New Nordic nutrition guidelines balance ecology and health

According to the new Nordic Nutrition Recommendations (NNR), foods that are both ecologically beneficial and healthy are largely one and the same. MSAH Ministerial adviser Heli Kuusipalo puts it in a nutshell: "More veg, whole grains, locally produced food and less red meat."

Now in their fifth edition, the latest recommendations are the result of work started in 2009 to renew existing guidelines issued in 2004. They have been drawn up by the NNR5 working group, nominated by the Nordic Council of Ministers, and have involved over 100 scientific experts, who have mainly focused on issues that have yielded new scientific knowledge.

In Finland, work on NNR5 has involved the National Nutrition Council, National Institute for Health and Welfare, and all universities that conduct nutrition research.

The NNR process is an unusual one, with no comparable approach to diet and health by a regional forum. A similar process of nutritional guidelines used in the United States to set nutritional standards at federal level, and the EU's policy on nutrition emulates US practice to some extent.

"The new Nordic recommendations will be published in October and will represent a common vision of the scientific community," Kuusipalo explains. "This will then be adapted into more specific guidelines at national level. Consumer organizations in each country will be responsible for this part."

The guidelines emphasise issues of ecology in the way dietary best practices are proposed. "The aim is to make as much use as possible of locally available seasonal foods, such as berries, vegetables, root vegetables and fruit, as well as preserving them for winter use. Proposals include having vegetarian days, and only having modest portions so that not so much food gets thrown away."

The guidelines work on the assumption that all essential nutrients can be obtained form ordinary, readily available food.  But while the sorts of foods available in the Nordic area are generally the same, there are significant differences in food culture throughout the Nordic countries.

This is why the NNR will be adapted to different national conditions. For instance, Finns need to supplement their diet with vitamin D, which is added to milk. In Denmark, on the other hand, there is no need to do this because people eat more fish than in Finland.

The guidelines do not propose quantitative changes to the energy nutrients in people's diets. There is more emphasis on their nutritional quality. The new NNR places particular attention on the type of fatty acids, dietary fibre and added sugars that are present when diets are evaluated and proposed.

We should get more proteins from plant products and fish, and from white, unprocessed meat. Finnish consumers are often confused when it comes to fish, as suggestions that people eat more fish are contradicted by warnings about environmental toxins. Kuusipalo emphasises that there is no cause for concern.

"The benefits of eating fish outweigh the drawbacks. There are restrictions for pregnant women, who should avoid eating large Baltic herrings, which have accumulated a lot of dioxin." She says that everyone else can even eat fish daily, but recommends that we vary the species.

Our consumption of fat also needs to alter. The trend in Finland has seen a resurgence in the amount of saturated fat being eaten, especially butter, at the expense of unsaturated fat. People should use more vegetable fats, as cholesterol levels among Finns are increasing.

One reason butter has become more popular is because people are wary of trans fats. Kuusipalo stresses that trans fats are not added to margarine in Finland. Neither is the vegetable fat in locally produced biscuits turned to saturated fat by hydrogenation as is the practice elsewhere, for instance the UK.

When it comes to carbohydrates, good quality relates in particular to fibre, which the body needs. Most people are aware that whole-wheat is healthier a white, but when it's a matter of carbohydrates in sugar they lose the plot.

"Sugar in the form of drinks are more harmful to one's health because it is absorbed by the body too rapidly," Kuusipalo observes. "There's no real difference between drinking too much soda and too much fruit juice, because there's as much fructose in juice as there is sugar added to sodas. Sure, fruit juice contains vitamins, but there's no fibre, and fructose is no healthier than other sugars. If one constantly drinks a lot of soda or fruit juice, it can lead to fatty liver disease or, if these drinks replace food, malnutrition."

Despite national variations in how the NNR will be applied, there are common problems of health related to diet and lifestyle.

"In general, we have growing numbers of the non-communicable-diseases and obesity," says Kuusipalo. "Food is over refined, contains too much salt and hard fats, and people drink and eat too much sugar, especially the younger generations. The healthiest diet and life-styles in Finland seem to be among elderly groups of 60 and upward."

There are enough similarities across the Nordic region in both the sorts of raw ingredients available and the way they are used that they can be characterised as the Baltic Sea Diet.

Based on healthy food typical to the Nordic area, the Baltic Sea Diet is emerging as the northern parallel to the much-celebrated Mediterranean Diet, with its focus on traditional Italian foods: cooked vegetables, legumes, cereals, olive oil and fish.

"The Baltic Sea Diet can be put together in similar fashion, but using raw ingredients found here, such as peas, root vegetables, onions and cabbage," Kuusipalo explains. "You can use rapeseed oil instead of olive oil, and instead of seasonal Italian fruit, berries, apples and plums. With cereals, it's good to opt for rye, oats, barley and whole-grain wheat, and to use low fat or fat-free dairy. The best sources of animal protein are fish, game and poultry."

The new NNR pay greater attention to the nutritional needs of different groups of people. Specific guidelines have been made for pregnant women, different age groups and people requiring nutritional care. Though the recommendations encourage people to eat more veg, they are not based on a mainly vegetarian diet. "Not everyone wants to go vegetarian, so we have to have the type of recommendations that include red meat," says Kuusipalo.