A national dietary analysis reveals striking differences in how Finnish adults measure up against newer Nordic targets for plant foods, meat, dairy, and fish.
Study: Adherence to the Nordic food-based dietary guidelines in subgroups of the Finnish adult population. Image Credit: Nattika / Shutterstock
In a recent study published in the journal Food & Nutrition Research, researchers examined adherence to the quantitative recommendations of the food-based dietary guidelines (FBDGs) of the 2023 edition of the Nordic Nutrition Recommendations (NNR) in Finnish adults using dietary data collected in 2017.
A healthy diet is a crucial factor that influences population health. Greater FBDG adherence has been reported to benefit environmental sustainability and human health. The need to incorporate environmental sustainability into FBDGs has been increasingly recognized as important for achieving the United Nations' Sustainable Development Goals.
The most recent NNR, published in 2023, considered the environmental impact of food systems and food intake in addition to health-oriented FBDGs. These FBDGs included eight descriptive and seven quantitative recommendations for food groups. Yet adherence to these quantitative recommendations has not been evaluated in Nordic populations.
About the study
In the present study, researchers evaluated adherence to the quantitative food group recommendations in the NNR 2023 FBDGs among Finnish adults. Participants from the FinDiet 2017 survey were included. Dietary intake was examined using two non-consecutive 24-hour dietary recalls administered by trained interviewers. Dietary information was logged using in-house software that incorporated the Finnish food composition database.
Dishes were disaggregated into ingredients and grouped according to the database's food grouping system to estimate daily food, energy, and nutrient intakes. The researchers then composed plant- and animal-based food groups for which the FBDGs provided quantitative recommendations. Food groups included whole grains, vegetable oils, fish and seafood, milk and dairy products, red and processed meat, nuts and seeds, and vegetables, fruits, and berries. For the analysis, researchers combined red and processed meat and applied the quantitative red-meat limit, although NNR 2023 separately advises keeping processed meat intake as low as possible.
Men and women were analyzed separately, given sex differences in food and energy intake. The researchers estimated usual food-group intakes across subgroups defined by age, BMI, education, leisure-time physical activity, and energy intake using the National Cancer Institute (NCI) method developed in the United States. The same method was used to estimate the proportions of the sample that met, exceeded, or fell short of the recommendations.
Findings
The study included 1,655 participants, 53% of whom were women, with a mean age of 51 years. The modeled mean daily intake of plant-based foods was generally low in both sexes, with most participants falling short of the recommendations. The proportions falling below the recommendations for plant-based food groups ranged between 66% for vegetable oils among men and 96% for whole grains among women. Nuts and seeds were not included in sex-specific subgroup modeling because intake was too infrequent for reliable estimates. Men had a higher intake of whole grains than women.
Participants in the highest energy-intake group were more likely to meet the whole-grain target than those in the lowest energy-intake group. Women had higher intakes of vegetables, fruits, and berries and tended to reach the recommended range more often than men. The physically active, highest-education, and highest-energy-intake groups were also more likely to reach this target than the lowest-education and lowest-energy-intake groups.
Vegetable oil intake was greater among men, who were more likely than women to reach the target. In both sexes, participants with the highest energy intake were more likely to reach the vegetable oil target than those with the lowest intake. The modeled mean daily intake of animal-based food groups, except for fish and seafood, exceeded the recommendations for both sexes, and men were more likely than women to exceed them.
In particular, men consumed almost twice as much red and processed meat as women. Differences in adherence by education varied by sex: men in the highest education group were more likely to reach the target than those in the middle group, while women in the highest group were more likely to reach the target than those in the lowest group. The lowest-energy-intake groups in both sexes were more likely to remain within the red and processed meat targets than the highest-energy-intake groups. While men had a higher intake of milk and dairy products, women were about twice as likely to fall within the recommended range.
Participants in the lowest physical activity and energy intake groups were more likely to fall within the recommended dairy range than those in the highest groups. The oldest men were more likely to fall within this range than the youngest men, whereas the oldest women were more likely than the middle-aged women. There were no significant differences in fish and seafood intake between sexes, and the only subgroup difference in adherence was among men, with physically active men more likely than inactive men to reach the recommended range.
Conclusions
The 2017 dietary data indicated that Finnish adults were far from meeting the quantitative food group recommendations later set out in the NNR 2023. Plant-based food intake was generally below recommended levels, while red and processed meat and milk and dairy intake exceeded the study's targets; fish and seafood intake was below the recommended range. Age, physical activity, education, and energy intake were associated with adherence to FBDGs and should be considered in policy and interventions. No differences in adherence were detected between BMI groups.
The cross-sectional design means these associations cannot establish causation. The authors also cited possible recall bias, the lack of energy-standardized food targets, and the inability to assess adherence to all FBDGs simultaneously as study limitations.
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