British Journal of Nutrition

Full Papers

Dietary Surveys and Nutritional Epidemiology

Adherence to a healthy Nordic food index is associated with a lower incidence of colorectal cancer in women: The Diet, Cancer and Health cohort study

Cecilie Kyrøa1 c1, Guri Skeiea2, Steffen Lofta3, Kim Overvada4, Jane Christensena1, Anne Tjønnelanda1 and Anja Olsena1

a1 Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark

a2 Institute of Community Medicine, University of Tromsø, Tromsø, Norway

a3 Department of Public Health, Section of Environmental Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

a4 Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark


Colorectal cancer (CRC) is a multi-factorial disease in which diet is believed to play a role. Little is known about the health effects of specific regional diets. The Nordic diet is high in fat and sugar but also includes a range of traditional products with anticipated health-promoting effects. The aim of this cohort study was to determine whether a healthy Nordic food index consisting of fish, cabbage, rye bread, oatmeal, apples, pears and root vegetables was related to CRC incidence. Data were obtained from a prospective cohort study of 57 053 Danish men and women aged 50–64 years, of whom 1025 developed CRC (13 years' follow-up). Incidence rate ratios (IRR) with 95 % CI were calculated from Cox proportional hazard models. Women who strongly adhered to a healthy Nordic food index had a 35 % lower incidence of CRC than women with poor adherence (adjusted IRR, 0·65; 95 % CI 0·46, 0·94); a similar tendency was found for men. Women had a 9 % lower incidence of CRC per point adherence to the healthy Nordic food index, but no significant effect was found for men. A regional diet based on healthy Nordic food items was therefore associated with a lower incidence of CRC in women. The protective effect was of the same magnitude as previously found for the Mediterranean diet, suggesting that healthy regional diets should be promoted in order to ensure health; this will also preserve cultural heredity and the environment.

(Received December 05 2011)

(Revised April 24 2012)

(Accepted April 24 2012)

(Online publication July 03 2012)

Key Words:

  • Colorectal cancer;
  • Colon cancer;
  • Dietary index;
  • Nordic diet;
  • Scandinavian


c1 Corresponding author: C. Kyrø, fax +45 35271811, E-mail:


  Abbreviations: CRC, colorectal cancer; IRR, incidence rate ratio