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Abstract

Diet has a significant impact on health, and ensuring that the population eats a healthy diet remains a public health challenge. Research is needed in order to improve the palatability of a healthy diet and make it attractive to the consumer. It has also been suggested that dietary recommendations should be tailored to regional conditions. The OPUS (Optimal well-being, development and health for Danish children through a healthy New Nordic Diet) project investigates whether it is possible to develop a healthy New Nordic Diet (NND) that is palatable, environmentally friendly and based on foods originating from the Nordic region. The present paper describes the overall guidelines for the NND, developed and investigated in the multidisciplinary, 5-year OPUS research project. All guidelines are described in relation to the key principles: health, gastronomic potential and Nordic identity, and sustainability. The NND is described by the overall guidelines: (i) more calories from plant foods and fewer from meat; (ii) more foods from the sea and lakes; and (iii) more foods from the wild countryside. These overall guidelines result in a set of proposed dietary components which will be presented in a subsequent paper. Both the guidelines and the diet are composed taking the potential health-promoting properties and Nordic identity of the NND into account, as well as concern for environmental issues and gastronomic potential.
Public Health Nutrition: 15(10), 1941–1947 doi:10.1017/S136898001100351X
Guidelines for the New Nordic Diet
Charlotte Mithril
1,
*, Lars Ove Dragsted
1
, Claus Meyer
2
, Emil Blauert
2
Mathias Krog Holt
1
and Arne Astrup
1
1
Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Rolighedsvej 30, DK-1958
Frederiksberg C, Denmark:
2
Meyers Madhus, Copenhagen, Denmark
Submitted 28 March 2011: Accepted 8 December 2011: First published online 17 January 2012
Abstract
Objective: Diet has a significant impact on health, and ensuring that the population
eats a healthy diet remains a public health challenge. Research is needed in
order to improve the palatability of a healthy diet and make it attractive to the
consumer. It has also been suggested that dietary recommendations should
be tailored to regional conditions. The OPUS (Optimal well-being, development
and health for Danish children through a healthy New Nordic Diet) project
investigates whether it is possible to develop a healthy New Nordic Diet (NND)
that is palatable, environmentally friendly and based on foods originating from
the Nordic region. The present paper describes the overall guidelines for the
NND, developed and investigated in the multidisciplinary, 5-year OPUS research
project. All guidelines are described in relation to the key principles: health,
gastronomic potential and Nordic identity, and sustainability.
Results: The NND is described by the overall guidelines: (i) more calories from
plant foods and fewer from meat; (ii) more foods from the sea and lakes; and
(iii) more foods from the wild countryside. These overall guidelines result in a set
of proposed dietary components which will be presented in a subsequent paper.
Conclusions: Both the guidelines and the diet are composed taking the potential
health-promoting properties and Nordic identity of the NND into account, as well
as concern for environmental issues and gastronomic potential.
Keywords
Diet
Health
Nordic
OPUS
Over the past two decades a New Nordic Cuisine has
been developed in Scandinavia. The New Nordic Cuisine
Manifestoywas formulated in 2003
(1)
and was adopted by
the Nordic Council of Ministers as the ideology of the
New Nordic Food programme in 2005
(2)
, with the aim of
establishing Nordic cuisine as part of the gourmet world
map. Restaurants and chefs focusing on Nordic food
are now rated among the best in the world
(3,4)
, so foods
from the Nordic region clearly have great gastronomic
potential. As regionally produced foods they are also
potentially environmentally sustainable
(1)
, the hypothesis
being that transport of food from production to consumer
can be minimized by increased consumption of local
produce, thus minimizing some of the negative effect on
the environment. Stressing regionality, the use of seasonal
produce and the use of foods from the wild countryside
might also be of benefit to the environment. The New
Nordic Cuisine therefore has real potential with regard to
sustainability in the Nordic countries.
The palatability of foods is not always in harmony with
their health-promoting qualities, as some of the nutritionally
dense and less beneficial elements, especially fats, are
important for flavour and mouthfeel
(5)
. A new diet needs to
take health aspects into account, as diet plays a major role in
the development of disease today
(6)
.InDenmark,asinthe
rest of the world, the prevalence of overweight and obesity
among both children and adults has increased dramatically
over the last 60 years
(7,8)
. Obesity increases the risk of a
wide range of serious medical complications, including
CVD, insulin resistance, type 2 diabetes, gallbladder disease,
osteoarthritis, asthma and several cancers
(9)
.Promotinga
healthy diet is therefore an important aspect of public health
policies in many countries, and the recommendations for
healthful eating are very similar across countries
(10)
.
yThe aims of the New Nordic Cuisine are to: (i) express the purity,
freshness, simplicity and ethics we wish to associate with our region;
(ii) reflect the changing of the seasons in the meals we make; (iii) base
our cooking on ingredients and produce whose characteristics are par-
ticularly excellent in our climates, landscapes and waters; (iv) combine
the demand for good taste with modern knowledge of health and well-
being; (v) promote Nordic products and the variety of Nordic producers,
and spread the word about their underlying cultures; (vi) promote animal
welfare and a sound production process in our seas, on our farmland and
in the wild; (vii) develop potentially new applications of traditional
Nordic food products; (viii) combine the best in Nordic cookery and
culinary traditions with impulses from abroad; (ix) combine local self-
sufficiency with regional sharing of high-quality products; and (x) join
forces with consumer representatives, other cooking craftsmen, agri-
culture, the fishing, food, retail and wholesale industries, researchers,
teachers, politicians and authorities on this project for the benefit and
advantage of everyone in the Nordic countries
(1)
.
*Corresponding author: Email mithril@life.ku.dk rThe Authors 2012
Dietary recommendations have not been successful in
reversing the obesity epidemic so far, and there are prob-
ably several reasons for this. Recent studies have shown
that current dietary recommendations may not be effective
for the control of body weight and the prevention of
weight gain and obesity
(11,12)
. Furthermore, palatability
and gastronomic potential are not taken into account in
current dietary recommendations
(13)
. Nutrition experts are
often confronted with unpalatability of the recommended
diet. A Danish study found that lack of sufficient focus on
the gastronomic properties of the recommended diet led to
increased drop-out during a course of weight maintenance
following a weight-loss programme in obese indivi-
duals
(14)
. In addition, it has been suggested that dietary
recommendations should be more tailored to regional
conditions
(15)
. Such regional tailoring may help to preserve
cultural diversity in eating habits and contribute to more
environmentally friendly consumption.
Both gastronomists and nutritionists are beginning to
believe that there is a shared route to creating regional
diets and an opportunity to develop a healthy diet that
bridges gastronomy, health and sustainability. This forms
the basis for the multidisciplinary, 5-year research project,
OPUS (Optimal well-being, development and health for
Danish children through a healthy New Nordic Diet),
which aims to define and test a New Nordic Diet (NND).
The hypothesis is that an optimal diet composition, based
on healthy, palatable meals, may not only contribute to
the prevention of excessive weight gain, obesity and
other health disorders, but may also improve quality of life,
learning ability, and mental and physical performance in
children
(16,17)
.
The objective of the present paper is to describe the
overall guidelines for the NND. All guidelines are
described in relation to key principles: health, gastro-
nomic potential and Nordic identity, and sustainability.
The nutritional value and dietary composition of an NND
for the Danish region will be elaborated and discussed in
a subsequent paper.
Development of a New Nordic Diet
The NND is developed on the basis of input from experts in
the fields of human nutrition, gastronomy, environmental
issues, food culture and history, and sensory science, and
from experts with knowledge about children and their food
habits and preferences. This forum was gathered at the
initial OPUS congress held in June 2009 in Copenhagen,
and some participants were subsequently selected to form
advisory boards for the OPUS working groups. The 2009
congress and the subsequent work resulted in a report
publishedinDanishinAugust2010
(18)
.
OPUS is a Danish project and two intervention studies
within the project are to be carried out in Denmark, so
‘the NND’ in this context is based on the Danish market
and food culture, with references to average dietary
intake in the Danish population. The overall principles
and guidelines can, however, easily be translated and
applied to any country in the Nordic or Northern European
region.
In the development of the NND the following principles
have been crucial: (i) health; (ii) gastronomic potential and
Nordic identity; and (iii) sustainability. These principles are
central in the guidelines for the NND and are elaborated
below.
Health
A healthy diet should contribute to the prevention of
weight gain, obesity, type 2 diabetes, CVD and cancer.
But being healthy is more than just the absence of dis-
ease. In addition, a healthy diet should help maintain and
improve general health, defined by WHO as a state of
complete physical, mental and social well-being
(19)
.
Health effects should be evaluated on the basis of evi-
dence from randomized controlled trials and prospective
cohort studies in human subjects. The NND is based
on the existing scientific knowledge within health and
nutrition. Dietary components with substantial evidence
of health-promoting properties that are included in the
National Food-based Dietary Guidelines (NFDG) are
naturally included in the NND; e.g. fruits, vegetables,
potatoes, whole grains, nuts, fish and shellfish
(20)
. The
hypothesis is that being healthy is not only achieved by
adding or refraining from specific nutrients, but more a
condition we approach through what we actually choose
to eat. Testing the hypothesis is a major aim of OPUS.
Gastronomic potential and Nordic identity
Palatability is an important consideration in the develop-
ment of the NND. The New Nordic Cuisine has gained
tremendous respect throughout the world because of its
gastronomically excellent meals based on Nordic foods.
The NND is based on food with a Nordic identity and
cultural heritage, i.e. foods produced in the Nordic
countries and expressing the Nordic terroir. The term
‘terroir’ means the impact of multiple conditions such
as soil, climate and microclimate, location and form of
cultivation on the properties of a specific food. Terroir has
been elaborated in other food cultures, but is still a
relatively new term for the Nordic food culture. A potato
is not just a potato. It can have a range of different
flavours and textures, dependent on where and how it is
grown. For example, the sandy soils and coastal climate
of the Danish island of Samsø give potatoes grown there
a distinct flavour. Other examples of produce often
associated with the specific terroir in Denmark include
carrots, apples, mutton, herrings, cheeses and smoked
foods based on terroir-defined produce and special
technology. Such produce are found in all countries,
illustrating the common understanding of the concept.
The Nordic terroir can be summarized as a cool climate
1942 C Mithril et al.
often leading to a slow growth rate, many hours of
light during the summer and the opposite during the
winter, limited differences in temperature from night to
day, and a lot of coastal waters with large variations in salt
content. The challenge is to identify the produce best
suited to a particular terroir, and in particular any produce
where its gastronomic properties are enhanced by local
conditions. In the development of the NND we have
been looking for foods which gain special gastronomic
potential when grown in the Nordic region. The origin
and historical time of entry to the local environment
of the different kinds of produce do not necessarily
determine whether a food can be part of the NND. The
more important factor is the ability of the produce to
thrive in the Nordic terroir with exceptional gastronomic
properties as a result.
Sustainability
Food production and preparation affect the environment
in many ways, including effects on greenhouse gases,
biodiversity, landscape, environmental toxins, etc.
(21)
.
The impact is affected by consumer demand. The global
population is growing rapidly and there is a need for food
supply strategies for all regions that will ensure food
security without jeopardizing the environment. Four
simple considerations for sustainability were used in the
formulation of the NND:
1. Focus on locally grown foods to minimize the
transport of foodstuffs, thereby minimizing the nega-
tive impact of transportation on the environment.
2. Focus on foods from organic food production. The
organic production principle is based primarily on
consideration for nature and biodiversity, and it is an
attempt to care for soil, biodiversity, quality, health
and the welfare of nature, including plants, animals
and humans. The current official organic labelling
system in Denmark is a technical and legal guarantee
that a food is grown without GM organisms, synthetic
pesticides, inorganic fertilizers or other synthetic agents,
and without the use of germicidal irradiation
(22)
.
In addition, manufacturers of organic food products
must comply with a clear set of rules regarding
the use of additives. Ideally, all meals and dietary
components in the NND should meet these basic
criteria with a minimal use of additives. However, this
would require that organic food production be fully
established and integrated in society, but it is not yet
fully developed and there are still many challenges to
be resolved.
3. Focus on composing a proportion of the diet from
foods sourced from the wild countryside, encouraging
biodiversity and minimizing use of fertilizers and
pesticides.
4. Focus on minimizing waste and utilizing all of every
food purchased.
Guidelines for the New Nordic Diet
The road from the overall concept of the New Nordic
Cuisine to an NND for the general population involved
generalization and popularization. This led to the formula-
tion of three fundamental guidelines as the basis of the NND
as compared with the current average Danish diet. These
are: (i) more calories from plant foods and fewer from
meat; (ii) more foods from the sea and lakes; and (iii) more
foods from the wild countryside. In the following each of
these guidelines is elaborated with respect to the overall
principles mentioned previously: health, gastronomic
potential and Nordic identity, and sustainability.
More calories from plant foods and fewer
from meat
Consumption of meat has almost doubled in the Nordic
countries over the past 50 years, and meat intake in the
Nordic population is among the highest in the world
(23)
.
There is evidence that high protein intake can reduce the
risk of several diseases, particularly among the large
proportion of sedentary and slightly overweight individ-
uals in the population
(24,25)
. However, meat is among the
least environmentally friendly foods, so more envir-
onmentally friendly protein sources, with greater health
benefits, are to be preferred
(26)
.
Health
A lower intake of meat makes room for more legumes,
vegetables, fruit, grains, potatoes, nuts, herbs, etc. in the
daily diet, most of which have substantially better impacts
on health. Studies have shown that a daily intake of 600 g
or more of fruits and vegetables reduces the risk of
CVD
(27,28)
, overweight and obesity
(29)
and probably certain
cancers
(30,31)
. Studies on whole grains have found a sig-
nificant inverse association between intake of whole grains
and risk of CVD
(32,33)
, type 2 diabetes
(34)
, cancer
(35)
and
weight gain or risk of obesity
(36)
. Starchy plant foods like
potatoes are an important source of dietary fibre, vitamins
B
6
and C, folate, Fe, K and Mg in the Danish diet
(37)
.A
replacement of some of the meat we eat today with plant
foods would lead to a reduction in the intake of saturated
fat and increased intakes of unsaturated fats, dietary fibres,
vitamins and minerals. Most plant foods are low in calories,
making it possible to eat larger amounts while lowering the
energy density of the diet and still satisfying the senses and
satiety. A high intake of plant foods therefore has a natural
place in a diet which, together with other lifestyle changes,
can reduce the risk of weight gain, obesity and the
development of several lifestyle diseases.
Gastronomic potential and Nordic identity
Plant foods help in defining a regional kitchen. They
provide colour and flavour variation in meals. Plant foods
such as berries, cabbages, root vegetables, legumes,
potatoes and herbs can maximize tastiness and help create
The New Nordic Diet 1943
a clear Nordic identity while being a minor burden to the
environment. They can form part of everyday meals
all year around, and could be the basis of many Nordic
meals. These plant foods thrive in the Nordic climate and
there is a long tradition of cultivating and consuming them
here
(38,39)
. Many plant foods have an as yet unexplored
production potential in the Northern climate, including
possibilities for cultivation across the seasonal calendar.
The introduction of new or different varieties could pro-
long the growing season and increase the selection of plant
foods grown in the Nordic countries. In the Middle Ages
foods such as fresh herbs, legumes, cabbage and root
vegetables played a major role in the Nordic diet, but their
use has decreased significantly over recent decades and
exotic dried spices, rice and pasta have partially taken their
place
(38,39)
. Nordic plant foods have a large gastronomic
potential and could very well be promoted to their former
importance in our food culture.
Sustainability
The suggestion of reducing intake of meat should be seen
in the light of the fact that the meat intake of the Nordic
populations is among the highest in the world
(23)
.Ithas
been estimated that the climate impact of the Danish diet
alone could be reduced by approximately 30 % compared
with the current average Danish diet if the population were
to consume a diet in accordance with the NFDG (less meat
and more plant foods and fish)
(20)
and choose their foods
with more consideration for the environment
(40)
.Meatis
among the least environmentally friendly foods and a 30 %
reduction in meat intake for the Danish population would
correspond to a reduction of 6?6 million tonnes of CO
2
equivalents per annum
(40)
. Plants such as cabbage, potatoes
and root vegetables can easily be grown using organic
farming methods in the Nordic countries. For example,
compared with producing 1 kg of beef, fifty-seven times
less greenhouse gases are emitted when producing
1 kg of potatoes
(41)
. In order to ensure adequate protein
content in the diet while reducing meat intake, the NND
includes larger amounts of alternative protein sources
such as legumes and fish. In this way protein intake can
be maintained and the environmental burden reduced.
More foods from the sea and lakes
The Nordic countries are surrounded by water, and
high-quality fish and shellfish are abundant here. A large
proportion of the Nordic fishing catch is currently exported,
so there is good potential for increasing local consumption.
Furthermore, the Nordic countries have vast amounts of
seaweed, a source of nutrition that has mostly been over-
looked in the Western world, except for a few Nordic
regions where its use has been traditional. Fish and shellfish
have a significant health-promoting potential, as does sea-
weed. However, there are some safety issues in the use of
seaweed in the human diet that still remain to be clarified
(42)
.
Increasing the proportion of freshwater and sea foods in the
diet has a large potential to improve health, provides
variation in meals and can contribute as an environmentally
friendly protein source in the NND.
Health
Fish and shellfish have a significant health-promoting
potential. Studies have shown that n-3 fatty acids, present
in significant amounts in fatty fish, may improve child
brain development and help prevent heart disease and
nervous disorders in adults
(43)
. In addition, fish and shell-
fish have high contents of valuable vitamins and minerals,
including vitamin D, iodine and Se, which are difficult to
find naturally in other foods. Low vitamin D status, espe-
cially during the winter, is relatively common in Denmark
and can lead to osteoporosis
(44)
. Some studies also suggest
that a high intake of Se is associated with a reduced risk of
cancer
(45)
. Fish and shellfish contain high amounts of
protein and an increased intake may help to prevent
weight gain and obesity, type 2 diabetes, and sarcopenia in
the elderly
(46,47)
. Different species of fish and shellfish
contain different amounts of vitamins, minerals and fatty
acids. The intake should therefore be alternated between
fatty and lean species, and between catches from different
origins (Atlantic, Baltic, fresh water, etc.) in order to get the
full health benefits while minimizing risks of toxicity from
pollution with organohalides and heavy metals.
Seaweed has high contents of essential minerals, pro-
tein, dietary fibre, vitamins (A, B, C, E) and essential fatty
acids
(48)
. It also contains a range of bioactive compounds
which may play a role in the prevention of CVD and
possess certain antiviral and anticancer effects
(49)
. Sea-
weed is a relatively unknown food in Denmark and it
deserves greater attention here. Exploration of variations
between species and origin in nutrient composition,
including evaluation of risks from relatively high content
of iodine in some species, is warranted.
Gastronomic potential and Nordic identity
Catch Area 27 is the sea around Denmark and the Nordic
countries, where the so-called arctic fish and shellfish are
found. The Nordic countries are characterized by long
coastlines, and several of the countries have a huge
number of freshwater lakes, providing extensive access to
large amounts of locally caught high-quality fish and
shellfish with very distinctive flavours. The waters of the
North Sea, Baltic Sea and the Bothnic Bay vary greatly in
salinity and mineral content, making distinct terroirs for
fish such as herring and salmon, which vary in texture
and taste according to locality. The majority of the fish
caught is currently exported. A greater knowledge of the
richness of these foods from the seas, coastal waters and
lakes could encourage increased local use and contribute
to a more distinct Nordic identity of our meals. The same
considerations apply to seaweed. Historically, seaweed
was part of the poor man’s diet along most Nordic
coastlines
(48)
. Seaweed has a broad application in the
1944 C Mithril et al.
kitchen and can be eaten raw, boiled, baked, roasted,
pure
´ed, dried, granulated or deep fried. The taste and
texture of seaweed are very dependent on how it is treated.
Seaweed can have a broad palette of flavours ranging from
a strong and robust taste to sweet or salty, mild or spicy
sea-notes. A supply chain would need to be established
before Nordic seaweed is commonly available as a food.
Sustainability
It is important to consider the environment when pro-
posing an increased consumption of fish and shellfish.
Raising fish in fish farms is less environmentally friendly
than catching fish in the wild
(50)
. Farmed fish are often fed
partly on vegetable oils because there is not enough trash
fish for feed, resulting in a reduced amount of healthy
fish oils in the fish sold for consumption as a con-
sequence
(51,52)
. The NND therefore focuses on wild-living
species, which can be fished in a sustainable manner.
One way to ensure a sustainable fishery is to choose fish
that are MSC (Marine Stewardship Council) labelled,
where the following criteria must be met: (i) the stock
of fish should be sustainably fished, or evidently on its
way to becoming so; (ii) fishing must not damage the
ecosystem or marine environment; and (iii) fishing should
be managed effectively so that sustainability and the
ecosystem are guaranteed
(53)
.
There is a great potential for sustainable harvesting of
seaweed, both wild and cultivated, in large quantities in
the Nordic seas. It is also possible to create aquacultures
where, together with clams and fish, seaweed can be
cultivated in sustainable ecosystems
(48)
.
More foods from the wild countryside
In the Nordic countries the population has reasonable
access to large quantities of foods from the wild country-
side, e.g. plants, mushrooms, berries, fruits and meat.
Foods foraged from the wild are interesting because of their
possible health potential, their firm gastronomic potential
and their minimal impact on the environment. They can be
collected by the individual or systematic gathering and
distribution could be established, making them available
for all. In this way some of the greatest gastronomic
experiences could be made accessible for all. Foods from
the wild countryside differ from country to country and are
an important part of the identity of a regional cuisine.
Health
It seems that wild plants contain higher amounts of vita-
mins, minerals, secondary plant metabolites and n-3 fatty
acids than conventionally grown plants
(54)
. It has been
found that wild plants have higher contents of vitamin C,
vitamin E, phenols and other compounds that increase
the antioxidant level in plants
(54)
. Purslane and white
goosefoot, usually regarded as weeds, have been described
as two of the most nutritious plants in the world. Purslane
contains large amounts of a-linolenic acid, while white
goosefoot is rich in protein, vitamin A, Ca, P and K
(55)
.
However, some caution should be exercised before
including wild plants in the diet as many have a high
content of bioactive components, the composition of
some is still unknown and or not well understood, and
some can be toxic if ingested in large quantities.
It is not only plant foods from the wild that seem to have
a health-promoting potential. Meat from wild animals
and fowl generally contains less fat and has a healthier
fatty acid composition, with less saturated fat and more
polyunsaturated fat, than meat from commercially reared
animals, kept inside with no access to pasture. Moreover, a
significantly higher content of n-3 fatty acids has been
found in meat from animals caught in the wild
(56)
. Access to
game and fowls is limited in the Nordic region, but studies
have shown that meat from domestic animals that graze in
open pastures also has a healthier fatty acid composition,
with less saturated fat and more polyunsaturated fat, than
meat from animals reared indoors without access to herbs
and grass
(56,57)
. The NND therefore focuses on game from
the wild, but includes meat from free-range animals.
Gastronomic potential and Nordic identity
Current dietary recommendations advise the population
to eat a diet that satisfies the body’s need for a wide range
of nutrients and with a certain energy composition, while
the importance of the individual’s needs for pleasure and
taste are not taken into consideration. A lean diet is often
experienced as tiresome, without satisfying the need for
pleasure, taste and sensory stimulation. The NND aims to
include foods that bring taste and volume to a meal.
Foods such as fresh herbs, wild plants and mushrooms
are highly aromatic and can provide taste and volume to a
meal containing less fat, helping to compensate for the
deprivation some people might experience when exposed
to a reduction of fat in the diet
(58)
.
Wild herbs, berries, etc. vary from region to region,
depending on the local climate and soil conditions. Salt
meadows, heath land and beech forests are examples of
habitats which provide distinctive foods, each with a
distinct taste and aroma. Meat from game shot in the wild
is highly prized in gastronomy, because the animals have
fed on wild plants that impart characteristics specific to
the region to the meat. Although perhaps mostly on the
symbolic and cultural level, game and wild plants play a
role in the NND in that they display a maximum of
diversity and local variation and at the same time differ-
entiate Nordic cuisine from other food cultures.
Sustainability
Fungi such as chanterelles and Portobello mushrooms,
and plants such as nettles, ground elder, wild garlic,
meadowsweet and goosefoot, can be gathered freely in
season in the countryside by everyone. The mileage from
soil to table can be reduced significantly when produce is
collected from our own backyard. Wild plants and fungi
The New Nordic Diet 1945
grow without fertilizers, pesticides or the expense of
external energy, making a very small negative impact
on the environment compared with conventional food
production. However, there is a limit to how much food
the population can gather from the wild before making
a negative impact on the environment. Even so, it is
estimated that only 2–4 % of the berries growing wild
in the Nordic region are collected and consumed by
humans
(59,60)
and that only a limited part of the remaining
96–98 % is consumed by birds and wild animals. The
same can be assumed for many other plants and foods, so
these could (and should) be exploited to a greater extent.
Concluding remarks
The current paper presents the principles and guidelines
behind the formulation of a healthy NND. These guidelines
have been used to identify specific components for the NND
and suggestions for intake. The resulting diet will be detailed
in a subsequent publication. The diet is currently being
tested in two intervention studies in the OPUS project, one
in adults and one in schoolchildren. The NND is a prototype
regional diet taking health, food culture, palatability and
the environment into account. The principles and guidelines
could be applied in any region, including any other specific
region within the Nordic countries.
Acknowledgements
Sources of funding: The present study is a part of the
OPUS project. OPUS is an acronym of the Danish title of
the project ‘Optimal well-being, development and health
for Danish children through a healthy New Nordic Diet’.
The OPUS Centre is supported by grant from the Nordea
Foundation, Denmark, and is independent of all com-
mercial interests. Conflict of interest: C. Mithril, L.O.D.
and M.K.H. have no conflicts of interest. C. Meyer is an
owner of restaurants, food companies and a cooking
school. As a food ideology, the New Nordic Cuisine is the
brainchild of one of these restaurants, noma, and today
the New Nordic Cuisine is a theme in most of C. Meyer’s
companies. E.B. is employed at Meyers Madhus. A.A. is an
advisor, an advisory board member or a scientific board
member for the Communications and Scientific Advisory
Board of The Global Dairy Platform (Chicago, IL, USA),
the Kraft Health & Wellness Advisory Council (Glenview,
IL, USA), the Beer Knowledge Institute (Amsterdam,
The Netherlands), the Pathway Genomics Corporation
(La Jolla, CA, USA) and Jennie Craig (Carlsbad, CA, USA);
and receives honoraria as a speaker and research funding
from a wide range of Danish and international concerns.
Authors’ contributions: The draft paper was elaborated by
C. Mithril based on an OPUS report on the NND, which
was developed by C. Mithril in close collaboration with
C. Meyer, E.B., M.K.H., L.O.D. and A.A. L.O.D. helped
C. Mithril shape the draft paper into its final form which
was then approved with minor corrections by the other
co-authors. Acknowledgements: The authors thank the
Advisory Boards assisting OPUS Work Package 1 and the
participants at the OPUS congress held in June 2009 in
Copenhagen for their valuable input and help in the
development of the NND.
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The New Nordic Diet 1947
... The so-called New Nordic Diet (NND) was developed in Copenhagen as a paradigm of healthy and sustainable diet integrating dietary and gastronomic traditions from the five mentioned Nordic countries. The NND concept received the input from experts in human nutrition, gastronomy, environmental issues, food culture, history, and sensory science, and also from experts with knowledge about children and their food habits and preferences as part of a multidisciplinary 5-year research project "Optimal well-being, development and health for Danish children through a healthy New Nordic Diet" (OPUS), which aimed to define and test the NND [142]. ...
... Interestingly, NND has several components that are also part of the Med Diet and Japanese diet (Table 1). For example, it includes organically and local grown fruits (i.e., berries, pears and apples), vegetables (i.e., cruciferous vegetables, wild aromatic herbs, edible plant roots, and green leafy vegetables), nuts, seeds, legumes, whole grains (i.e., rye, oats and barley), fish (i.e., salmon, sardines, mackerel, herring), herbs, seaweeds, and mushrooms; NND contains low amounts of meat, sweets and fat, and avoids processed food [142,143]. Hence, NND also follows principles of environmental protection and sustainability as the Med Diet. The main difference between the two diets is the primary fat source, which is extra virgin olive oil in the Med Diet and rapeseed/canola oil in NND. ...
... More longitudinal and large prospective studies are needed in the future to provide further evidence-based recommendations [143]. The key messages underlying the NND guidelines are the following: (1) including more calories from plant-based foods and less from meat; (2) use of more foods coming from the lakes and sea (comprising seaweeds and shellfish); and (3) including more wild local foods from the countryside (plants, berries, mushrooms, and aromatic herbs) [142]. Although NND has been developed in recent times, the literature on this healthy dietary pattern has grown, showing significant associations between NND and several health outcomes including various NCDs (i.e., CVD, obesity, some types of cancer, neurodegenerative diseases) and mortality [59,141,[144][145][146][147][148][149][150][151][152][153][154][155][156][157][158][159], thus increasing overall life and health expectancies. ...
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... The nutritional characteristics of the Mediterranean diet have inspired institutions and experts in several regions of the world and, more specifically, in individual countries, to implement healthier approaches to food consumption into their specific nutritional guidelines [9]. Some examples of this approach include the New Nordic Diet [10] and the US Dietary Guidelines for Americans, 2020-2025, 9th ed. [11]. ...
... When considering the geographical location and Mediterranean diet, it is worthwhile to mention an important European experience, represented by the New Nordic Diet, developed in some northern Europe countries (Denmark, Sweden and Finland), characterized by a markedly colder climate. Here, the plant-based nutrition present in the Mediterranean diet is translated into the consumption of healthy regional-specific foods, such as vegetables available in that area (pears, apples, berries, root and cruciferous vegetables, cabbages, rye bread and whole grain) as well as potatoes, a high intake of fish, low-fat dairy products, and vegetable fats, among other dietary lipid sources [10,64,65]. Moreover, it contains 35% less meat than the average Danish diet and appears to be effective in sustainability terms [66]. ...
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... The New Nordic Diet (NND) is a chef-driven constructed diet, building on four key principles: Nordic Identity, gastronomy, sustainability and health. Taking all four principles into account eight dietary guidelines have been suggested (Mithril et al., 2012(Mithril et al., , 2013. The idea is that the food should be produced locally, be organic, mainly plant based and of high quality and high biodiversity (Mithril et al., 2012(Mithril et al., , 2013Bügel et al., 2016). ...
... Taking all four principles into account eight dietary guidelines have been suggested (Mithril et al., 2012(Mithril et al., , 2013. The idea is that the food should be produced locally, be organic, mainly plant based and of high quality and high biodiversity (Mithril et al., 2012(Mithril et al., , 2013Bügel et al., 2016). The first scientific studies looking at the health effects of the NND suggest that the diet may be a suitable alternative for areas that have cultural difficulties adhering to the Mediterranean diet (Adamsson et al., 2014;Poulsen et al., 2014;Lankinen et al., 2016). ...
Chapter
Sustainable diets are those diets with low environmental impacts that contribute to food and nutrition security and to healthy lives for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable, are nutritionally adequate, safe, and healthy, and optimize natural and human resources. (FAO, 2010). This book takes a transdisciplinary approach and considers multisectoral actions, integrating health, agriculture and environmental sector issues to comprehensively explore the topic of sustainable diets. The team of international authors informs readers with arguments, challenges, perspectives, policies, actions and solutions on global topics that must be properly understood in order to be effectively addressed. They position issues of sustainable diets as central to the Earth’s future. Presenting the latest findings, they: • Explore the transition to sustainable diets within the context of sustainable food systems, addressing the right to food, and linking food security and nutrition to sustainability. • Convey the urgency of coordinated action, and consider how to engage multiple sectors in dialogue and joint research to tackle the pressing problems that have taken us to the edge, and beyond, of the planet’s limits to growth. • Review tools, methods and indicators for assessing sustainable diets. • Describe lessons learned from case studies on both traditional food systems and current dietary challenges. As an affiliated project of the One Planet Sustainable Food Systems Programme, this book provides a way forward for achieving global and local targets, including the Sustainable Development Goals and the United Nations Decade of Action on Nutrition commitments. This resource is essential reading for scientists, practitioners, and students in the fields of nutrition science, food science, environmental sciences, agricultural sciences, development studies, food studies, public health and food policy
... (Livsmedelsverket, 2021b). In terms of eating greener, the recommendations by Livsmedelsverket (2021a), the so-called plate-of-food model, and the Nordic diet (Mithril et al., 2012), follow plant-based consumption. In the same manner, the Mediterranean food pyramid, the Baltic Sea diet pyramid, and the vegan food pyramid promote a healthy and potentially sustainable meal pattern because all those pyramids suggest eating food with low environmental impact. ...
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The underlying assumption throughout this thesis is that the continuity of a cultivated diversity can be strengthened by investigating its sensory qualities and specifying particular culinary utilities of landraces and cultivars. How can a foodstuff’s sensory qualities and culinary utility be explored, tested, and refined together with the food industry and the public meal? This thesis aims to create a path toward sustainable gastronomy with greater sensory variation that originate from a cultivated diversity. The thesis bridges sensory science, culinary arts, and food design, using sensory descriptive methods with consumers as well as trained sensory panelists, consumer tests with different target groups, and a recipe-development process joined up with culinary arts and agriculture. The thesis is based on four papers. Paper One shows that cultivated diversity generates a range of flavors and textures to advance in food and cooking. Paper Two investigates the interacting influence of cultivar, place of cultivation, and year of harvest on the sensory quality of peas. In Paper Three, a recipe development process is modelled and applied to gray peas, showing how appealing plant-based products can be developed. Finally, Paper Four suggests that unique/novel and natural are promising terms to use for plant-based food products, both of which could be strengthened by elements of artisanal but not vegetarian associations. A cyclic investigation and the inclusive continual improvement of a foodstuff’s sensory qualities and culinary utility with purpose and target is proposed and applied in the culinary funnel model (Paper Three), and culinary action as a tool for multi-sectoral cooperation in Paper Four. Since sensory variation is necessary for gastronomic potential, it would be useful to perceive cultivated diversity as a fundamental quality in any cuisine. Who knows which species and cultivars might be favored in the light of climate change, unsustainable resource consumption, and a growing food demand?
... In contrast to exploratory DPs, per se being dependent on the study population they were derived from, numerous a priori DPs have been investigated across different study populations [2]. Within the latter, DPs were either developed to reflect healthy regional dietary habits, e.g., the Mediterranean diet or the Nordic diet [3,4], or to measure achievements of improvements in interventions of certain health conditions, e.g., Dietary Approaches to Stop Hypertension (DASH) [5]. Other well-investigated diet quality scores derived in the United States were the Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI). ...
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Previously, the attempt to compile German dietary guidelines into a diet score was predominantly not successful with regards to preventing chronic diseases in the EPIC-Potsdam study. Current guidelines were supplemented by the latest evidence from systematic reviews and expert papers published between 2010 and 2020 on the prevention potential of food groups on chronic diseases such as type 2 diabetes, cardiovascular diseases and cancer. A diet score was developed by scoring the food groups according to a recommended low, moderate or high intake. The relative validity and reliability of the diet score, assessed by a food frequency questionnaire, was investigated. The consideration of current evidence resulted in 10 key food groups being preventive of the chronic diseases of interest. They served as components in the diet score and were scored from 0 to 1 point, depending on their recommended intake, resulting in a maximum of 10 points. Both the reliability (r = 0.53) and relative validity (r = 0.43) were deemed sufficient to consider the diet score as a stable construct in future investigations. This new diet score can be a promising tool to investigate dietary intake in etiological research by concentrating on 10 key dietary determinants with evidence-based prevention potential for chronic diseases.
... Diets high in fruits and non-starchy vegetables, whole grains, legumes, nuts and seeds, fish and shellfish, and unsaturated fat-rich vegetable oils, and low in refined starches, red meat and processed foods and beverages with high sodium, added sugars and/or TFA content are associated with a lower risk of developing CVD, T2DM and some types of cancer in Western populations (Mozaffarian, 2016;Willett et al., 2019;USDA, 2020). The Mediterranean-style diet pattern (Davis et al., 2015) and the New Nordic diet-style pattern (Mithril et al., 2012(Mithril et al., , 2013, also called Baltic Sea diet-style pattern, are good examples of such dietary patterns in Europe. The relationship between the consumption of other foods groups (e.g. ...
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Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods. This Opinion is based on systematic reviews and meta-analyses of human studies on nutritionally adequate diets, data from the Global Burden of Disease framework, clinical practice guidelines, previous EFSA opinions and the priorities set by EU Member States in the context of their Food-Based Dietary Guidelines and associated nutrient/food intake recommendations. Relevant publications were retrieved through comprehensive searches in PubMed. The nutrients included in the assessment are those likely to be consumed in excess or in inadequate amounts in a majority of European countries. Food groups with important roles in European diets have been considered. The Panel concludes that dietary intakes of saturated fatty acids (SFA), sodium and added/free sugars are above, and intakes of dietary fibre and potassium below, current dietary recommendations in a majority of European populations. As excess intakes of SFAs, sodium and added/free sugars and inadequate intakes of dietary fibre and potassium are associated with adverse health effects, they could be included in nutrient profiling models. Energy could be included because a reduction in energy intake is of public health importance for European populations. In food group/category-based nutrient profiling models, total fat could replace energy in most food groups owing to its high-energy density, while the energy density of food groups with low or no fat content may be well accounted for by the inclusion of (added/free) sugars. Some nutrients may be included in nutrient profiling models for reasons other than their public health importance, e.g. as a proxy for other nutrients of public health importance, or to allow for a better discrimination of foods within the same food category.
... İskandinav Mutfağı; Danimarka ve diğer İskandinav ülkelerinin (Norveç, İsveç, Finlandiya ve İzlanda) gastronomi gündeminde daha sık yer almaya başlamıştır (Micheelsen 2014). Nordik Diyeti; Baltık Deniz Diyet Piramidi'nden uyarlanarak Nordik ülkeleri halkının daha fazla taze, mevsimsel ve yerel besin tüketimlerini desteklemek amacıyla geliştirilen bir diyet modelidir (Mithril 2012). ...
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Öz: Diz eklemi; kas, kapsül, menüsküs, sı̇novya, tendon ve lı̇gamanlardan oluşan bir anatomik boşluktur. Tüm bu yapılar dize stabilite yanı sıra hareket özgürlüğü tanır. Nedeni tam bilinmemekle ilerleyen yaşla kıkırdak başlangıçlı eklemi oluşturan yapılardaki histopatolojik bozulmayla osteoartrit olarak tanımlanan dizde ağrı, şişlik, etraf dokulardaki değişimle hareket kısıtlılığı ve atrofi gelişir. Kişinin hareket kabiliyeti ve yaşam kalitesi bozulur. Osteoartrit çoğunluğu farmakolojik yolla tedavi edilse de yine de eklem içi ve etraf dokularda atrofi ve eklem hareket açıklığı kaybı gibi kayıplar gelişebilir. Bu kayıpları önleme veya geri kazanmadaki tedavilerden biri rehabilitasyon programıdır. Gerekli etik onaylar alınarak, SBÜ Gazi Yaşargil Eğitim Araştırma Hastanesi Fiziksel Tıp ve Rehabilitasyon Polikliniğine başvuranlar arasında en az 6 aydır devam eden osteoartrit tanısı konulmuş ve bu amaçla farmakolojik tedavi almış kişiler, belirlenen muayene kriterine göre atrofi ve eklem hareket açıklığı bozulan, ilerlememiş radyolojik değişimli 70 hasta, rastgele seçilerek iki ayrı grupta değerlendirildi. Tekrar ilaç verilmeden, 3 hafta ve günde 2 kez eşit sürede uygulayacağı ev programı/aile eğitimi kapsamında, ağrı sınırında birinci guruba “Eklem Hareket Açıklığı”, ikinci gruba “İzometrı̇k Güçlendirme” egzersizi ayrıca hastanın aktif/pasif katılımı dikkate alınarak refakatçı eşliğinde eğitim verildi. Hastaların çoğunlukla kadınlardan oluştuğu (%83,3, n=57), hastaların yaş ortalaması ve standart sapma 65±9,4 olduğu, orta�lama boy ve standart sapma 163,3cm±7,6cm olduğu ve ortalama kilo ve standart sapmanın 80,4 kg±15,3kg olduğu tespit edilmiştir. Hastaların hesaplanan ortalama Vücut Kitle İndeksleri ve standart sapma 30,3±6,2 olarak tespit edilmiştir. Her iki gruptaki hastalara ilk başvuruda ve 3 haftalık egzersiz sonrası kontrolde, Lequesne Algofonksiyon İndeks Ölçeği uygulanmış ve söz konusu ölçek 0 ile 24 puan arasında skorlanmaktadır. Gruplara ilk ve son skorlar doğrultusunda bağımsız örneklem t-testi uygulanmıştır. Elde edilen sonuçlara göre her iki grup arasında egzersiz etkinliği açısında anlamlı farklılık bulunmuştur (p<0,05). Söz konusu ölçeğin ilk ve son puanları arasındaki fark incelendiğinde, Hareket Açıklığı Egzersizi uygulayan gruptaki ortalama fark ve standart sapması 9±3 iken, İzometrik Egzersiz uygulayan gruptaki ortalama fark ve standart sapması 7±3 olarak tespit edilmiş ve Hareket Açıklığı Egzersizlerinin daha etkin olduğu görülmüştür. Uygulanan programla hastaların geliş şikayetlerinde anlamlı iyileşmelerin olduğu tespit edilmiştir.
... The importance of dietary guidance for sustainability has been recognized by nutrition professional organizations (5,6), government dietary guidance agencies (7)(8)(9)(10)(11), and international organizations (12)(13)(14). One of the most extensive sets of dietary recommendations developed to meet both health and environmental goals is that of the recent EAT Lancet report (13). ...
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