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.
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 (1993-1997) 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.
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.
Our findings suggest that a healthy Nordic diet may be recommended for the prevention of stroke.
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.
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.
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).
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.
We examined the hypothesis that high adherence to a Mediterranean diet reduces the risk of developing heart failure (HF) as well as the risk of death from HF.
The study population comprised 37 308 men from the Cohort of Swedish Men who were free from cardiovascular disease at baseline. The modified Mediterranean diet (mMED) score was created from a self-administered food frequency questionnaire, based on consumption of presumed beneficial/detrimental foods, on a 0-8 scale. Incident HF events were ascertained by linkage to the Swedish National Patient and the Cause of Death Registers. Relative risks (RR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated by Cox proportional hazards regression models. We identified 146 deaths from HF and 1269 incident HF events over a median follow-up of 10.9 years (1998-2008). The mMED score was inversely associated with risk of HF (multivariable RR for the highest vs. lowest quartile 0.69, 95% CI 0.57, 0.83); the corresponding RR of HF mortality was 0.55 (95% CI 0.31, 0.98). The multivariable RR for every two-point increment in the mMED score was 0.85 (95% CI 0.78, 0.91) for incidence of HF and 0.78 (95% CI 0.62, 0.98) for mortality from HF, respectively.
High adherence to a Mediterranean diet was associated with a lower risk of HF and mortality from HF in men. Further studies are needed to replicate these findings in other populations.
INTRODUCTION: Mediterranean countries such as Greece have experienced rapid social change in the last decade. These community changes affect nutritional habits and there is a tendency for the traditional healthy Mediterranean diet to be abandoned. METHODS: The parents of children from one rural Greek village on Crete (Neapolis), and one rural village in Sweden (Kisa) were invited to their primary health care centers for an interview and to fill in a validated nutrition questionnaire, KidMed. RESULTS: There were no differences (p = 0.48) in total KidMed score between the Cretan and Swedish children, adjusted for gender and age. However, there were some significant differences in scores on certain KidMed questions. Parents of the Cretan children reported significantly higher daily use of olive oil at home and more regular nut consumption, but also more commercially baked goods or pastries for breakfast. The parents of Swedish children reported significantly higher use of cereals, grains or bread for breakfast. The mean BMIs were similar for the Cretan (Neapolis mean 16.8, 95% CI 13.5-23.0) and for the Swedish children (Kisa mean 17.4, 95% CI 13.7-25.5) CONCLUSION: The results suggest the possibility of changing nutritional habits, measurable among young children in rural areas. The study raises the question of whether Cretan children may have abandoned some aspects of the traditional Mediterranean diet. It may also be that Swedish children have changed their diet in favor of a more Mediterranean food choice. The major limitation of the study is the small sample size, and further, larger studies are warranted.
BACKGROUND: Thus far, few factors with a causal relation to preterm birth have been identified. Many studies have focused on the woman's diet, but most have been discouraging. The aim of the present study was to examine if maternal intake of a Mediterranean-type diet (MD) is associated with reduced risk of preterm birth. METHODS: The Danish National Birth Cohort assessed diet in mid-pregnancy by food frequency questionnaires (FFQ). Women consuming MD were those who ate fish twice a week or more, used olive or rape seed oil, consumed 5+ fruits and vegetables a day, ate meat (other than poultry and fish) at most twice a week, and drank at most 2 cups of coffee a day. RESULTS: Of 35,530 non-smoking women, 1,137 (3.2%) fulfilled all MD criteria, and 540 (1.5%) none. Odds ratios for preterm birth and early preterm birth were 0.61 (95% Confidence Interval (CI): 0.35-1.05) and 0.28 (0.11-0.76), respectively, in MD women compared to women fulfilling none of the MD criteria. CONCLUSION: Shifting towards a MD during pregnancy may reduce the risk of early delivery in Danish women.
Dietary quality in relation to bone health has been analysed in relatively few studies. The current study aimed to assess the association of the Baltic Sea diet (BSD) and the Mediterranean diet (MD) with bone mineral density (BMD) among elderly women.
Lumbar, femoral and total body BMD were measured by dual-energy X-ray absorptiometry at baseline and year 3. Dietary intake was measured by 3 d food record at baseline. BSD and MD scores were calculated from food and alcohol consumption and nutrient intake. Information on lifestyle, diseases and medications was collected by questionnaires. Longitudinal associations of BSD and MD scores with BMD were analysed using linear mixed models.
Interventional prospective Kuopio Osteoporosis Risk Factor and Fracture Prevention study including women aged 65-71 years and residing in Kuopio province, Finland.
Women (n 554) with mean age of 67·9 (sd 1·9) years and mean BMI of 28·8 (sd 4·7) kg/m2.
Higher BSD scores were associated with higher intakes of fruit and berries, vegetables, fish and low-fat dairy products, and lower intake of sausage. Higher MD scores were associated with higher consumption of fruit and berries and vegetables. BSD and MD scores were associated with higher PUFA:SFA and higher fibre intake. Femoral, lumbar or total body BMD was not significantly different among the quartiles of BSD or MD score.
The lack of associations suggest that Baltic Sea and Mediterranean dietary patterns may not adequately reflect dietary factors relevant to bone health.
Mediterranean diets are characterized by olive oil, as the dominant fat source and a high to moderate consumption of fruit and vegetables, cereal products, fish, legumes, in combination with little meat and wine with meals. The "reference" Mediterranean diet seems to differ according to country, but is associated with good health and a long life expectancy. From the Seven Countries Studies, it has been shown that especially the traditional Cretan diet was associated with very low 25-year mortality rates for coronary heart disease, cancer and all-causes. In terms of nutrients and bioactive compounds the "reference" Mediterranean diet is low in saturated fat and high in monounsaturated fatty acids, high in antioxidants especially vitamin C and E, and high in fiber and folic acid. Several epidemiological studies have investigated these dietary components either separately or in combination in other than Mediterranean populations. In general, also in other populations beneficial effects on the coronary risk profile have been observed, which gives further support to the positive health effects of the Mediterranean diet. Intervention studies in East Finland and Southern Italy have convincingly shown that the coronary risk profile (lower LDL cholesterol and blood pressure levels) is improved by a Mediterranean diet. Moreover, the Cretan diet was tested in cardiac patients and showed a 70 % lower cardiac and all-causes mortality compared to the control diet. In conclusion, epidemiological studies and intervention trials suggest that the Cretan Mediterranean diet lowers the risk of coronary heart disease.
In our daily life, we are exposed to perfluoroalkyl substances (PFAS) with possible health implications. The main exposure route for these substances is diet but comparative studies on how dietary habits influence exposure are lacking.
To examine the relations between blood levels of PFAS and adherence to three predefined dietary patterns (a WHO recommended diet, a Mediterranean-like diet, and a Low-Carbohydrate High-Protein (LCHP) diet) in an elderly Swedish population.
Dietary data from 7-day food records and serum concentrations of PFAS were obtained from a 70-year-old Swedish population (n=844), the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. The Healthy Diet Indicator score (based on WHO recommendations), the Mediterranean Diet Score and LCHP score were used to assess adherence. Multivariate linear regression was used to assess the associations between eight major PFAS and adherence to each dietary pattern.
The WHO recommended diet was positively associated with perfluorohexane sulfonic acid (PFHxS). The LCHP diet was positively related to four out of eight PFAS; namely, perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA) and perfluoroundecanoic acid (PFUnDA). The Mediterranean-like diet was positively associated with most PFAS; namely perfluorooctanoic acid (PFOA), perfluorooctane sulfonamide (PFOSA), PFHxS, PFNA, PFDA, and PFUnDA.
All dietary patterns were positively associated with blood levels of PFAS. The highest body burden of PFAS was found in individuals with high adherence to a Mediterranean-like diet, whilst individuals who more closely followed the officially recommended diet displayed a lower body burden of these compounds.
High adherence to healthy diets has the potential to prevent disease and prolong life span, and healthy dietary pattern scores have each been associated with disease and mortality. We studied two commonly promoted healthy diet scores (modified Mediterranean diet score (mMED) and the Healthy Nordic Food Index (HNFI)) and the combined effect of the two scores in association with all-cause and cause-specific mortality (cancer, CVD and ischaemic heart disease). The study included 38 428 women (median age of 61 years) from the Swedish Mammography Cohort. Diet and covariate data were collected in a questionnaire. mMED and HNFI were generated and categorised into low-, medium- and high-adherence groups, and in nine combinations of these. Multivariable-adjusted hazard ratios (HR) of register-ascertained mortality and 95 % CI were calculated in Cox proportional hazards regression analysis. During follow-up (median: 17 years), 10 478 women died. In the high-adherence categories compared with low-adherence categories, the HR for all-cause mortality was 0·76 (95 % CI 0·70, 0·81) for mMED and 0·89 (95 % CI 0·83, 0·96) for HNFI. Higher adherence to mMED was associated with lower mortality in each stratum of HNFI in the combined analysis. In general, mMED, compared with HNFI, was more strongly associated with a lower cause-specific mortality. In Swedish women, both mMED and HNFI were inversely associated with all-cause and cardiovascular mortality. The combined analysis, however, indicated an advantage to be adherent to the mMED. The present version of HNFI did not associate with mortality independent of mMED score.
With global aging population, age-related cognitive decline becomes epidemic. Lifestyle-related factor is one of the key preventative measures. Dietary pattern analysis which considers dietary complexity has recently used to examine the linkage between nutrition and cognitive function. A priori approach defines dietary pattern based on existing knowledge. Results of several dietary pattern scores were summarized. The heterogeneity of assessment methods and outcome measurements lead to inconsistent results. Posteriori approach derives a dietary pattern independently of the existing nutrition-disease knowledge. It showed a dietary pattern abundant with plant-based food, oily fish, lower consumption of processed food, saturated fat, and simple sugar which appears to be beneficial to cognitive health. Despite inconclusive evidence from both approaches, diet and exercise, beneficial for other diseases, remains to be the two key modifiable factors for cognitive function. Large-scale prospective studies in multiethics population are required to provide stronger evidence in the future.