Conclusion
The Nordic Monitoring System comprises data collected in 2011, 2014 and 2024. Results from 2024 are presented in the report and compared to 2014 where relevant.
The overall picture shows that the behavior in the Nordic region has not become healthier and more sustainable. The diet in the Nordic region has become less aligned with the Nordic Nutrition Recommendations 2023 (NNR2023). Contrary to 2014, fruits and vegetables have declined or been stable in the Nordic countries, and whole-grain bread have declined among both adults and children, and discretionary drinks have increased, while discretionary foods have increased in children but broadly unchanged in adults. Meat intake is relatively high, while intake of pulses is low, and fish consumption is generally low. Results in 2014 indicated one favorable development in dietary intake among adults and children in terms of a reduction in the intake of added sugar. Results in 2024 indicate that this has not been the case in 2014 to 2024.
Alcohol consumption remains a widespread behavior, typically 1–2 times per week, as in 2014, while adults reporting binge drinking at least once in the past month remains high, but has declined to nearly 40% compared to 45% in 2014, due to modest decline in Norway and Sweden.
Physical inactivity and sedentary time are still high in adults and children in the Nordic region. About one in four to one in three adults were physically inactive (= not meeting the recommendations) across the Nordic countries and adults spent around 3.5–4 hours per day on recreational screen use; approximately one in four reported high screen time (> 4 h/day). Physical inactivity (= not meeting the recommendations) affected roughly about half of the children. Children spent between 2.75 and 3.5 hours per day on recreational screen time, and 12–16 % exceeded four hours daily. The proportion of adults and children not meeting the physical activity recommendations ranged from 24 to 29% and 35 to 59%, respectively, in the individual countries. Active commuting (walking or cycling for transportation) varied substantially, among both adults and children from about 2 to 5 hours per week. In addition, adults and children across all Nordic countries reported spending an average of 5 to 5.6 and 6.6 to 9.6 hours per week on moderate-to-vigorous physical activity (MVPA) during leisure time. Finnish adults showed stable activity levels from 2014 to 2024 and in children an increase in moderate-to-vigorous physical activity (MVPA) was observed. In the other Nordic countries, changes from 2014 to 2024 were uncertain due to varying data collection seasons.
The prevalence of OW/OB and OB among adults was high in the Nordic region. OW/OB continued to rise steadily among both adults (from 49 to 56%) and children (from 16 to 19%). In 2024, over half of adults in the Nordic Region had OW/OB, and one in five had OB. Today, it is more common to have overweight or obesity as an adult than being normal weight. In 2024, nearly one in five children had OW/OB, and about 4 % had OB.
Though smoking continues to decline (from ≈16 % to 10 %), the use of snuff and nicotine pouches (14%) now surpasses smoking in prevalence. E-cigarette use was relatively low (≈3 %).
Results show gender differences in health behavior and weight status in the Nordic region: men had less favorable diets, higher sedentary behavior and prevalence of physical inactivity, greater use of snuff or nicotine pouches daily, higher alcohol intake and more were OW/OB than women – as observed in 2014, but there were no gender differences in OB anymore, and smoking and e-cigarette use showed no gender differences. However, whole grain intake was higher among men than women.
There were no gender differences in dietary consumption among children. There was a general trend of boys spending more time on moderate to vigorous physical activity than girls, and girls having higher rates of inactivity. Boys also had a significantly higher prevalence of high screen time than girls in some countries. As with adults, OW/OB was more common among boys than girls in all countries, and OB prevalence alone did not differ by gender.
Social inequality was observed in dietary intake. Adults and children of parents with higher levels of education reported higher intake of total fruits & vegetables and pulses compared to those having lower levels of education. Among adults the same was found for fish. Adults and children of parents with low or medium levels of education also reported higher intake of discretionary drinks than those with parents in the high-education group, and in children the same trend was observed for light or sugar-free beverages. Conversely, adults with higher levels of education reported lower intake of total meat compared with those with medium levels of education, and lower intake of veal, beef, and lamb than both the low- and medium-education groups. Only small and few (minimal) differences in alcohol consumption across education levels were seen.
Social inequality was also seen in the prevalence of OW/OB. The average BMI was significantly higher in the low education group compared to the higher education group. Among adults with low education, around two out of three were classified as OW/OB, compared to approximately one out of two among those with high education. The prevalence of OB was about one out of three for individuals with low education, while only about one out of eight was affected among high educated. Among children, the Nordic average showed a significant difference as well, with 24.4% from low/medium education households having OW/OB, compared to 15.7% from high education households, and OB was 7.2% versus 2.1%, indicating a consistent and significant disparity.
Total nicotine use, and daily smoking, and snuff, pouch, and e-cigarette use followed an inverse social gradient; use was lowest among adults with higher levels of education.
The development and status in health behavior and weight status is of concern. There is still a need for improvements in all the Nordic countries in all areas. Each of the five Nordic countries is challenged with specific unfavorable development and status in health behavior and/or weight among adults and/or children compared to the other Nordic countries, as described in the summary above.
The strength of the Nordic Monitoring System is the high comparability between survey years, age groups, educational levels and countries. Other national surveys cannot provide such comparability.
Implications
The findings suggest that diet quality in the Nordic Region is moving in an unfavorable direction, with lower consumption of plant-based foods and higher consumption of discretionary foods and drinks compared with 2014. Increasing the intake of fruits, vegetables, pulses, whole grains, and fish - and decreasing meat would improve alignment with NNR2023 recommendations and contribute positively to both health and environmental goals. Policy-level factors such as pricing and taxation could play a crucial role in promoting healthy and sustainable changes in food choices across the Nordic region. Also, restricting advertising for unhealthy food to children could be essential for promoting healthy eating habits, in line with WHO recommendations.
The observed differences between national dietary patterns indicate that cultural preferences continue to shape consumption trends. Moreover, the disparities observed in dietary patterns related to educational status highlight the need to promote and enhance equitable access to healthy foods. Future monitoring should continue to harmonize dietary assessment methods and ensure comparability over time, ideally future studies should support linking frequency data with gram-based estimates to support more precise evaluation of adherence to dietary guidelines.
Binge drinking remains a key public health challenge, particularly in Denmark, among men, and among young adults (18–29 years). Given the consistent gender and age disparities, targeted prevention initiatives may be relevant for these groups. Policy-level factors—such as pricing, taxation, and retail regulation—continue to appear influential, underscoring the importance of alcohol policies in the Nordic Region.
A substantial proportion of both adults and children in the Nordic Region fail to meet the WHO physical activity recommendations. The results on physical activity suggest that the WHO Global Action Plan targets are unlikely to be met in the Nordic Region without intensified efforts. Nordic countries still have substantial work to do in creating more active societies, environments, people, and systems. Policies supporting active transport, equitable access to recreation, and reductions in screen-based sedentary time—especially among children—should be prioritized. Monitoring systems should seek to combine self-reported and objective measures in future rounds to enhance accuracy and comparability over time. Although implementing this would be beneficial, it is not feasible within NORMO due to financial limitations.
The overweight and obesity results underscore that a major public health challenge remains in the Nordic Region. While all countries are affected, the increases in Iceland and Finland in obesity and overweight or obesity are particularly notable, and the rise in overweight or obesity among children—especially in Denmark and Iceland—is of special concern because of its long-term health implications and the potential for early onset of obesity-related conditions. The continued association with education highlights persistent social differences in weight status among both adults and children. Differences between data sources, such as NORMO and WHO, emphasize the importance of continued monitoring and comparable measurement methods to track changes in overweight and obesity over time.
Finally, the results also underscore the need for targeted public health strategies that consider both traditional and emerging nicotine products. Efforts must address not only smoking cessation but also the growing popularity of alternative nicotine products among younger populations and those with lower levels of education.
Since behavior in the Nordic region has become less healthy and sustainable, policy-level factors such as pricing and taxation could play a crucial role in promoting more healthy and sustainable changes in behaviour across the Nordic region.