title: Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial. Low-fat, high-fiber diet favorably affects several independent risk markers of ischemic heart disease: observations on blood lipids, coagulation, and fibrinolysis from a trial of middle-aged Danes. Effectiveness of a weight loss intervention in postpartum women: results from a randomized controlled trial in primary health care. Health effect of the New Nordic Diet in adults with increased waist circumference: a 6-mo randomized controlled trial. Effects of school meals with weekly fish servings on vitamin D status in Danish children: secondary outcomes from the OPUS (Optimal well-being, development and health for Danish children through a healthy New Nordic Diet) School Meal Study The effects of Nordic school meals on concentration and school performance in 8- to 11-year-old children in the OPUS School Meal Study: a cluster-randomised, controlled, cross-over trial. Plate waste and intake of school lunch based on the new Nordic diet and on packed lunches: a randomised controlled trial in 8- to 11-year-old Danish children Diet-Induced Weight Loss Alters Functional Brain Responses during an Episodic Memory Task Dietary effects of introducing school meals based on the New Nordic Diet - a randomised controlled trial in Danish children. The OPUS School Meal Study. Adherence to a Healthy Nordic Food Index Is Associated with a Lower Risk of Type-2 Diabetes—The Danish Diet, Cancer and Health Cohort Study No association between adherence to the healthy Nordic food index and cardiovascular disease amongst Swedish women: a cohort study. Plasma alkylresorcinols C17:0/C21:0 ratio, a biomarker of relative whole-grain rye intake, is associated to insulin sensitivity: a randomized study An olive oil-rich diet results in higher concentrations of LDL cholesterol and a higher number of LDL subfraction particles than rapeseed oil and sunflower oil diets. Influence of a prudent diet on circulating cathepsin S in humans Diet-induced changes in iron and n-3 fatty acid status and associations with cognitive performance in 8-11-year-old Danish children: secondary analyses of the Optimal Well-Being, Development and Health for Danish Children through a Healthy New Nordic Diet School Meal Study. Effects of school meals based on the New Nordic Diet on intake of signature foods: a randomised controlled trial. The OPUS School Meal Study. Adherence to the healthy Nordic food index and total and cause-specific mortality among Swedish women Influence of a healthy Nordic diet on serum fatty acid composition and associations with blood lipoproteins – results from the NORDIET study Accuracy of self-reported intake of signature foods in a school meal intervention study: comparison between control and intervention period. No Association between Adherence to a Healthy Nordic Food Index and Colorectal Cancer: Results from a Swedish Cohort Study Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial [Food intake of Danes and cardiac risk factors]. Design of the OPUS School Meal Study: A randomised controlled trial assessing the impact of serving school meals based on the New Nordic Diet Effects of a healthy Nordic diet on cardiovascular risk factors in hypercholesterolaemic subjects: a randomized controlled trial (NORDIET). Plasma alkylresorcinols reflect important whole-grain components of a healthy Nordic diet.
abstract: BACKGROUND Effects of diet on blood lipids are best known in white men , and effects of type of carbohydrate on triacylglycerol concentrations are not well defined . OBJECTIVE Our goal was to determine the effects of diet on plasma lipids , focusing on subgroups by sex , race , and baseline lipid concentrations . DESIGN This was a r and omized controlled outpatient feeding trial conducted in 4 field centers . The subjects were 436 participants of the Dietary Approaches to Stop Hypertension ( DASH ) Trial [ mean age : 44.6 y ; 60 % African American ; baseline total cholesterol : < or = 6.7 mmol/L ( < or = 260 mg/dL ) ] . The intervention consisted of 8 wk of a control diet , a diet increased in fruit and vegetables , or a diet increased in fruit , vegetables , and low-fat dairy products and reduced in saturated fat , total fat , and cholesterol ( DASH diet ) , during which time subjects remained weight stable . The main outcome measures were fasting total cholesterol , LDL cholesterol , HDL cholesterol , and triacylglycerol . RESULTS Relative to the control diet , the DASH diet result ed in lower total ( -0.35 mmol/L , or -13.7 mg/dL ) , LDL- ( -0.28 mmol/L , or -10.7 mg/dL ) , and HDL- ( -0.09 mmol/L , or -3.7 mg/dL ) cholesterol concentrations ( all P < 0.0001 ) , without significant effects on triacylglycerol . The net reductions in total and LDL cholesterol in men were greater than those in women by 0.27 mmol/L , or 10.3 mg/dL ( P = 0.052 ) , and by 0.29 mmol/L , or 11.2 mg/dL ( P < 0.02 ) , respectively . Changes in lipids did not differ significantly by race or baseline lipid concentrations , except for HDL , which decreased more in participants with higher baseline HDL-cholesterol concentrations than in those with lower baseline HDL-cholesterol concentrations . The fruit and vegetable diet produced few significant lipid changes . CONCLUSIONS The DASH diet is likely to reduce coronary heart disease risk . The possible opposing effect on coronary heart disease risk of HDL reduction needs further study We served a low-fat ( 28 % of energy ) , high-fiber ( 3.3 g/MJ ) diet according to Nordic nutrition recommendations ( Rec diet ) , and a high-fat diet ( 39 % of energy ) corresponding to the average Danish diet ( Dane diet ) for periods of 2 wk in a r and omized crossover study of 21 healthy middle-aged individuals . The Rec diet result ed in lower serum concentrations of low-density-lipoprotein ( LDL ) cholesterol ( medians : 2.77 vs 3.04 mmol/L , P < 0.001 ) and high-density-lipoprotein ( HDL ) cholesterol ( 1.08 vs 1.24 mmol/L , P < 0.001 ) , and higher fasting triglycerides ( 1.11 vs 0.86 mmol/L , P = 0.04 ) than did the Dane diet . Furthermore , the Rec diet lowered plasma factor VII coagulant activity ( FVIIc ) ( 88 % vs 96 % , P = 0.002 ) and raised plasma fibrinolytic activity . Our observations indicate that a low-fat , high-fiber diet may not only reduce the atherogenic but also the thrombogenic tendency of an individual compared with a diet corresponding to the average Danish diet BACKGROUND Reproduction has been identified as an important factor for long-term  weight gain among women . A previous efficacy trial has successfully produced postpartum weight loss ; however , the effectiveness of this intervention needs to be established . OBJECTIVE This study was design ed to evaluate the short- and long-term effectiveness of a diet behavior modification treatment to produce weight loss in postpartum women within the primary health care setting in Sweden . DESIGN During 2011 - 2014 , 110 women with a self-reported body mass index ( BMI ; in kg/m(2 ) ) of ≥27 at 6 - 15 wk postpartum were r and omly assigned to the diet behavior modification group ( D group ) or the control group ( C group ) . Women r and omly assigned to the D group ( n = 54 ) received a structured 12-wk diet behavior modification treatment by a dietitian and were instructed to gradually implement a diet plan based on the Nordic Nutrition Recommendations and to self-weigh ≥3 times/wk . Women r and omly assigned to the C group ( n = 56 ) were given a brochure on healthy eating . The primary outcome was change in body weight after 12 wk and 1 y. The retention rate was 91 % and 85 % at 12 wk and 1 y , respectively . RESULTS At baseline , women had a median ( 1st , 3rd quartile ) BMI of 31.0 ( 28.8 , 33.6 ) , and 84 % were breastfeeding . After 12 wk , median weight change in the D group was -6.1 kg ( -8.4 , -3.2 kg ) compared with -1.6 kg ( -3.5 , -0.4 kg ) in the C group ( P < 0.001 ) . The difference was maintained at the 1-y follow-up for the D group , -10.0 kg ( -11.7 , -5.9 kg ) compared with -4.3 kg ( -10.2 , -1.0 kg ) in the C group ( P = 0.004 ) . In addition , the D group reduced BMI , waist circumference , hip circumference , and body fat percentage more than did the C group at both 12 wk and 1 y ( all P < 0.05 ) . CONCLUSION A low-intensity diet treatment delivered by a dietitian within the primary health care setting can produce clinical ly relevant and sustainable weight loss in postpartum women with overweight and obesity . This trial was registered at clinical trials.gov as NCT01949558 BACKGROUND The regional Mediterranean Diet has been associated with lower risk of disease . OBJECTIVE We tested the health effects of the New Nordic Diet ( NND ) , which is a gastronomically driven regional , organic , and environmentally friendly diet , in a carefully controlled but free-living setting . DESIGN A total of 181 central ly obese men and women , with a mean ( range ) age of 42 y ( 20 - 66 y ) , body mass index ( in kg/m(2 ) ) of 30.2 ( 22.6 - 47.3 ) , and waist circumference of 100 cm ( 80 - 138 cm ) were r and omly assigned to receive either the NND ( high in fruit , vegetables , whole grains , and fish ) or an average Danish diet ( ADD ) for 26 wk . Participants received cookbooks and all foods ad libitum and free of charge by using a shop model . The primary endpoint was the weight change analyzed by both completer and intention-to-treat analyses . RESULTS A total of 147 subjects [ 81 % ( NND 81 % ; ADD 82 % ) ] completed the intervention . A high dietary compliance was achieved , with significant differences in dietary intakes between groups . The mean ( ±SEM ) weight change was -4.7 ± 0.5 kg for the NND compared with -1.5 ± 0.5 kg for the ADD ( adjusted difference : -3.2 kg ; 95 % CI : -4.6 , -1.8 kg ; P < 0.001 ) for the completer analysis , and the difference was -3.0 kg ( 95 % CI : -4.0 , -2.1 kg ) for the intention-to-treat analysis . The NND produced greater reductions in systolic blood pressure ( adjusted difference : -5.1 mm Hg ; 95 % CI : -8.2 , -2.1 mm Hg ) and diastolic blood pressure ( adjusted difference : -3.2 mm Hg ; 95 % CI : -5.7 , -0.8 mm Hg ) than did the ADD . CONCLUSION An ad libitum NND produces weight loss and blood pressure reduction in central ly obese individuals . This trial was registered at www . clinical trials.gov as NCT01195610 Children 's vitamin D intake and status can be optimised to meet recommendations . We investigated if nutritionally balanced school meals with weekly fish servings affected serum 25-hydroxyvitamin D ( 25(OH)D ) and markers related to bone in 8- to 11-year-old Danish children . We conducted an explorative secondary outcome analysis on data from 784 children from the OPUS School Meal Study , a cluster-r and omised cross-over trial where children received school meals for 3 months and habitual lunch for 3 months . At baseline , and at the end of each dietary period , 25(OH)D , parathyroid hormone ( PTH ) , osteocalcin ( OC ) , insulin-like growth factor-1 ( IGF-1 ) , bone mineral content ( BMC ) , bone area ( BA ) , bone mineral density ( BMD ) , dietary intake and physical activity were assessed . School meals increased vitamin D intake by 0·9 ( 95 % CI 0·7 , 1·1 ) μg/d . No consistent effects were found on 25(OH)D , BMC , BA , BMD , IGF-1 or OC . However , season-modified effects were observed with 25(OH)D , i.e. children completing the school meal period in January/February had higher 25(OH)D status ( 5·5 ( 95 % CI 1·8 , 9·2 ) nmol/l ; P = 0·004 ) than children completing the control period in these months . A similar tendency was indicated in November/December ( 4·1 ( 95 % CI –0·12 , 8·3 ) nmol/l ; P = 0·057 ) . However , the effect was opposite in March/April ( –4·0 ( 95 % CI –7·0 , –0·9 ) nmol/l ; P = 0·010 ) , and no difference was found in May/June ( P = 0·214 ) . Unexpectedly , the school meals slightly increased PTH ( 0·18 ( 95 % CI 0·07 , 0·29 ) pmol/l ) compared with habitual lunch . Small increases in dietary vitamin D might hold potential to mitigate the winter nadir in Danish children 's 25(OH)D status while higher increases appear necessary to affect status throughout the year . More trials on effects of vitamin D intake from natural foods are needed It is widely assumed that nutrition can improve school performance in children ; however , evidence remains limited and inconclusive . In the present study , we investigated whether serving healthy school meals influenced concentration and school performance of 8- to 11-year-old Danish children . The OPUS ( Optimal well-being , development and health for Danish children through a healthy New Nordic Diet ) School Meal Study was a cluster-r and omised , controlled , cross-over trial comparing a healthy school meal programme with the usual packed lunch from home ( control ) each for 3 months ( NCT 01457794 ) . The d2 test of attention , the Learning Rating Scale ( LRS ) and st and ard tests on reading and mathematics proficiency were administered at baseline and at the end of each study period . Intervention effects were evaluated using hierarchical mixed models . The school meal intervention did not influence concentration performance ( CP ; primary outcome , n 693 ) or processing speed ; however , the decrease in error percentage was 0·18 points smaller ( P<0·001 ) in the intervention period than in the control period ( medians : baseline 2·03 % ; intervention 1·46 % ; control 1·37 % ) . In contrast , the intervention increased reading speed ( 0·7 sentence , P=0·009 ) and the number of correct sentences ( 1·8 sentences , P<0·001 ) , which corresponded to 11 and 25 % , respectively , of the effect of one school year . The percentage of correct sentences also improved ( P<0·001 ) , indicating that the number correct improved relatively more than reading speed . There was no effect on overall math performance or outcomes from the LRS . In conclusion , school meals did not affect CP , but improved reading performance , which is a complex cognitive activity that involves inference , and increased errors related to impulsivity and inattention . These findings are worth examining in future trials The aim of the present study was to compare total food intake , total and relative edible plate waste and self-reported food likings between school lunch based on the new Nordic diet ( NND ) and packed lunch from home . In two 3-month periods in a cluster-r and omised controlled unblinded cross-over study 3rd- and 4th- grade children ( n 187 ) from two municipal schools received lunch meals based on NND principles and their usual packed lunch ( control ) .  Food intake and plate waste ( n 1558 ) were calculated after weighing lunch plates before and after the meal for five consecutive days and self-reported likings ( n 905 ) assessed by a web-based question naire . Average food intake was 6 % higher for the NND period compared with the packed lunch period . The quantity of NND intake varied with the menu ( P < 0·0001 ) and was positively associated with self-reported likings . The edible plate waste was 88 ( sd 80 ) g for the NND period and 43 ( sd 60 ) g for the packed lunch period whereas the relative edible plate waste was no different between periods for meals having waste ( n 1050 ) . Edible plate waste differed between menus ( P < 0·0001 ) , with more waste on soup days ( 36 % ) and vegetarian days ( 23 % ) compared with the packed lunch period . Self-reported likings were negatively associated with percentage plate waste ( P < 0·0001 ) . The study suggests that portion sizes need to be considered in new school meal programmes . New strategies with focus on reduction of plate waste , children 's likings and nutritious school meals are crucial from both a nutritional , economic and environmental point of view Objective : It has been suggested that overweight is negatively associated with cognitive functions . The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women . Methods : 20 overweight postmenopausal women were r and omized to either a modified paleolithic diet or a st and ard diet adhering to the Nordic Nutrition Recommendations for 6 months . We used functional magnetic resonance imaging to examine brain function during an episodic memory task as well as anthropometric and biochemical data before and after the interventions . Results : Episodic memory performance improved significantly ( p = 0.010 ) after the dietary interventions . Concomitantly , brain activity increased in the anterior part of the right hippocampus during memory encoding , without differences between diets . This was associated with decreased levels of plasma free fatty acids ( FFA ) . Brain activity increased in pre-frontal cortex and superior/middle temporal gyri . The magnitude of increase correlated with waist circumference reduction . During episodic retrieval , brain activity decreased in inferior and middle frontal gyri , and increased in middle/superior temporal gyri . Conclusions : Diet-induced weight loss , associated with decreased levels of plasma FFA , improves episodic memory linked to increased hippocampal activity The OPUS ( Optimal well-being , development and health for Danish children through a healthy New Nordic Diet ( NND ) ) School Meal Study investigated the effects on the intake of foods and nutrients of introducing school meals based on the principles of the NND covering lunch and all snacks during the school day in a cluster-r and omised cross-over design . For two 3-month periods , 834 Danish children aged 8 - 11 years from forty-six school classes at nine schools received NND school meals or their usual packed lunches brought from home ( control ) in r and om order . The whole diet of the children was recorded over seven consecutive days using a vali date d Web-based Dietary Assessment Software for Children . The NND result ed in higher intakes of potatoes ( 130 % , 95 % CI 2·07 , 2·58 ) , fish ( 48 % , 95 % CI 1·33 , 1·65 ) , cheese ( 25 % , 95 % CI 1·15 , 1·36 ) , vegetables ( 16 % , 95 % CI 1·10 , 1·21 ) , eggs ( 10 % , 95 % CI 1·01 , 1·19 ) and beverages ( 6 % , 95 % CI 1·02 , 1·09 ) , and lower intakes of bread ( 13 % , 95 % CI 0·84 , 0·89 ) and fats ( 6 % , 95 % CI 0·90 , 0·98 ) were found among the children during the NND period than in the control period ( all , P < 0·05 ) . No difference was found in mean energy intake ( P= 0·4 ) , but on average children reported 0·9 % less energy intake from fat and 0·9 % higher energy intake from protein during the NND period than in the control period . For micronutrient intakes , the largest differences were found for vitamin D ( 42 % , 95 % CI 1·32 , 1·53 ) and iodine ( 11 % , 95 % CI 1·08 , 1·15 ) due to the higher fish intake . In conclusion , the present study showed that the overall dietary intake at the food and nutrient levels was improved among children aged 8 - 11 years when their habitual packed lunches were replaced by school meals following the principles of the NND Background : Type-2 diabetes ( T2D ) prevalence is rapidly increasing worldwide . Lifestyle factors , in particular obesity , diet , and physical activity play a significant role in the etiology of the disease . Of dietary patterns , particularly the Mediterranean diet has been studied , and generally a protective association has been identified . However , other regional diets are less explored . Objective : The aim of the present study was to investigate the association between adherence to a healthy Nordic food index and the risk of T2D . The index consists of six food items : fish , cabbage , rye bread , oatmeal , apples and pears , and root vegetables . Methods : Data was obtained from a prospect i ve cohort study of 57,053 Danish men and women aged 50–64 years , at baseline , of whom 7366 developed T2D ( median follow-up : 15.3 years ) . The Cox proportional hazards model was used to assess the association between the healthy Nordic food index and risk of T2D , adjusted for potential confounders . Results : Greater adherence to the  healthy Nordic food index was significantly associated with lower risk of T2D after adjusting for potential confounders . An index score of 5−6 points ( high adherence ) was associated with a statistically significantly 25 % lower T2D risk in women ( HR : 0.75 , 95%CI : 0.61–0.92 ) and 38 % in men ( HR : 0.62 ; 95%CI : 0.53–0.71 ) compared to those with an index score of 0 points ( poor adherence ) . Conclusion : Adherence to a healthy Nordic food index was found to be inversely associated with risk of T2D , suggesting that regional diets other than the Mediterranean may also be recommended for prevention of T2D BACKGROUND In several intervention trials , a healthy Nordic diet showed beneficial effects on markers of cardiovascular disease . We investigated the association between a healthy Nordic diet and clinical diagnosis of cardiovascular disease . OBJECTIVE Our aim was first to examine the association between a healthy Nordic food index ( wholegrain bread , oatmeal , apples/pears , root vegetables , cabbages and fish ) and the incidence of overall cardiovascular disease ( ischaemic heart disease , stroke , arrhythmia , thrombosis and hypertensive disease ) , and secondly to test for possible effect modification by smoking , body mass index ( BMI ) , alcohol consumption and age . METHODS We conducted an analysis of data from the prospect i ve Swedish Women 's Lifestyle and Health cohort , including 43 310 women who completed a food frequency question naire in 1991 - 1992 , and followed up until 31 December 2012 through Swedish registries .  Hazard ratios ( HRs ) and 95 % confidence intervals ( CIs ) were calculated using Cox proportional hazards models . RESULTS During follow-up , 8383 women developed cardiovascular disease .  We found no association between the healthy Nordic food index and overall cardiovascular disease risk or any of the subgroups investigated . There was a statistically significant interaction with smoking status ( P = 0.02 ) , with a beneficial effect only amongst former smokers ( HR 0.96 , 95 % CI 0.94 - 0.99 per 1-point increment ) . CONCLUSION 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 Background / Objectives : Few studies have used biomarkers of whole-grain intake to study its relation to glucose metabolism . We aim ed to investigate the association between plasma alkylresorcinols ( AR ) , a biomarker of whole-grain rye and wheat intake , and glucose metabolism in individuals with metabolic syndrome (MetS).Subjects/ Methods : Participants were 30–65 years of age , with body mass index 27–40 kg/m2 and had MetS without diabetes . Individuals were recruited through six centers in the Nordic countries and r and omized to a healthy Nordic diet ( ND , n=96 ) , rich in whole-grain rye and wheat , or a control diet ( n=70 ) , for 18–24 weeks . In addition , associations between total plasma AR concentration and C17:0/C21:0 homolog ratio as an indication of the relative whole-grain rye intake , and glucose metabolism measures from oral glucose tolerance tests were investigated in pooled ( ND+control ) regression analyses at 18/24 weeks . Results : ND did not improve glucose metabolism compared with control diet , but the AR C17:0/C21:0 ratio was inversely associated with fasting insulin concentrations ( P=0.002 ) and positively associated with the insulin sensitivity indices Matsuda ISI ( P=0.026 ) and disposition index ( P=0.022 ) in pooled analyses at 18/24 weeks , even after adjustment for confounders . The AR C17:0/C21:0 ratio was not significantly associated with insulin secretion indices . Total plasma AR concentration was not related to fasting plasma glucose or fasting insulin at 18/24 weeks . Conclusions : The AR C17:0/C21:0 ratio , an indicator of relative whole-grain rye intake , is associated with increased insulin sensitivity in a population with We investigated the effect of olive oil , rapeseed oil , and sunflower oil on blood lipids and lipoproteins including number and lipid composition of lipoprotein subclasses .  Eighteen young , healthy men participated in a double-blinded r and omized cross-over study ( 3-week intervention period ) with 50 g of oil per 10 MJ incorporated into a constant diet .  Plasma cholesterol , triacylglycerol , apolipoprotein B , and very low density lipoprotein ( VLDL ) , intermediate density lipoprotein ( IDL ) , and low density lipoprotein ( LDL ) cholesterol concentrations were 10;-20 % higher after consumption of the olive oil diet compared with the rapeseed oil and sunflower oil diets [ analysis of variance ( ANOVA ) , P < 0.05 ] . The size of IDL , VLDL , and LDL subfractions did not differ between the diets , whereas a significantly higher number ( apolipoprotein B concentration ) and lipid content of the larger and medium-sized LDL subfractions were observed after the olive oil diet compared with the rapeseed oil and sunflower oil diets ( ANOVA , P < 0.05 ) . Total HDL cholesterol concentration did not differ significantly , but HDL(2a ) cholesterol was higher after olive oil and rapeseed oil compared with sunflower oil ( ANOVA , P < 0.05).In conclusion , rapeseed oil and sunflower oil had more favorable effects on blood lipids and plasma apolipoproteins as well as on the number and lipid content of LDL subfractions compared with olive oil . Some of the differences may be attributed to differences in the squalene and phytosterol contents of the oils Background Increased circulating cathepsin S levels have been linked to increased risk of cardiometabolic diseases and cancer . However , whether cathepsin S is a modifiable risk factor is unclear . We aim ed to investigate the effects of a prudent diet on plasma cathepsin S levels in healthy individuals . Findings Explorative analyses of a r and omized study were performed in 88 normal to slightly overweight and hyperlipidemic men and women ( aged 25 to 65 ) that were r and omly assigned to ad libitum prudent diet , i.e. healthy Nordic diet ( ND ) or a control group ( habitual Western diet ) for 6 weeks . Whereas all foods in the ND were provided , the control group was advised to consume their habitual diet throughout the study . The ND was in line with dietary recommendations , e.g. low in saturated fats , sugars and salt , but high in plant-based foods rich in fibre and unsaturated fats . The ND significantly decreased cathepsin S levels ( from 20.1 ( + /-4.0 SD ) to 19.7 μg/L ( + /-4.3 SD ) ) compared with control group ( from 18.2 ( + /-2.9 SD ) to 19.1 μg/L ( + /-3.8 SD ) ) . This difference remained after adjusting for sex and change in insulin sensitivity ( P = 0.03 ) , and near significant after adjusting for baseline cathepsin S levels ( P = 0.06 ) , but not for change in weight or LDL-C. Changes in cathepsin S levels were directly correlated with change in LDL-C. Conclusions Compared with a habitual control diet , a provided ad libitum healthy Nordic diet decreased cathepsin S levels in healthy individuals , possibly mediated by weight loss or lowered LDL-C. These differences between groups in cathepsin S were however not robust and therefore need further investigation Fe and n-3 long-chain PUFA ( n-3 LCPUFA ) have both been associated with cognition , but evidence remains inconclusive in well-nourished school-aged children . In the Optimal Well-Being , Development and Health for Danish Children through a Healthy New Nordic Diet ( OPUS ) School Meal Study , the 3-month intervention increased reading performance , inattention , impulsivity and dietary intake of fish and Fe . This study investigated whether the intervention influenced n-3 LCPUFA and Fe status and , if so , explored how these changes correlated with the changes in cognitive performance . The study was a cluster-r and omised cross-over trial comparing school meals with packed lunch ( control ) . At baseline and after each treatment , we measured serum ferritin , whole-blood n-3 LCPUFA and Hb , and performance in reading , mathematics and d2-test of attention . Data were analysed using mixed models ( n 726 ) and principal component analysis of test performances ( n 644 ) , which showed two main patterns : ' school performance ' and ' reading comprehension ' . The latter indicated that children with good reading comprehension were also more inattentive and impulsive ( i.e. higher d2-test error% ) . The intervention improved ' school performance ' ( P=0·015 ) , ' reading comprehension ' ( P=0·043 ) and EPA+DHA status 0·21 ( 95 % CI 0·15 , 0·27 ) w/w % ( P<0·001 ) , but it did not affect serum ferritin or Hb . At baseline , having small Fe stores was associated with poorer ' school performance ' in girls , but with better ' reading comprehension ' in both boys and girls . Both baseline EPA+DHA status and the intervention-induced increase in EPA+DHA status was positively associated with ' school performance ' , suggesting that n-3 LCPUFA could potentially explain approximately 20 % of the intervention effect . These exploratory associations indicate that increased fish intake might explain some of the increase in reading performance and inattention in the study A New Nordic Diet ( NND ) was developed in the context of the Danish OPUS Study ( Optimal well-being , development and health for Danish children through a healthy New Nordic Diet ) . Health , gastronomic potential , sustainability and Nordic identity were crucial principles of the NND . The aim of the present study was to investigate the effects of serving NND school meals compared with the usual packed lunches on the dietary intake of NND signature foods . For two 3-month periods , 834 Danish children aged 8 - 11 years received NND school meals or their usual packed lunches brought from home ( control ) in r and om order . The entire diet was recorded over 7 consecutive days using a vali date d Web-based Dietary Assessment Software for Children . The NND result ed in higher intakes during the entire week ( % increase ) of root vegetables ( 116 ( 95 % CI 1·93 , 2·42 ) ) , cabbage ( 26 ( 95 % CI 1·08 , 1·47 ) ) , legumes ( 22 ( 95 % CI 1·06 , 1·40 ) ) , herbs ( 175 ( 95 % CI 2·36 , 3·20 ) ) , fresh berries ( 48 ( 95 % CI 1·13 , 1·94 ) ) , nuts and seeds ( 18 ( 95 % CI 1·02 , 1·38 ) ) , lean fish and fish products ( 47 ( 95 % CI 1·31 , 1·66 ) ) , fat fish and fish products ( 18 ( 95 % CI 1·02 , 1·37 ) ) and potatoes ( 129 ( 95 % CI 2·05 , 2·56 ) ) . Furthermore , there was a decrease in the number of children with zero intakes when their habitual packed lunches were replaced by NND school meals . In conclusion , this study showed that the children increased their intake of NND signature foods , and , furthermore , there was a decrease in the number of children with zero intakes of NND signature foods when their habitual packed lunches were replaced by school meals following the NND principles 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 prospect i ve analysis in the Swedish Women ’s Lifestyle and Health cohort , including 44,961 women , aged 29–49 years , who completed a food frequency question naire 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 Background The fatty acid ( FA ) composition of serum lipids is related to the quality of dietary fat intake . Objective To investigate the effects of a  healthy Nordic diet ( ND ) on the FA composition of serum cholesterol esters ( CE-FA ) and assess the associations between changes in the serum CE-FA composition and blood lipoproteins during a controlled dietary intervention . Design The NORDIET trial was a 6-week r and omised , controlled , parallel-group dietary intervention study that included 86 adults ( 53±8 years ) with elevated low-density lipoprotein cholesterol ( LDL-C ) . Serum CE-FA composition was measured using gas chromatography . Diet history interviews were conducted , and daily intake was assessed using checklists . Results Food and nutrient intake data indicated that there was a reduction in the intake of fat from dairy and meat products and an increase in the consumption of fatty fish with the ND . The levels of saturated fatty acids in cholesterol esters ( CE-SFA ) 14:0 , 15:0 , and 18:0 , but not 16:0 , showed a significant decrease after intake of ND compared to the control diet ( p<0.01 ) . Also , a significant increase in serum 22:6n – 3 was observed compared with the control diet ( p<0.01 ) . The changes in CE-SFA 14:0 , 15:0 , and 18:0 correlated positively with changes in LDL-C , HDL-C , LDL-C/HDL-C , ApoA1 , and ApoB ( p<0.01 ) , respectively , whereas the changes in polyunsaturated fatty acids in cholesterol esters ( CE-PUFA ) 22:6n – 3 were negatively correlated with changes in the corresponding serum lipids . Conclusions The decreased intake of saturated fat and increased intake of n-3 PUFA in a  healthy ND is partly reflected by changes in the serum CE-FA composition , which are associated with an improved serum lipoprotein pattern Bias in self-reported dietary intake is important when evaluating the effect of dietary interventions , particularly for intervention foods . However , few have investigated this in children , and none have investigated the reporting accuracy  of fish intake in children using biomarkers . In a Danish school meal study , 8- to 11-year-old children ( n 834 ) were served the New Nordic Diet ( NND ) for lunch . The present study examined the accuracy of  self-reported intake  of signature foods ( berries , cabbage , root vegetables , legumes , herbs , potatoes , wild plants , mushrooms , nuts and fish ) characterising the NND . Children , assisted by parents , self-reported their diet in a Web-based Dietary Assessment Software for Children during the intervention and control ( packed lunch ) periods . The reported fish intake by children was compared with their ranking according to fasting whole-blood EPA and DHA concentration and weight percentage using the Spearman correlations and cross-classification . Direct observation of school lunch intake ( n 193 ) was used to score the accuracy of food-reporting as matches , intrusions , omissions and faults . The reporting of all lunch foods had higher percentage of matches compared with the reporting of signature foods in both periods , and the accuracy was higher during the control period compared with the intervention period . Both Spearman 's rank correlations and linear mixed models demonstrated positive associations between EPA+DHA and reported fish intake . The direct observations showed that both reported and real intake of signature foods did increase during the intervention period . In conclusion , the self-reported data represented a true increase in the intake of signature foods and can be used to examine dietary intervention effects Background : Recently , the Nordic diet has gained interest , and a healthy Nordic food index has been developed , which has been found inversely related to colorectal cancer among Danish women . This single finding , however , requires replication in other cohorts . Methods : We conducted a prospect i ve study in the Women 's Lifestyle and Health cohort , including 45,222 women , recruited in 1991–92 , and followed up ever since through Swedish registries . Participants were classified according to the Nordic food index ( consisting of whole grain bread , oatmeal , apples/pears , cabbages , root vegetables , and fish/shellfish ) , and the association between adherence and colorectal cancer was assessed using the Cox proportional hazards models . Results : In the fully adjusted models , we found no association , neither with the continuous index score [ incidence rate ratio ( IRR ) , 1.04 ; 95 % confidence interval ( CI ) , 0.95–1.12 , per 1-point increment ] nor in the categorical analyses ( IRR , 1.09 ; 95 % CI , 0.78–1.52 for highest vs. lowest adherers ) . Conclusion : The present study does , thus , not support a previous finding of an inverse association between a healthy Nordic food index and colorectal cancer . Impact : This article adds new evidence to the field of the Nordic diet in disease prevention . Cancer Epidemiol Biomarkers Prev ; 24(4 ) ; 755–7 . © 2015 AACR The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD . However , the extent of food changes needed to achieve these effects is less explored . The aim of the present study was to investigate the effects of exchanging a few commercially available , regularly consumed key food items ( e.g. spread on bread , fat for cooking , cheese , bread and cereals ) with improved fat quality on total cholesterol , LDL-cholesterol and inflammatory markers in a double-blind r and omised , controlled trial . In total , 115 moderately hypercholesterolaemic , non-statin-treated adults ( 25 - 70 years ) were r and omly assigned to an experimental diet group ( Ex-diet group ) or control diet group ( C-diet group ) for 8 weeks with commercially available food items with different fatty acid composition ( replacing SFA with mostly n-6 PUFA ) . In the Ex-diet group , serum total cholesterol ( P<0·001 ) and LDL-cholesterol ( P<0·001 ) were reduced after 8 weeks , compared with the C-diet group . The difference in change between the two groups at the end of the study was -9 and -11 % in total cholesterol and LDL-cholesterol , respectively . No difference in change in plasma levels of inflammatory markers ( high-sensitive C-reactive protein , IL-6 , soluble TNF receptor 1 and interferon-γ ) was observed between the groups . In conclusion , exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol , with no negative effect on levels of inflammatory markers . This shows that an exchange of a few commercially available food items was easy and manageable and led to clinical ly relevant cholesterol reduction , potentially affecting future CVD risk Background / Objectives : Short-term studies have suggested beneficial effects of a Palaeolithic-type diet ( PD ) on body weight and metabolic balance . We now report the long-term effects of a PD on anthropometric measurements and metabolic balance in obese postmenopausal women , in comparison with a diet according to the Nordic Nutrition Recommendations (NNR).Subjects/ Methods : Seventy obese postmenopausal women ( mean age 60 years , body mass index 33 kg/m2 ) were assigned to an ad libitum PD or NNR diet in a 2-year r and omized controlled trial . The primary outcome was change in fat mass as measured by dual-energy X-ray absorptiometry . Results : Both groups significantly decreased total fat mass at 6 months ( −6.5 and −2.6 kg ) and 24 months ( −4.6 and −2.9 kg ) , with a more pronounced fat loss in the PD group at 6 months ( P<0.001 ) but not at 24 months ( P=0.095 ) . Waist circumference and sagittal diameter also decreased in both the groups , with a more pronounced decrease in the PD group at 6 months ( −11.1 vs−5.8 cm , P=0.001 and −3.7 vs−2.0 cm , P<0.001 , respectively ) . Triglyceride levels decreased significantly more at 6 and 24 months in the PD group than in the NNR group ( P<0.001 and P=0.004 ) . Nitrogen excretion did not differ between the groups . Conclusions : A PD has greater beneficial effects vs an NNR diet regarding fat mass , abdominal obesity and triglyceride levels in obese postmenopausal women ; effects not sustained for anthropometric measurements at 24 months . Adherence to protein intake was poor in  the PD group . The long-term consequences of these changes remain to be studied We served a low-fat ( 28 % of energy ) high-fibre ( 3.3 g/MJ ) diet according to Nordic Nutrition Recommendations ( REC diet ) , and a high-fat diet ( 39 % of energy ) corresponding to the average Danish diet ( DANE diet ) to 21 healthy middle-aged individuals in a two times two weeks cross-over study . The REC diet result ed in lower serum concentrations of low density lipoprotein ( LDL ) cholesterol ( medians : 2.77 vs 3.04 mmol/l , p < 0.001 ) , and high-density lipoprotein ( HDL ) cholesterol ( 1.08 vs 1.24 mmol/l , p < 0.001 ) , and higher fasting triglycerides ( 1.11 vs 0.86 mmol/l , p = 0.04 ) than the DANE diet . Furthermore , the REC diet lowered plasma factor VII coagulant activity ( FVIIc ) ( 88 vs 96 % , p = 0.002 ) and raised plasma fibrinolytic activity . Our observations indicate that a low-fat high-fibre diet may not only reduce the atherogenic , but also the thrombogenic tendency of an individual compared with a diet corresponding to the average Danish diet Introduction : Danish children consume too much sugar and not enough whole grain , fish , fruit , and vegetables . The Nordic region is rich in such foods with a strong health-promoting potential . We lack r and omised controlled trials that investigate the developmental and health impact of serving school meals based on Nordic foods . Aim : This paper describes the rationale , design , study population , and potential implication s of the Optimal well-being , development and health for Danish children through a healthy New Nordic Diet ( OPUS ) School Meal Study . Methods : In a cluster-r and omised cross-over design , 1021 children from 3rd and 4th grade s ( 8–11 years old ) at nine Danish municipal schools were invited to participate . Classes were assigned to two 3-month periods with free school meals based on the New Nordic Diet ( NND ) or their usual packed lunch ( control ) .  Dietary intake , nutrient status , physical activity , cardiorespiratory fitness , sleep , growth , body composition , early metabolic and cardiovascular risk markers , illness , absence from school , wellbeing , cognitive function , social and cultural features , food acceptance , waste , and cost were assessed . Results : In total , 834 children ( 82 % of those invited ) participated . Although their parents were slightly better educated than the background population , children from various socioeconomic background s were included . The proportion of overweight and obese children ( 14 % ) resembled that of earlier examinations of Danish school children . Drop out was 8.3 % . Conclusions : A high inclusion rate and low drop out rate was achieved . This study will be the first to determine whether school meals based on the NND improve children ’s diet , health , growth , cognitive performance , and early disease risk markers OBJECTIVE the aim of this study was to investigate the effects of a healthy Nordic diet ( ND ) on cardiovascular risk factors . DESIGN AND SUBJECTS in a r and omized controlled trial ( NORDIET ) conducted in Sweden , 88 mildly hypercholesterolaemic subjects were r and omly assigned to an ad libitum ND or control diet ( subjects ' usual Western diet ) for 6 weeks . Participants in the ND group were provided with all meals and foods . Primary outcome measurements were low-density lipoprotein ( LDL ) cholesterol , and secondary outcomes were blood pressure ( BP ) and insulin sensitivity ( fasting insulin and homeostatic model assessment -insulin resistance ) . The ND was rich in high-fibre plant foods , fruits , berries , vegetables , whole grains , rapeseed oil , nuts , fish and low-fat milk products , but low in salt , added sugars and saturated fats . RESULTS the ND contained 27 % , 52 % , 19 % and 2 % of energy from fat , carbohydrate , protein and alcohol , respectively . In total , 86 of 88 subjects r and omly assigned to diet completed the study . Compared with controls , there was a decrease in plasma cholesterol ( -16 % , P < 0.001 ) , LDL cholesterol ( -21 % , P < 0.001 ) , high-density lipoprotein ( HDL ) cholesterol ( -5 % , P < 0.01 ) , LDL/HDL ( -14 % , P < 0.01 ) and apolipoprotein (apo)B/apoA1 ( -1 % , P < 0.05 ) in the ND group . The ND reduced insulin ( -9 % , P = 0.01 ) and systolic BP by -6.6 ± 13.2 mmHg ( -5 % , P < 0.05 ) compared with the control diet . Despite the ad libitum nature of the ND , body weight decreased after 6 weeks in the ND compared with the control group ( -4 % , P < 0.001 ) . After adjustment for weight change , the significant differences between groups remained for blood lipids , but not for insulin sensitivity or BP . There were no significant differences in diastolic BP or triglyceride or glucose concentrations . CONCLUSIONS a healthy ND improves blood lipid profile and insulin sensitivity and lowers blood pressure at clinical ly relevant levels in hypercholesterolaemic subjects Biomarkers of dietary intake can be important tools in nutrition research . Our aim was to assess whether plasma alkylresorcinol ( AR ) and β-carotene concentrations could be used as dietary biomarkers for whole-grain , fruits and vegetables in a healthy Nordic diet ( ND ) . Participants ( n = 166 ) , 30 - 65 y with a body mass index of 27 - 40 kg/m(2 ) and two more features of metabolic syndrome ( International Diabetes Federation definition , slightly modified ) , were recruited through six centers in the Nordic countries and r and omly assigned to an ND or control diet for 18 or 24 wk , depending on study center . Plasma AR and β-carotene were analyzed and nutrient intake calculated from 4-d food records . Median fiber intake increased in the ND group from 2.5 g/MJ at baseline to 4.1 g/MJ ( P < 0.001 ) at end point ( week 18 or 24 ) , and median ( IQR ) fasting plasma total AR concentration increased from 73 ( 88 ) to 106 ( 108 ) nmol/L , or 45 % , from baseline to end point ( P < 0.001 ) . The AR concentration was significantly higher in the ND group ( P < 0.001 ) than in the control group at end point . β-Carotene intake tended to increase in the ND group ( P = 0.07 ) , but the plasma β-carotene concentration did not change significantly throughout the study and did not differ between the groups at follow-up . In conclusion , an ND result ed in higher dietary fiber intake and increased plasma total AR concentration compared with the control diet , showing that the total AR concentration might be a valid biomarker for an ND in which whole-grain wheat and rye are important components . No significant difference in plasma β-carotene concentrations was observed between the ND and control groups , suggesting that β-carotene may not be a sensitive enough biomarker of the ND
target: Conclusion The Nordic dietary pattern  improves blood pressure and also some of blood lipid markers and it should be considered as a healthy dietary pattern
background: Background and aims The Nordic diet ( ND ) , is supposed to be associated with a reduced cardiovascular risk ; however , clinical trials have led to inconsistent results regarding the effect of this diet on cardio-metabolic markers .
  Using systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , this study aim ed to investigate the effect of the ND on circulating levels of total , low-density lipoprotein ( LDL ) , and high-density lipoprotein ( HDL ) cholesterol , and triglyceride ( TG ) , as well as blood pressure in human adults .