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Nordic Food Associated with Lowering Risk of Type 2 Diabetes

Diet containing foods high in antioxidants found to reduce risk of stroke.

Many studies have focused on the effects of different dietary foods that lower the risk of type 2 diabetes such as whole grains, dietary fiber, root vegetables, and green leafy vegetables. While previous research has been mainly on single foods or nutrients, it may be more relevant to examine a combination of a variety of foods as meals consist of combinations of numerous nutrients and foods.

Previous research has showed that the Mediterranean diet reduced the risk of developing diabetes. A prospective cohort study looking at 13,380 Spanish university graduates over a median of 4.4 years showed that the Mediterranean diet reduced the risk of diabetes. Dietary habits were assessed using a 136-item food frequency questionnaire and scored on a nine-point index. The results from the study showed that a two-point increase in the score was associated with a 35% relative reduction in the risk of diabetes.

While it is clear that Mediterranean food could reduce risk of diabetes, a recent study looked at the Nordic diet impact on diabetes. A Danish prospective cohort study aims to look at people eating a variety of food and their risk of type 2 diabetes. Study subjects who were living in the Copenhagen and Aarhus areas were enrolled from December 1993 to May 1997. A total of 55,060 subjects were enrolled ranging from 50-64 years old. The study looked at the association between adherence of a healthy Nordic food index and the risk of type 2 diabetes. The Nordic food index was composed of six food items: fish, cabbage, rye bread, oatmeal, apples and pears, and root vegetables.  The study found that greater adherence to the healthy Nordic food index statistically significantly reduced risk of type 2 diabetes by 25% in women and 38% in men. These results offer patients more options in their daily diet while remaining healthy.

Other studies looking at fruits and vegetables reinforce the results found in the Danish study as well as bring insights to additional benefits. Fruits such as apples are rich in antioxidants that reduce the risk of other diseases. Antioxidants directly scavenge free radicals and increase endogenous cellular defensese. Phloretin and pectic acid, found in apples, have been shown to induce apoptosis in cancer cells. A study looking directly at human breast cancer cells shows that pectic acid inhibited cell growth and reduced cell attachment after 24 hours of incubation. The findings from the study indicated that pectic acid induced caspase-dependent apoptosis and apoptosis frequency increased after 24 hours incubation.

Daily intake of fruits and vegetables have also been shown to reduce the risk of stroke through the presence of pigmented bioactive compounds such as carotenoids, anthocyanidins, and flavonoids. A large prospective cohort study looking at 20,069 men and women age 20 to 65 looked at the risk of stroke associated with the intake of fruits and vegetables. The study accounted for age, sex, lifestyle, and dietary factors. Results showed that green, orange/yellow, and red/purple fruits and vegetables were not associated with the incidence of stroke.

Interestingly, higher intake of white fruits and vegetables was inversely associated with an incidence of stroke with the most common white fruit being apples and pears. The study showed that a 25-gram increase in daily intake of fruits and vegetables reduced the risk of stroke by 9%.

Presently, there are data suggesting that Mediterranean food reduces risk of type 2 diabetes. This recent study suggests that Nordic food may also be recommended for the prevention of type 2 diabetes. The findings of the Danish study are reinforced by other studies looking at components of the Nordic diet.

Food containing high levels of antioxidants provide a wide array of benefits. Through these studies, patients have a wider variety in their diet and daily intake so that they may choose one that best suit their needs.

Practice Pearls:

  • Dietary patterns should look at whole meals consisting of multiple foods rather than single foods or nutrients.
  • Nordic food is an alternative to Mediterranean food in reducing the risk of type 2 diabetes, reducing risk by 25% in women and 38% in men.
  • Food rich in antioxidants not only reduces risk in diabetes, but also offer a wide variety of benefits such as reduction in the risk of stroke.

Martínez-González, M. Á., et al. “Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study.” Bmj 336.7657 (2008): 1348-1351.

Lacoppidan, Sandra Amalie, et al. “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.” Nutrients 7.10 (2015): 8633-8644.

Delphi, Ladan, et al. “Pectic-Oligoshaccharides from Apples Induce Apoptosis and Cell Cycle Arrest in MDA-MB-231 Cells, a Model of Human Breast Cancer.”Asian Pacific journal of cancer prevention: APJCP 16.13 (2015): 5265.

Griep, Linda M. Oude, et al. “Colors of fruit and vegetables and 10-year incidence of stroke.” Stroke 42.11 (2011): 3190-3195.