NORDIC NUTRITION RECOMMENDATIONS 2023

For more information about the health effects, please refer to the background paper by Henna Vepsäläinen and Jaana Lindström (2023). For more information about the environmental impacts, please refer to the following background papers (Benton et al., 2022; Harwatt et al., 2023; Meltzer et al., 2023; Trolle et al., 2023).

Food and nutrient intake. Dietary patterns attempt to describe the totality of the diet over a given time. A dietary pattern can be defined as the quantities, proportions, variety, or combination of foods and drinks typically consumed. The dietary pattern approach aims to place the emphasis on the total diet as a long-term health determinant, instead of focusing on separate foods and nutrients, which may interact or confound each other.

Health effects. Several qSRs on the role of dietary patterns and health effects are available (2020 Dietary Guidelines Advisory Committee, 2020; Boushey et al., 2020a, b, c, d, e, f, g) . The conclusions from these qSRs are described in detail in Vepsäläinen and Lindström (2023).

A healthy diet can be characterized as follows: high in vegetables, fruits, whole grains, fish, low-fat dairy, and legumes and low in red and processed meats, sugar-sweetened beverages, high sugar foods, and refined grains. Such dietary patterns are often micronutrient dense, including high intake of unsaturated fats and fibre, and low intake of saturated fats, added sugar and sodium. Healthy dietary patterns are associated with beneficial health outcomes, such as reduced risk of cardiovascular disease, type 2 diabetes, obesity, cancer, bone health, and premature death (Vepsäläinen & Linström, 2023).  

Environmental impacts. The current average Nordic diets greatly exceed the planetary boundaries related to GHG emissions cropland use, biodiversity, nitrogen use, and phosphorus use (Harwatt et al., 2023; Trolle et al., 2023). The water footprint is mainly located outside the Nordic regions (Trolle et al., 2023). In Nordic dietary patterns, the majority of the GHGE are from ruminant meat and dairy with some country- and gender-specific differences (Harwatt et al., 2023; Meltzer et al., 2023; Trolle et al., 2023). Transitioning from the current Nordic diets to the previous national FBDGs (which are based on NNR2012) would reduce GHG emissions. Larger changes, within the framework of the recommendations in NNR2023, are needed to stay within the limits of planetary boundary for  GHG emissions. The environmental impact of dietary patterns depends on the specific foods included, thus also including type of production and site-specific impacts. The foodstuffs comprising the diet should contribute positively and/or have the least negative impact on the environment. In order for dietary patterns to be resource efficient it is fundamental to reduce overconsumption and prevent food waste including using several parts of the animal/plant and encouraging combined systems, e.g., meat and dairy production. 

Main data gaps. There is a lack of a comprehensive, structured information on pre-defined and explicit dietary patterns over time in the Nordic and Baltic countries. There is a need for more studies on health effects of different dietary patterns in certain subgroups, such as children, adolescents, and the frail older adults.  There is a lack of precision and nuance in present modelling of environmental impact of diets. This is due to a lack of studies providing modelling data on environmental aspects other than climate impact such as biodiversity aspects. Data on region of origin and local conditions constitute fundamental input data for modelling but these are usually lacking for imported products. There is also a need for data on variation within product groups. Moreover, the production of supplements and fortification have environmental impact, though there is a lack of data on this.

Risk groups. People with relatively low energy requirement and those with low appetite (e.g., frail older adults) are at risk of low nutrient intake even when eating a healthy and sustainable diet.