Adherence to the healthy Nordic food index and total and cause-specific mortality among Swedish women

Eur J Epidemiol. 2015 Jun;30(6):509-17. doi: 10.1007/s10654-015-0021-x. Epub 2015 Mar 18.

Abstract

Several healthy dietary patterns have been linked to longevity. Recently, a Nordic dietary pattern was associated with a lower overall mortality. No study has, however, investigated this dietary pattern in relation to cause-specific mortality. The aim of the present study was to examine the association between adherence to a healthy Nordic food index (consisting of wholegrain bread, oatmeal, apples/pears, root vegetables, cabbages and fish/shellfish) and overall mortality, and death by cardiovascular disease, cancer, injuries/suicide and other causes. We conducted a prospective analysis in the Swedish Women's Lifestyle and Health cohort, including 44,961 women, aged 29-49 years, who completed a food frequency questionnaire between 1991-1992, and have been followed up for mortality ever since, through Swedish registries. The median follow-up time is 21.3 years, and mortality rate ratios (MRR) were calculated using Cox Proportional Hazards Models. Compared to women with the lowest index score (0-1 points), those with the highest score (4-6 points) had an 18% lower overall mortality (MRR 0.82; 0.71-0.93, p < 0.0004). A 1-point increment in the healthy Nordic food index was associated with a significantly lower risk of all-cause mortality: 6% (3-9%), cancer mortality: 5% (1-9%) and mortality from other causes: 16% (8-22%). When examining the diet components individually, only wholegrain bread and apples/pears were significantly inversely associated with all-cause mortality. We observed no effect-modification by smoking status, BMI or age at baseline. The present study encourages adherence to a healthy Nordic food index, and warrants further investigation of the strong association with non-cancer, non-cardiovascular and non-injury/suicide deaths.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiovascular Diseases / mortality
  • Cause of Death
  • Diet*
  • Edible Grain
  • Feeding Behavior*
  • Female
  • Fruit
  • Health Promotion*
  • Humans
  • Middle Aged
  • Mortality*
  • Neoplasms / mortality
  • Norway
  • Prospective Studies
  • Regression Analysis
  • Sweden / epidemiology
  • Vegetables