A Healthy Nordic diet score and risk of incident coronary heart disease among men: the Kuopio Ischaemic Heart Disease Risk Factor Study.

Healthy Nordic diet has been beneficially associated with coronary heart disease (CHD) risk factors, but few studies have investigated risk of developing CHD. We investigated the associations of healthy Nordic diet with major CHD risk factors, carotid atherosclerosis, and incident CHD in middle-aged and older men from eastern Finland. A total of 1981 men aged 42-60 years and free of CHD at baseline in 1984-1989 were investigated. Diet was assessed with 4-d food recording and the healthy Nordic diet score was calculated based on the Baltic Sea Diet Score. Carotid atherosclerosis was assessed by ultrasonography of the common carotid artery intima-media thickness in 1053 men. Analysis of covariance and Cox proportional hazards regression analyses were used for analyses. Healthy Nordic diet score associated with lower serum C-reactive protein concentrations (multivariable-adjusted extreme-quartile difference 0.69 mg/L, 95% confidence interval 0.15-1.22 mg/L), but not with serum lipid concentrations, blood pressure, or carotid atherosclerosis. During the average follow-up of 21.6 years (SD 8.3 years), 407 men had a CHD event, of which 277 were fatal. The multivariable-adjusted hazard ratios (95% confidence interval) in the lowest vs. the highest quartile of the healthy Nordic diet score were 1.10 (0.85-1.45) for any CHD event (P-trend 0.429) and 1.38 (0.95-2.00) (P-trend 0.119) for fatal CHD event. We did not find evidence that adherence to a healthy Nordic diet would be associated with a lower risk of CHD or with carotid atherosclerosis or major CHD risk factors, except for an inverse association with serum C-reactive protein concentrations.