The study did not look at specific foods and their effects, but rather at how different groups of people ate according to a number of food patterns that were identified. The researchers used dietary data from 20 487 healthy participants; comparing it with their health status 20 years on.
“If you want to give dietary recommendations to the general public, you must examine overall food patterns, not just individual food products”, explains Ulrika Ericson, the Lund University researcher who led the study.
The result may not seem particularly sensational. What we usually refer to as healthy eating, i.e. a high intake of fibre-rich bread, fruit and vegetables and not a lot of red meat or sugary drinks, was linked to a lower risk of heart attack and type 2 diabetes in both men and women. Men also had a reduced risk of stroke and less pronounced weight gain.
A diet consisting of a high intake of low-fat products such as low-fat margarine, low-fat milk and low-fat yogurt, on the other hand, was associated with an increased risk of type 2 diabetes.
“Our findings show that what we call health conscious food choices corresponds to the European dietary guidelines and reduces the risk of cardiovascular disease and, in particular, the risk of type 2 diabetes”, says Ulrika Ericson.
The researchers identified the following six groups of people:
The health-conscious group: A high intake of fibre-rich bread, fruit, vegetables, breakfast cereals, fish and low-fat yogurt, and a low intake of low-fibre bread. For men it also included higher intake of cream and for women a lot of fresh cheese. A low intake of red and processed meat and sugary drinks was noted in both women and men.
The low-fat group: A high intake of low-fat margarine, low-fat milk and low-fat yogurt, and a low intake of butter.
The dressing and vegetables group: A high intake of polyunsaturated fat in the form of dressing/oil, vegetables, chicken, salty snacks, rice/pasta, fried potatoes and cheese, and a low intake of boiled potatoes, jam and sugar.
The traditionalists’ group: A high intake of eggs, margarine, boiled potatoes, fish, red and processed meat, cream and high-fat milk.
The tea-breakfast group: A high intake of tea, breakfast cereals, jam/sugar, high-fat yogurt, high-fat milk, and a low intake of coffee and red meat.
The sugar group: A high intake of sweets, cakes, ice-cream and sugary drinks.
The men in the “Dressing and vegetables group" also showed a reduced risk of heart attack.
The remaining food patterns showed no link to cardiovascular disease or type 2 diabetes (traditionalists, tea-breakfast and sugar groups).
However, the women in the “tea-breakfast group” had gained the least amount of weight at the time of the follow-up.
Those adhering to the “Health-conscious” food pattern were characterised as being older and more educated, with a higher intake of energy, protein, carbohydrates, fibre and vitamin C, and lower intake of fat and sugar (sucrose) than those not adhering to the pattern. Their lifestyle also involved being more physically active in their spare time and smoking to a lesser degree. Perhaps surprisingly, the women in the group had a higher BMI.
The importance of diet has proved very difficult to study, partly because the research material is often based on self-reported data, and partly because we do not eat individual food products but combinations of foods.
According to Ulrika Ericson, it is the bigger picture that counts.
“Good eating habits do not necessarily mean completely excluding certain foods, but choosing primarily to eat what is considered healthy, such as whole grains, fruits and vegetables”, she concludes.
Link to publication: Food patterns in relation to weight change and incidence of type 2 diabetes, coronary events and stroke in the Malmö Diet and Cancer cohort
Facts: The study
The eating habits of 20 487 people between the ages of 45 and 74, who took part in the study “Malmö Diet Cancer” in the early 1990s, were studied. They were followed for up to 20 years and, by then, 2 206 people had type 2 diabetes, 1 571 had experienced a heart attack and 1 332 a stroke. The researchers investigated how the consumption of 33 common food groups was combined to identify different food patterns.
Contact:
Ulrika Ericson, PhD, nutritionist, researcher, Diabetes and Cardiovascular Disease – Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University
ulrika [dot] ericson [at] med [dot] lu [dot] se
+46 72 981 91 00