People who adhere to a healthy Nordic diet consisting of fish, apples, cabbage, root vegetables, rye bread, and oatmeal, among other elements, may have a reduced risk of stroke, according to data published in Stroke.
While a Mediterranean diet rich in vegetables and healthy fats has traditionally been associated with stroke prevention,2 populations in Nordic countries have struggled to adhere to that diet due to cultural preferences and geographic availability.3 Previous research has demonstrated beneficial effects of the Nordic diet on cardiovascular factors,4 although results were not definitive or inclusive of all stroke types and genders.5
In this study, researchers led by Camilla Plambeck Hansen, PhD, of Aarhus University in Denmark, evaluated the effects of the Nordic diet on the risk of total stroke and stroke subtypes in a large cohort of Danish men and women.
A total of 55,338 participants (52% women) were included in the study, all of whom completed a food-frequency questionnaire and surveys on lifestyle, sociodemographic factors, and overall health at baseline. Adherence to a Nordic diet was scored using the Healthy Nordic Food Index, with participants deemed “low adherers” (0-1 point), “medium adherers” (2-3 points), or “high adherers” (4-6 points).
Over the course of follow-up (median, 13.5 years), 2283 participants experienced a first-time stroke. Compared to the total study population, participants who had a stroke were more likely to have a less-healthy lifestyle and a lower intake of foods included in the Healthy Nordic Food Index. Analysis revealed a statistically significant inverse trend between the Healthy Nordic Food Index and risk of stroke. Compared with low adherers, high adherers had a 14% reduced risk of stroke (hazard ratio [HR] 0.86; 95% CI, 0.76-0.98). An inverse, statistically significant trend was also observed for ischemic stroke but not hemorrhagic stroke. The investigators pointed out that participants with the highest Healthy Nordic Food Index scores had a 32% reduced risk of stroke due to large-artery atherosclerosis compared with participants who scored lowest on the index (HR 0.68; 95% CI, 0.48-0.95). The results remained significant after adjusting for smoking history, body mass index, and waist circumference.
The investigators noted that several limitations, including competing risks, the self-administered dietary assessment, and the exclusion of other common Nordic foods with known health benefits, may have compromised results, although most would contribute to an underestimation of the association.
Based on the results, the investigators suggest that a traditional Nordic diet may be a good regional alternative to the Mediterranean diet with similar preventive health benefits. Further studies are warranted to confirm these results and explore the possible benefits of other regional diets on stroke prevention.
Disclosure: This study was partially funded by the Danish Cancer Society and Innovation Fund Denmark.
- Hansen CP, Overvad K, Kyrø C, et al. Adherence to a healthy Nordic diet and risk of stroke: A Danish cohort study [published online January 3, 2017]. Stroke. doi: 10.1161/STROKEAHA.116.015019
- Lakkur S, Judd SE. Diet and stroke: recent evidence supporting a Mediterranean-style diet and food in the primary prevention of stroke. Stroke. 2015;46:2007-2011.
- da Silva R, Bach-Faig A, Raidó Quintana B, Buckland G, Vaz de Almeida MD, Serra-Majem L. Worldwide variation of adherence to the Mediterranean diet, in 1961-1965 and 2000-2003. Public Health Nutr. 2009;12(9A):1676-1684.
- Poulsen SK, Due A, Jordy AB, et al. Health effect of the New Nordic Diet in adults with increased waist circumference: a 6-mo randomized controlled trial. Am J Clin Nutr. 2014;99:35-45.
- Roswall N, Sandin S, Scragg R, et al. No association between adherence to the healthy Nordic food index and cardiovascular disease amongst Swedish women: a cohort study. J Intern Med. 2015;278:531-541.