Adherence to the Nordic Nutrition Recommendations 2023 and risk of Myocardial Infarction: The Danish Diet, Cancer and Health cohort
In a large Danish cohort study, higher adherence to the 2023 Nordic Nutrition Recommendations was found to be significantly associated with a reduced risk of myocardial infarction in both men and women, with the risk decreasing linearly as adherence increased.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
For decades, scientists have known that what we eat shapes our health, particularly our heart. Unhealthy diets are a leading cause of heart attacks, a condition where blood flow to the heart muscle is blocked, causing severe damage or death. In the Nordic countries, poor eating habits are estimated to be responsible for the vast majority of cardiovascular deaths. While doctors and nutritionists have long advised people to eat more vegetables and fewer processed meats, a new challenge has emerged: how to eat well for our bodies while also protecting the planet. The foods we choose have a heavy footprint on the environment, from the greenhouse gases emitted by livestock to the water used to grow crops. In response, experts in the Nordic region recently updated their official dietary advice to balance human health with environmental sustainability. These new guidelines, known as the Nordic Nutrition Recommendations 2023, suggest shifting away from red meat and toward more plant-based foods like whole grains, legumes, and berries. But a critical question remained unanswered: does following these new, eco-friendly rules actually lower the risk of having a heart attack?
To find the answer, researchers turned to a massive group of people living in Denmark. They studied nearly 55,000 men and women who were between 50 and 65 years old when they first joined the study in the mid-1990s. At the start, these participants filled out detailed questionnaires about what they typically ate over the previous year, listing everything from the coffee they drank to the fish they ate. The researchers then used a scoring system based on the new 2023 guidelines to rate how well each person's diet matched the recommendations. This score looked at fifteen different food groups, giving points for eating more of the "encouraged" items like vegetables and whole grains, and fewer points for "discouraged" items like red meat and added sugar. The team then tracked these participants for many years, checking national health records to see who developed a heart attack. By comparing the diets of those who had heart attacks against those who did not, the researchers could see if sticking to the new guidelines made a difference.
The results were clear and encouraging. The study found that people who followed the new Nordic recommendations more closely had a lower rate of heart attacks. This pattern held true for both men and women, and the risk dropped steadily as the diet scores improved. The relationship appeared to be a straight line: the more a person adhered to the guidelines, the lower their risk. When looking at the group with the highest adherence, who scored between 11 and 15 points on the diet scale, the reduction in risk was significant. For women in this high-scoring group, the risk of a heart attack was roughly 37 percent lower than for women with the lowest scores. For men, the risk was about 22 percent lower, though this finding was just on the edge of statistical certainty. The researchers noted that no one in the study achieved a perfect score of 15, and the lowest score was 3, suggesting that even small improvements in diet could offer benefits.
Digging deeper into the specific foods, the researchers found that whole grains were the most powerful driver of this protection. Whether for men or women, eating more whole grains was strongly linked to a lower risk of heart attack. Other components also played a role; for men, eating less processed meat and less added sugar was associated with better outcomes, while for women, drinking less fruit juice was a key factor. The study also ruled out the idea that these results were simply because healthier eaters happened to be richer, more educated, or more active. The researchers carefully adjusted their calculations to account for smoking, physical activity, education levels, and existing health conditions like diabetes or high blood pressure. Even after accounting for these factors, the link between the diet and a lower heart attack rate remained strong, particularly for women.
This work provides strong evidence that the new Nordic guidelines are not just good for the environment, but are also a practical strategy for preventing heart disease. The study suggests that a diet focused on whole grains, vegetables, and plant-based proteins, while limiting red meat and processed foods, offers a dual benefit for human and planetary health. While the researchers cannot say with absolute certainty that the diet caused the lower risk in every single case, the large size of the group and the long period of observation make the connection very robust. The findings indicate that people do not have to choose between eating for their heart and eating for the climate; the two goals align, with the simple act of choosing whole grains and vegetables offering a clear path to a healthier heart.
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