The new Nordic Nutrition Recommendations for 2023 for the first time include the environmental impacts of the diets of people in the region, but according to Rune Blomhoff, the Oslo University professor who has managed the project, most foods which are better for the environment are also healthy.
"What we eat is incredibly important for the climate and environment. A third of greenhouse gas emissions can be linked to our food," Blomhoff told Swedish newswire TT as the report was published on Tuesday.
"At the same time, we have gained much more knowledge about the synergies: what is good for health is also good for the environment."
What are the Nordic Nutrition Recommendations?
The Nordic Nutrition Recommendations have been influential across the world ever since the review was first published back in 1980 by the Nordic Council of Ministers, a body representing ministers from Denmark, Finland, Iceland, Norway and Sweden.
The recommendations have a real impact on the way people eat in the Nordics as they are supposed to steer the national dietary guidelines and thereby affect what ends up on plates in schools, hospitals, and other public-sector canteens.
So what's changed in the current report?
No alcohol at all. Whereas the previous 2012 report said that consuming small amounts of alcohol - up to two small glasses of wine a day (< 20 g/d) for men and up to one small glass of wine a day (< 10 g/d) for women, was OK, the new report recommends drinking no alcohol at all, arguing that recent research has challenged the idea of a safe lower limit for alcohol consumption.
"Since no safe limit for alcohol consumption can be provided, the recommendation in NNR2023 is that everyone should avoid drinking alcohol," the council said in a press release. "If consuming alcohol, the intake should be low. This recommendation also applies to women who are breastfeeding. A more restrictive recommendation (total abstinence) applies to children, adolescents, and pregnant women."
Blomhoff put much of the published research claiming health benefits for alcohol consumption down to "people with special interests", arguing that "within the scientific literature there is a large consensus" on its likely harmfulness.
Red meat consumption "considerably lower than 350g". The new report cuts the recommendation for consumption of red meat from 500g a week in 2012 to just 350g, basing this decision on research showing that eating too much red meat is the second biggest dietary factor causing disabling illnesses and early deaths in Denmark and Iceland, and the third biggest in Norway, Sweden and Finland.
"There is strong evidence that the risk of bowel cancer increases if you exceed 350 grams of red meat per week," Blomhoff told TT. The high environmental burden from red meat, however, means that the council recommends reducing consumption even further.
At least 200g a week of fatty fish. One lifestyle pattern people in the Nordics don't need to change much is their consumption of fatty fishes such as herring, mackerel and salmon.
The new report calls on people to eat between 300 and 450g of fish a week, citing reports from the Norwegian Scientific Committee for Food and Environment (VKM) which have found it lowers the risk of coronary heart disease, myocardial infarction and strokes, and probably protects against Alzheimer's and other forms of dementia.
Between 500g and 800g of vegetables, fruit and berries every day. The report recommends a very high consumption of vegetables, fruit and berries, with people in the Nordics recommended to eat at least half a kilo each a day, which is associated with a lower risk of cancer, heart disease, and early death.
Unlike the 2012 report, however, this update recommends against a high intake of fruit juices, particularly for children.
Greater consumption of beans, peas, pulses and other legumes. The report says that legumes are good sources of dietary fibre, protein, iron and zinc, and cites evidence that eating more of them protects against cancer and lowers mortality. But the main reason this year's report puts more emphasis on them is environmental, with the crops having "among the lowest relative climate impacts" of any food group.
Eat at least 90g of whole grains a day. The council recommends eating more wholegrains. A bowl of porridge and a slice of whole grain rye bread each come to about 50g, so to meet the daily recommendation, people would need to eat one of each.
No recommendations for ultra-processed foods. The council does not make specific recommendations to avoid ultra-processed foods, such as canned soda drinks, packaged cakes, many breakfast cereals, and ready meals, arguing that "the categorization of foods as ultra-processed foods does not add to the already existing food classifications and recommendations" in the recommendations.
The report does warn that ultra-processed foods often contain high amounts of sugar, fats, and salt, encourage over-eating and the risk of obesity, heart disease, diabetes, cancer, depression and early death. It says, however, that they can sometimes be healthy, especially if fortified with vitamins.
More of some vitamins and less of others. The new report increases the recommended intake of vitamins A, E, B2, B6, B12, C, calcium, iron, zinc, iodine, and selenium, and decreases the recommended intake of B1 (thiamine) and phosphorus.
What have been the reactions from politicians, researchers, and the media?
Marit Kolby, a food scientist at Oslo New University College who contributed to the report, has described the decision not to give recommendations on ultra-processed foods as "problematic and very surprising", given that more than 400 researchers, including herself, had worked together on preparing background documents on them.
Agnes Wold, a Swedish professor, attacked a draft recommendation that breastfeeding women abstain completely from alcohol as "unscientific, backwards and moralistic" in an opinion article in Svenska Dagbladet. This recommendation was later changed to the same as for the rest of the adult population, that breastfeeding women should have a low intake, but preferably no intake at all, of alcohol.
Sweden's agriculture minister Peter Kullgren wrote an opinion piece in the Aftonbladet newspaper arguing that Swedes should produce more, not less red meat, as increasing the cattle population would help restore the country's historic pasturelands.
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