Diets benefiting health and climate relate to longevity in northern Sweden

• Published in: The American journal of clinical nutrition Vol. 114; no. 2; pp. 515 - 529
• Main Authors: Strid, Anna, Johansson, Ingegerd, Bianchi, Marta, Sonesson, Ulf, Hallström, Elinor, Lindahl, Bernt, Winkvist, Anna
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2021; Oxford University Press; American Society for Clinical Nutrition, Inc
• Subjects: Adult; Agriculture; carbon dioxide equivalents; carbon footprint serve; Climate Change; climate impact; consumption; Density; density index; Diet; diet quality; Diet Surveys; Energy intake; Evaluation; Female; food; food frequency questionnaire; Greenhouse effect; Greenhouse gases; greenhouse-gas emissions; Humans; Life cycle analysis; Life cycle assessment; Life cycles; Longevity; Male; Middle Aged; Mortality; nutrient; Nutrient cycles; nutrient density index; Nutrition & Dietetics; Nutrition and Dietetics; nutritional quality; Näringslära; Original Research Communications; outcomes; Population studies; questionnaire; recommendations; Risk; Statistical models; sustainability; Sweden; validation; Women; Sweden; CO2e; HNutr/HClim; NRF; MRI; LNutr/LClim; WWF; nutrient density index; food frequency questionnaire; FIL; carbon dioxide equivalents; LCA; RISE; WF; LNutr/HClim; NNR; diet quality; mortality; HNutr/LClim; VIP; GHGE; climate impact
• ISSN: 0002-9165; 1938-3207; 1938-3207
• DOI: 10.1093/ajcn/nqab073

Diets combining adequate nutritional quality and low climate impact are highly needed for human and planet health.
We aimed to 1) evaluate nutrient density indexes’ ability to predict mortality, and 2) assess the effects of diets varying in nutrient density and climate impact on total mortality.
Dietary data from 49,124 women and 47,651 men aged 35–65 y in the population-based prospective study Västerbotten Intervention Programme (Sweden) were used. Greenhouse gas emissions (GHGEs) were estimated using data from life cycle assessments. Fifteen variants of nutrient density indexes were evaluated and the index that best predicted mortality was used to estimate participants’ nutrient density. GHGEs and nutrient density were adjusted for energy intakes. Total mortality risk was estimated by Cox proportional hazards models for 4 groups of women and men, respectively, i.e., higher nutrient density, lower climate impact (HNutr/LClim); higher nutrient density, higher climate impact (HNutr/HClim); lower nutrient density, lower climate impact (LNutr/LClim); and lower nutrient density, higher climate impact (LNutr/HClim—reference group).
NRF11.3, a Sweden-adapted variant of the Nutrient Rich Foods index, was identified to have the best ability to predict mortality in the study population. Median follow-up times for women and men were 16.0 and 14.7 y, respectively. For women a significantly lower mortality risk was found for HNutr/LClim (HR: 0.87; 95% CI: 0.79, 0.96; P = 0.008) and HNutr/HClim (HR: 0.87; 95% CI: 0.78, 0.97; P = 0.011) than for LNutr/HClim. Among men LNutr/LClim had a significantly higher mortality risk (HR: 1.10; 95% CI: 1.01, 1.21; P = 0.033) than LNutr/HClim.
Diets beneficial for both health and climate are feasible and associated with lower mortality risk in women. Further studies are needed to understand how men may transition into diets that are more sustainable from a combined health and climate perspective.
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