Adherence to the Nordic Nutrition Recommendations as a measure of a healthy diet and upper respiratory tract infection

Abstract

Objective: The Nordic countries have published joint dietary recommendations, the Nordic Nutrition Recommendations (NNR), since 1980. We evaluated adherence to the NNR as a measure of a healthy diet and its potential association with self-reported upper respiratory tract infection (URTI). Design: A prospective, population-based study with a follow-up period of 4 months. Dietary intake was assessed using a semi-quantitative FFQ with ninetysix items, along with other lifestyle factors, at baseline. URTI was assessed every three weeks. A Poisson regression model was used to control for age, sex and other confounding factors. Setting: A middle-sized county in northern Sweden. Subjects: Swedish men and women (n 1509) aged 20-60 years. Results: The NNR include recommendations on macronutrient proportions, physical activity and intake of micronutrients, sodium, fibre and alcohol. We found that overall adherence to the NNR was moderately good. In addition, we found that high adherence to the NNR (.5?5 adherence points) was not associated with a lower risk of URTI (incidence rate ratio (IRR) 0?89, 95 % CI 0?73, 1?08) compared with low adherence (,4?5 adherence points). When investigating individual components of the NNR, only high physical activity was associated with lower URTI risk (IRR 5 0?82, 95 % CI 0?69, 0?97) whereas none of the dietary components were associated with risk of URTI. Conclusions: Overall adherence to the NNR was moderately good. Overall adherence to the NNR was not associated with URTI risk in our study. However, when investigating individual components of the NNR, we found that high physical activity was associated with lower URTI risk.

Energy and nutrient intakes in relation to National Nutrition Recommendations in a Norwegian population-based sample: the Tromsø Study 2015–16

“…Almost all participants in our study had trans fat intakes below 1 E%. A total of 27% of our population was not in compliance with the recommended intake of polyunsaturated fat, as has also been found in several other studies from the Nordic countries (29)(30)(31). A substantial proportion of our population had alcohol intakes that were higher than the maximum recommended level.…”

Lifetime body size and prostate cancer risk in a population-based case–control study in Sweden

“…Considering the aim of the NNR, it is pertinent to evaluate their potential to reduce the risk of common chronic diseases in the Nordic population. To our knowledge, only one study has previously evaluated the NNR 2004 in relation to health outcomes, showing no association with upper respiratory tract infections (54) . Since prostate cancer is the most common cancer among Nordic men, comprising about 36 % of all male cancer in Sweden (7) , it is highly relevant to investigate the association between adherence to recommendations for the Nordic population and prostate cancer risk.…”

“…However, we used a proportional scoring system to assess the relative adherence to each nutrient recommendation, as it is less likely to be subject to misclassification than a strictly categorical score. Several NNR scoring models have been tested in a population of Swedish men and women, and no major differences were seen (54) .…”

The Nordic Nutrition Recommendations and prostate cancer risk in the Cancer of the Prostate in Sweden (CAPS) study

“…We also tested different ways of grouping the macro-and micronutrients within the total score, and seeing no major differences in the results, we decided to hold fat, protein and carbohydrates separate, as well as vitamins and minerals, each giving equal weight to the total score. Furthermore, different NNR scoring models have previously been tested by Fondell et al (4) , showing no substantial differences. In summary, we believe that any exposure misclassification due to the scoring method may have influenced our results only marginally.…”