Abstract
PurposeTo investigate the association between healthy Nordic diet and risk of type 2 diabetes (T2D) in middle-aged and older men from eastern Finland.MethodsA total of 2332 men aged 42–60 years and free of T2D at baseline in 1984–1989 were included. Diet was assessed with 4-day food records at baseline and the healthy Nordic diet score was calculated based on a modified Baltic Sea Diet Score. T2D diagnosis was based on self-administered questionnaires, fasting and 2-h oral glucose tolerance test blood glucose measurements, or by record linkage to national health registries. Cox proportional hazards regression and analysis of covariance were used for analyses.ResultsDuring the mean follow-up of 19.3 years, 432 men (18.5%) were diagnosed with T2D. The multivariable-adjusted hazard ratio for T2D in the lowest vs. the highest quartile of the healthy Nordic diet score was 1.35 (95% CI 1.03–1.76) (P trend across quartiles 0.028). Lower adherence to healthy Nordic diet was also associated with higher plasma glucose and insulin concentrations.ConclusionsIn this prospective population-based cohort study among middle-aged and older men from eastern Finland, lower adherence to healthy Nordic diet was associated with higher risk of T2D and higher plasma glucose and serum insulin concentrations.
Highlights
Lifestyle factors and diet have been associated with the risk of type 2 diabetes (T2D) [1, 2]
Because of the limited research data about adherence to a healthy Nordic diet and risk of glucose metabolism disturbances, our aim was to examine the association between a healthy Nordic diet, based on a modified Baltic Sea Diet Score, and risk of incident T2D in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), a population of middle-aged and older men from eastern Finland
Participants who had lower adherence to healthy Nordic diet had lower leisure-time physical activity and education, and they were less likely to use hypertension and cholesterol medications at baseline. They had higher alcohol intake, diastolic blood pressure, total, LDL and HDL cholesterol concentrations and C-reactive protein (CRP) concentration and they were more likely smokers and less likely married and less likely to have history of diabetes in family compared to the participants with higher adherence to healthy Nordic diet
Summary
Lifestyle factors and diet have been associated with the risk of type 2 diabetes (T2D) [1, 2]. Even though some individual dietary factors, such as whole grains and fiber [3], have been associated with lower risk of T2D, diet consists of combinations of numerous nutrients and foods. Dietary scores are used to measure the healthiness of the whole diet by considering the cumulative effects and interactions between several food items and nutrients [4]. The Mediterranean diet is one example of the diets that have been associated with lower T2D risk [5] but due to cultural and geographical factors adherence to it is relatively poor in Nordic countries [6]. A healthy Nordic diet has been reported to beneficially associate with T2D risk factors such as abdominal obesity
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