Development of the Norwegian diet index and the Norwegian lifestyle index and evaluation in a national survey

• Published in: Food & nutrition research Vol. 67; pp. 1 - 11
• Main Authors: Henriksen, Hege Berg, Berg, Hedda Beate, Andersen, Lene Frost, Weedon-Fekjær, Harald, Blomhoff, Rune
• Format: Journal Article
• Language: English
• Published: Open Academia 29.09.2023; Swedish Nutrition Foundation
• Subjects: alcohol; body weight; diet index; food-based dietary guidelines; lifestyle index; national lifestyle recommendations; Original; physical activity; tobacco
• ISSN: 1654-661X; 1654-661X
• DOI: 10.29219/fnr.v67.9217

BackgroundDietary and lifestyle indices are composite tools that are used to estimate risk of health outcomes. ObjectiveWe aimed to develop a diet and a lifestyle index assessing adherence to the national guidelines in Norway, and to investigate adherence in a nationwide survey of healthy subjects (Norkost3). DesignCut-off values for the indices were based on the Norwegian food based dietary guidelines and national lifestyle guidelines. Adherence was evaluated in the Norkost3 (n = 1,787). ResultsTwelve dietary components were included in the diet index 1) fruit and berries, 2) vegetables, 3) whole grains, 4) unsalted nuts, 5) fish, 6) low-fat dairy products, 7) margarine/oils, 8) red meat, 9) processed meat, 10) foods rich in sugar and fat, 11) drinks with added sugar, and 12) dietary supplements. Each of the components was assigned a value of 0, 0.5 or 1 corresponding to low, intermediate and high adherence, except for plant-based foods, which were assigned a value of 0, 1.5 or 3, providing a composite diet index ranging from 0 to 20 points. The five components in the lifestyle index (i.e. diet, body mass index (BMI), physical activity, tobacco and alcohol) was assigned a value of 0, 0.5 or 1, giving a final score ranging from zero to five points. In Norkost3, 49% (95% CI: 47, 52) of the participants had low adherence to the diet component, whereas only 2% (95% CI: 2, 3) achieved high adherence, although most of the subjects had high educational level. High adherence to the recommendations of BMI, tobacco and alcohol intake was observed in 50% (95% CI: 47, 52), 72% (95% CI: 70, 74) and 68% (95% CI: 66, 70) of the participants, respectively. Due to the lack of data on physical activity, adherence to this component in the lifestyle index is not presented in this study. ConclusionThe new diet and lifestyle indices assess adherence to the Norwegian food-based dietary guidelines (FBDGs) and other national lifestyle guidelines. In this study, half of the subjects had low diet and lifestyle index scores. There is a need to implement interventions to improve this by focusing on the specific lifestyle components with low adherence.