Adherence to the Nordic Diet and the Risk of Cardiovascular Events in a Non-Nordic Population: A Prospective Cohort Study

Abstract

Background Although both observational and interventional studies have demonstrated the beneficial effects of the Nordic diet on cardiovascular disease (CVD) risk factors, the association between adherence to this diet and CVD incidents is unknown. Therefore, in the present study, we aimed to investigate the association between adherence to the Nordic diet and the risk of CVD events in non-Nordic adults. Methods In the present cohort study, 2918 participants from the third wave of the Tehran Lipid and Glucose Study (TLGS) were included. All the participants who were free of CVD at baseline were followed up for 10.6 years. The Nordic diet score was assessed by applying a validated food frequency questionnaire (FFQ). Patients’ medical records were used to evaluate cardiovascular events, including coronary heart disease (CHD), stroke, and CVD-related mortality. Results During a median follow-up of 10.6 years, 203 subjects experienced cardiovascular events. Participants in the third and fourth quartiles of the Nordic diet had a 46% (HR: 0.64; 95% CI: 0.44, 0.93) and 58% (HR: 0.48; 95% CI: 0.28 to 0.62) lower risk of CVD than those in the lowest quartile. Among components of the Nordic diet, each score increase in cereals was associated with a 24% (HR: 0.76; 95% CI: 0.67 to 0.87), low-fat milk with a 23% (HR: 0.77; 95% CI: 0.68 to 0.87), and fish with a 22% (HR: 0.78; 95% CI: 0.69 to 0.89) lower risk of CVD. Conclusion We found high adherence to the Nordic diet might be beneficial in the prevention of cardiovascular events in the non-Nordic community. The main components of the Nordic diet that indicated an inverse relationship with CVD were cereals, fish, and low-fat milk.