatic herbs) [142]. Although NND has been developed in recent times, the literature on this healthy dietary pattern has grown, showing significant associations between NND and several health outcomes including various NCDs (i.e., CVD, obesity, some types of cancer, neurodegenerative diseases) and mortality [59,141,[144][145][146][147][148][149][150][151][152][153][154][155][156][157][158][159], thus increasing overall life and health expectancies.…”

“…In particular, following the Nordic diet was associated with improvements in blood lipid profiles [146], lower blood pressure in patients with hypercholesterolemia [147], reduction in diastolic and mean blood pressure in persons with features of the cardiometabolic syndrome without changes in body weight [148], and reduction in blood pressure in persons with central obesity [149]. However, in a recent study conducted in 1981, men aged 42-60 years and free of coronary heart disease (CHD) at baseline in 1984-1989 reported no association of adherence to a healthy Nordic diet with a lower risk of CHD or with carotid atherosclerosis or major CHD risk factors, except for an inverse association with serum C-reactive protein concentrations [150].…”

Dietary Therapy in Prevention of Cardiovascular Disease (CVD)—Tradition or Modernity? A Review of the Latest Approaches to Nutrition in CVD

“…This diet limits the consumption of red meat and products, providing saturated fat while increasing the supply of Scandinavian fruit and vegetables (mainly berries), vegetable fats (rapeseed oil), and fish (salmon, mackerel, herring) [72,73]. Following a Nordic diet has been shown to support the cardiovascular system by lowering the inflammatory marker C-reactive protein (CRP) [74]. An effect of the Nordic diet on lowering blood pressure and blood cholesterol levels, including LDL fraction cholesterol, has also been observed [67,75].…”

The dynamics in food selection stemming from price awareness and perceived income adequacy: a cross-sectional study using 1-year loyalty card data

“…A plant-dominant, mixed diet has been the base of dietary guidelines for decades [ 1 , 2 ]. Examples of these kinds of healthy dietary patterns are the traditional Mediterranean diet [ 3 ] and the “Healthy Nordic diet” [ 4 ]. More recently, the focus on environmental sustainability has emphasized the importance of decreasing the consumption of animal proteins and a concomitant increase in the use of legumes and other sources of plant protein [ 5 ].…”