No association between adherence to the healthy Nordic food index and cardiovascular disease amongst Swedish women: a cohort study

Roswall, Nina; Sandin, Sven; Scragg, Robert; Löf, Marie; Skeie, Guri; Olsen, Anja; Adami, Hans Olov; Weiderpass, Elisabete

doi:10.1111/joim.12378

Cited by 37 publications

(47 citation statements)

References 43 publications

(58 reference statements)

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“…As discussed by the authors, failure to properly account for wholegrain intake could explain the lack of an association between whole-grain intake and cardiovascular disease and potentially also the lack of an association with the entire index. 10 Evidence from cohort studies suggest that a high intake of whole grains is associated with a lower risk of stroke, and our analyses of the individual Healthy Nordic Food Index items also indicated that oatmeal and rye bread are important components. 27 Adherence to a healthy Nordic diet may affect the risk of stroke through several mechanisms.…”

Section: Discussionmentioning

confidence: 55%

“…20 In contrast to our results, no association between adherence to the Healthy Nordic Food Index and risk of stroke was reposted in a cohort study among Swedish women. 10 To adapt the Healthy Nordic Food Index to the FFQ used in their cohort, the authors included whole-grain bread instead of rye bread. Further, whole-grain crisp bread, which is expected to be a major source of whole grains in the Swedish population, could not be separated from nonwhole-grain crisp bread.…”

Section: Discussionmentioning

confidence: 99%

“…9 A Swedish followup study also found no associations between adherence to a healthy Nordic food index and risk of cardiovascular disease, including risk of stroke. 10 This study only included women and did not investigate subtypes of stroke. However, total stroke includes ischemic and hemorrhagic subtypes with different etiology, pathogenesis, and prognosis.…”

mentioning

confidence: 99%

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Adherence to a Healthy Nordic Diet and Risk of Stroke

Hansen

Overvad

Kyrø

et al. 2017

Stroke

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Background and Purpose-Specific dietary patterns, including the Mediterranean diet, have been associated with stroke prevention. Our aim was to investigate whether adherence to a healthy Nordic diet, including fish, apples and pears, cabbages, root vegetables, rye bread, and oatmeal, was associated with risk of stroke. Methods-Incident cases of stroke among 55 338 men and women from the Danish Diet, Cancer and Health cohort were identified from the Danish National Patient Register and verified by review of records. Cases of ischemic stroke were further subclassified based on etiology according to the TOAST classification system (Trial of Org 10172 in Acute Stroke Treatment). Information on diet was collected at baseline (1993)(1994)(1995)(1996)(1997)) using a semiquantitative food-frequency questionnaire. Cox proportional hazards models were used to estimate hazards ratios of total stroke and subtypes of ischemic and hemorrhagic stroke. Results-During a median follow-up of 13.5 years, 2283 cases of incident stroke were verified, including 1879 ischemic strokes. Adherence to a healthy Nordic diet, as reflected by a higher Healthy Nordic Food Index score, was associated with a lower risk of stroke. The hazards ratio comparing an index score of 4 to 6 (high adherence) with an index score of 0 to 1 (low adherence) was 0.86 (95% confidence interval 0.76-0.98) for total stroke. Inverse associations were observed for ischemic stroke, including large-artery atherosclerosis. No trend was observed for hemorrhagic stroke; however, a statistically insignificant trend was observed for intracerebral hemorrhage. Conclusions-Our findings suggest that a healthy Nordic diet may be recommended for the prevention of stroke. Correspondence to Camilla Plambeck Hansen, PhD, Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark. E-mail cph@ph.au.dk © 2017 American Heart Association, Inc. Materials and Methods Study PopulationFrom December 1993 to May 1997, all men and women aged 50 to 64 years, born in Denmark, living in the greater areas of Aarhus or Copenhagen, and with no previous cancer diagnosis in the Danish Cancer Registry were invited to participate in the Diet, Cancer and Health study (n=160 725). At baseline, the enrolled participants (n=57 053) completed a food-frequency questionnaire (FFQ), a questionnaire about lifestyle, sociodemographic factors, and health, and underwent physical examinations at one of the study clinics. The regional Ethics Committees and the Danish Data Protection Agency approved the study, and informed consent was obtained from all participants. The study design and measurement procedures have been described in detail previously. 11 Dietary IntakeInformation on dietary intake was collected at baseline using a 192-item semiquantitative FFQ, which had been developed for the cohort and validated against weighed diet records. 12,13 Participants were asked to report their average intake of different food and beverage items over the previous 12 m...

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Adherence to a Healthy Nordic Diet and Risk of Stroke

Hansen

Overvad

Kyrø

et al. 2017

Stroke

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“…Six key Nordic foods formed the basis of the healthy Nordic food index, which was associated with an 18% lower total mortality between the highest and lowest diet scores over 21 years in Swedish women [96] . However, the diet was not associated with CVD risk in the same cohort [97] . In a Danish cohort, greater adherence to the healthy Nordic index was associated with a 25% lower risk of type 2 diabetes over 15 years in women and a 38% lower risk in men [98] .…”

Section: Translating Dietary Recommendations To Food-based Guidelinesmentioning

confidence: 77%

Dietary Fatty Acids: Is it Time to Change the Recommendations?

Nettleton¹,

Lovegrove

Mensink

et al. 2016

Ann Nutr Metab

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Limiting the saturated fatty acid (SAFA) consumption forms the basis of dietary fat recommendations for heart health, despite several meta-analyses demonstrating no link between dietary SAFA and the risk of cardiovascular disease (CVD). Three experts on dietary fat and health discussed the evidence of reducing SAFA intake at a symposium of the Federation of European Nutrition Societies in Berlin, Germany, October 23, 2015. Ronald P. Mensink, Maastricht University, the Netherlands, discussed the evidence linking dietary fatty acids and CVD risk. He emphasized the importance of the replacement nutrient(s) when SAFA intake is reduced. Julie Lovegrove, University of Reading, UK, addressed the question of whether higher intakes of unsaturated fatty acids are beneficial. She discussed the replacement of SAFA by polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA), noting the reduction in CVD risk with PUFA replacement and in CVD risk markers with MUFA replacement of SAFA. Ursula Schwab, University of Eastern Finland, Kuopio, Finland, discussed the importance of dietary patterns in achieving reduced risk of CVD, observing that several dietary patterns following the principles of a health-promoting diet and adapted to local customs, food preferences and seasonality are effective in reducing the risk of CVD, type 2 diabetes and other chronic diseases. This paper summarizes the symposium presentations.

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“…Allerdings basieren die bisherigen Daten auf kleinen Untersuchungen, die nur über einen kurzen Zeitraum von einigen Wochen oder Monaten durchgeführt wurden. Weitere Studien im Hinblick auf klinische Endpunkte erscheinen notwendig, zumal aktuelle Ergebnisse einer schwedischen Kohorte keine Assoziation zwischen der NORDIC Diet und kardiovaskulären Ereignissen detektieren konnte[18].…”

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Fettarme Kost oder Mittelmeerdiät

Zyriax

2015

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Eine gesundheitsförderliche Ernährung trägt maßgeblich dazu bei, das Herz-Kreislauf-Risiko zu senken. Durch drastische Fettreduktion, explizit der gesättigten Fette, konnten beachtliche Ergebnisse hinsichtlich der koronaren Herzkrankheit erzielt werden. Eine Senkung kardiovaskulärer Endpunkte basierend auf mediterranen Kostformen ist ebenfalls überzeugend dokumentiert. Unter Praxisbedingungen bestimmt die Adhärenz der Patienten maßgeblich den Erfolg der diätetischen Intervention.

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No association between adherence to the healthy Nordic food index and cardiovascular disease amongst Swedish women: a cohort study

Abstract: The present results do not support an association between a healthy Nordic food index and risk of cardiovascular disease in Swedish women. There was also no effect modification by alcohol intake, BMI or age. Our finding of an interaction with smoking status requires reproduction.

Cited by 37 publications

References 43 publications

Adherence to a Healthy Nordic Diet and Risk of Stroke

Adherence to a Healthy Nordic Diet and Risk of Stroke

Dietary Fatty Acids: Is it Time to Change the Recommendations?

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