dc.contributor.advisor | Skeie, Guri | |
dc.contributor.author | Jensen, Torill | |
dc.date.accessioned | 2024-09-11T09:34:09Z | |
dc.date.available | 2024-09-11T09:34:09Z | |
dc.date.issued | 2024-10-10 | |
dc.description.abstract | <p><i>Background:</i> Noncommunicable diseases (NCDs) such as cancer and cardiovascular diseases (CVDs) are predominant causes of mortality in Norwegian women. With a national goal to reduce premature mortality from NCDs by 33% by 2030, Norway is also committed to achieving Sustainable Development Goals, including those related to climate change. The Food and Agriculture Organization (FAO) emphasizes the importance of adopting traditional diets that incorporate local foods.
<p><i>Aim:</i> This study investigates the adherence to the healthy Nordic diet among Norwegian women and the association between healthy Nordic food groups and mortality. It also examines the impact of replacing red and processed meat with fish on mortality.
<p><i>Methods:</i> Using data from the Norwegian Women and Cancer Study (NOWAC), which includes over 170,000 participants, this research assessed adherence through the Healthy Nordic Food Index (HNFI). Cox proportional hazard models and restricted cubic splines were employed to analyze the relationship between the healthy Nordic food groups and all-cause mortality. Substitution analyses were also performed to evaluate the effects of replacing red and processed meats with fish on specific mortality causes.
<p><i>Results:</i> The findings indicate that most participants had moderate adherence to the HNFI. Higher consumption of lean fish and whole grains was associated with lower all-cause mortality. The intake of Nordic fruits and vegetables, fatty fish, and low-fat dairy showed a non-linear association with mortality, with moderate consumption being most beneficial. Substituting processed meat with lean fish significantly decreased all-cause, cancer, and CVD mortality.
<p><i>Conclusion:</i> Promoting whole grains, lean fish, and Nordic fruits and vegetables within the diet could enhance longevity in Norwegian women. Encouraging the replacement of processed meat with lean fish may further reduce mortality, especially from CVDs. Additional studies are needed to assess the health impacts of other Nordic diet components and refine our understanding of its benefits on mortality. | en_US |
dc.description.abstract | <p><i>Bakgrunn:</i> Ikke-smittsomme sykdommer (NCD) som kreft og hjerte- og karsykdommer (CVD) er dominerende årsaker til dødelighet hos norske kvinner. Med et nasjonalt mål om å redusere for tidlig dødelighet fra NCDer med 33 % innen 2030, er Norge også forpliktet til å nå bærekraftsmålene, inkludert de som er knyttet til klimaendringer. Food and Agriculture Organization (FAO) understreker viktigheten av tradisjonelle regionale kosthold for å nå disse målene.
<p><i>Mål:</i> Denne studien undersøker etterlevelsen av det sunne nordiske kostholdet blant norske kvinner og sammenhengen mellom sunne nordiske matvaregrupper og dødelighet. Den undersøker også sammenhengen mellom å erstatte rødt og bearbeidet kjøtt med fisk og dødeligheten.
<p><i>Metoder:</i> Ved å bruke data fra Norwegian Women and Cancer Study (NOWAC), som inkluderer over 170 000 deltakere, har denne forskningen vurdert etterlevelse gjennom Healthy Nordic Food Index (HNFI). Cox proporsjonale hasardmodeller og «restricted cubic splines» ble brukt for å analysere forholdet mellom de sunne nordiske matvaregruppene og dødelighet. Substitusjonsanalyser ble også utført for å evaluere sammenhengen mellom å erstatte rødt og bearbeidet kjøtt med fisk og dødelighet.
<p><i>Resultater:</i> Funnene indikerer at de fleste deltakerne hadde moderat etterlevelse av HNFI. Høyere inntak av mager fisk og fullkornsprodukter var assosiert med lavere dødelighet av alle årsaker. Inntaket av nordisk frukt og grønnsaker, fet fisk og magre meieriprodukter viste en ikke-lineær sammenheng med dødelighet, med moderat forbruk som mest fordelaktig. Det å erstatte bearbeidet kjøtt med mager fisk reduserte betydelig dødelighet av alle årsaker, kreft og hjerte-kar-sykdom.
<p><i>Konklusjon:</i> Å fremme fullkorn, mager fisk og nordisk frukt og grønnsaker i kostholdet kan øke levetiden hos norske kvinner. Det å erstatte bearbeidet kjøtt med mager fisk kan redusere dødeligheten, blant kvinner med høyere inntak av bearbeidet kjøtt. | en_US |
dc.description.doctoraltype | ph.d. | en_US |
dc.description.popularabstract | Noncommunicable diseases, including cancer and cardiovascular diseases, are major causes of death in Norway. Norway has set targets to reduce premature deaths from these diseases and to meet Sustainable Development Goals aimed at protecting the environment and climate. Emphasizing the adoption of regional diets that utilize local foods is a key strategy in this initiative. This thesis explored how closely Norwegian women adhere to the healthy Nordic diet and the association between healthy Nordic food groups and mortality. The results indicated that a higher consumption of whole grain products, lean fish, and moderate amounts of Nordic fruits and vegetables could increase longevity among Norwegian women. Additionally, replacing processed meat with lean fish could reduce mortality for those who typically consume processed meat. | en_US |
dc.identifier.uri | https://hdl.handle.net/10037/34682 | |
dc.language.iso | eng | en_US |
dc.publisher | UiT The Arctic University of Norway | en_US |
dc.publisher | UiT Norges arktiske universitet | en_US |
dc.relation.haspart | <p>Paper I: Jensen, T.E., Braaten, T., Jacobsen, B.K., Barnung, R.B., Olsen, A. & Skeie, G. (2018). Adherence to the Healthy Nordic Food Index in the Norwegian Women and Cancer (NOWAC) cohort. <i>Food & Nutrition Research, 62</i>, 1339. Also available in Munin at <a href=https://hdl.handle.net/10037/13970>https://hdl.handle.net/10037/13970</a>.
<p>Paper II: Jensen, T.M.E., Braaten, T., Jacobsen, B.K. & Skeie, G. (2022). Non-linear associations between healthy Nordic foods and all-cause mortality in the NOWAC study: a prospective study. <i>BMC Public Health, 22</i>, 169. Also available in Munin at <a href=https://hdl.handle.net/10037/24512>https://hdl.handle.net/10037/24512</a>.
<p>Paper III: Jensen, T.M.E., Braaten, T., Jacobsen, B.K., Ibsen, D.B. & Skeie, G. (2024). Replacing red and processed meat with lean or fatty fish and all-cause and cause-specific mortality in Norwegian women. The Norwegian Women and Cancer Study (NOWAC): a prospective cohort study. <i>British Journal of Nutrition, 131</i>(3), 531-543. Also available in Munin at <a href=https://hdl.handle.net/10037/32178>https://hdl.handle.net/10037/32178</a>. | en_US |
dc.rights.accessRights | openAccess | en_US |
dc.rights.holder | Copyright 2024 The Author(s) | |
dc.subject.courseID | DOKTOR-003 | |
dc.subject | Nordic diet | en_US |
dc.subject | Lean fish | en_US |
dc.subject | Fatty fish | en_US |
dc.subject | Whole grain products | en_US |
dc.subject | Nordic fruits and vegetables | en_US |
dc.subject | Low-fat dairy | en_US |
dc.subject | Processed meat | en_US |
dc.subject | Red meat | en_US |
dc.subject | Mortality | en_US |
dc.subject | Non-linear | en_US |
dc.subject | Substitution analyses | en_US |
dc.title | Nordic diet and mortality: The Norwegian Women and Cancer study | en_US |
dc.type | Doctoral thesis | en_US |
dc.type | Doktorgradsavhandling | en_US |