The Nordic countries (including Finland, Norway, Sweden, Denmark, and Iceland) are well known for having some of the healthiest and happiest populations in the world. Sweden consistently maintains one of the world’s highest life expectancies, and Forbes, Bloomberg, and others have featured all five countries on lists of ‘the world’s healthiest countries.’
Many have attributed their good health to the Nordic diet. As with most of the countries we’ve talked about so far, the Nordic regional diet is rapidly becoming westernized, but their traditional diet pattern has a lot of positives. It’s high in dairy, rye bread, fish, berries, apples, cabbage, root vegetables, potatoes, pork, and game meat, and until recently, they weren’t afraid of dairy fat.
But I think their good health has as much to do with the fact that they exercise frequently, have superior healthcare, maintain a healthy balance between work and stress, and have environments with abundant natural beauty and low levels of pollution as it does with their diet. There are still a couple aspects of their diet I’d like to discuss, but I also think we can learn a lot from how they approach diet, rather than what that diet actually is.
Sourdough rye bread
The consumption of meat, fruit, and vegetables varies across the Nordic region, but rye bread has long been a staple in all five countries, and is part of the reason the Nordic diet is considered so beneficial. But unlike the grains consumed in Africa, which I talked about last week, rye doesn’t have the redeeming quality of being ‘gluten-free.’ The problematic protein in rye is actually called secalin, but it’s very similar to wheat gluten, and Celiacs must avoid it all the same.
However, there are a number of things that make the rye consumed in the Nordic region superior to the modern wheat consumed in increasing amounts all over the world. First of all, wheat bread elicits a significantly higher insulin response than rye bread. (1) One study compared the insulin response from white wheat bread to that of three variants of sourdough rye bread, each containing different amounts of fiber. Researchers found that postprandial blood glucose did not initially differ among the breads, but a couple hours after eating, the wheat bread caused a drop in blood glucose below fasting levels while the rye bread allowed blood glucose to remain stable. There was no significant difference between the rye breads with varying fiber contents, indicating that factors other than fiber content give rye bread a more favorable insulin response than wheat.
We already know that fermenting flour to make sourdough is beneficial for reducing toxins and increasing the bioavailability of nutrients. (2) But it could also be beneficial for increasing the resistant starch content of bread (particularly rye), thereby improving insulin response and gaining prebiotic effect. One analysis found that white wheat bread, sourdough barley bread, and scalded barley bread all contained between 0.8% and 1.7% resistant starch, while sourdough rye bread contained about 8% resistant starch. (3) Another study found that a combination of long, slow baking times and sourdough technique markedly increased the resistant starch content of not only rye bread, but other types as well. (4)
The Nordic countries are a good reminder that as humans, we are always evolving. Lactase persistence (the ability to digest lactose as an adult) is not the norm for adult humans, yet the vast majority of the adult Scandinavian population can digest lactose, giving them the highest level of lactase persistence in the world. (5) In Sweden and Denmark, over 90% of the population can digest lactose. (6) The Scandinavian countries also have the highest consumption of dairy in the world, indicating that their ability to digest lactose co-evolved with cattle domestication and the incorporation of dairy into the daily diet. (7)
On a related note, I ran across this study attempting to link lactase persistence and dairy consumption in Sweden and Finland to prostate cancer. Interestingly, the only association they found was an increased risk of prostate cancer with a higher intake of low-fat dairy, but not full-fat dairy. (Add that to the long list of studies indicating that there’s no benefit to consuming low-fat dairy over full-fat!)
Willingness to make a change
One of the biggest obstacles to health for many people is the unwillingness to change their diet or lifestyle when they clearly aren’t working. Resistance to change is also a huge problem with government guidelines and other sources of ‘conventional wisdom.’ But when you look at the health history of the Nordic countries, it’s quite remarkable how willing they are to try new things in the name of health.
Take Finland, for example. In the 1980’s, they had the highest rates of heart disease in the world. (8, 9) In fact, Finland’s example helped establish the notion that saturated fat leads to heart disease, because at the time, Finland also had one of the highest levels of saturated fat consumption in the world.
Then the North Karelia project was introduced, with goals to cut smoking, increase fruit and vegetable consumption, and replace saturated animal fats with vegetable oils in the North Karelia region of Finland. But soon the rest of the country caught on, and their lifestyle changes brought about one of the most remarkable public health transformations in history. In just 20 years, rates of heart disease in Finland decreased by about 60%. (10, 11)
Now, there are a lot of factors at play here – the dramatic reduction in smoking, genetics, and the curious east-west health disparity, to name a few – and although the North Karelia project has been used to further demonize saturated fat, the evidence doesn’t support that stance. (12, 13) But the point I want to make is that the Finns made a radical shift in their lifestyle, and weren’t afraid to embrace change. It may have (in part) been a misguided shift; their rising triglycerides, falling HDL, and increasing rates of obesity indicate that replacing saturated fat with vegetable oils was likely not the best choice. (14) But their heart disease rates did fall dramatically, and no other country in history has been able to make that kind of a positive shift in their health.
Sweden’s recent low-carb craze is another example. After one forward-thinking doctor began recommending low-carb, high-fat diets to some of her patients, the Swedish equivalent of the USDA reviewed the science on low-carb diets and stated that “A low carbohydrate diet can today be said to be in accordance with science and well-tried experience for reducing obesity and Type 2 diabetes.” (15) “Low-carbing” became socially and scientifically acceptable, and millions of Swedes hopped on the low-carb, high-fat bandwagon.
Naysayers have published research “proving” that this new trend is killing Sweden, which Denise Minger has dismantled for us here and here. We really don’t know what effect this trend will have on Sweden in the long run, but the simple fact that their people – and their government – were willing to embrace a new dietary perspective is quite amazing.
Food is more than just nutrients
Finally, I want to highlight a new dietary initiative in Denmark, called the ‘New Nordic Diet.’ Essentially, the NND is like any other set of dietary recommendations: they’ll be disseminated to the public, with the intent of improving public health. (16) But this is one of the most holistic sets of dietary recommendations I’ve seen, and I sincerely hope this trend catches on in other countries.
The creators of the NND didn’t redeem saturated fat or caution against omega-6s, but they did something equally impressive: they shifted the focus off of nutrients and onto foods. They recommend consuming tasty, local, sustainable foods that have been part of the Nordic diet for ages, including berries, cabbages, root vegetables, legumes, fresh herbs, potatoes, plants and mushrooms from the wild countryside, whole grains, nuts, fish and shellfish, seaweed, dairy, eggs, free-range livestock, and game. They also make a point of encouraging other countries to craft similar recommendations, but using foods that are local and traditional to their own culture.
Overall, I think the Nordic countries set a great example of how modern, industrialized countries should approach health. When Finland experienced a public health crisis, they came together as a community and made drastic changes to solve the problem. When the Swedish government was presented with scientific evidence that contradicted their prior conclusions, they changed their stance. And instead of trying to reduce food down to ‘good’ and ‘bad’ nutrients, Denmark is moving towards a holistic view of food that takes culture, palatability, and the environment into account as well. I think we can learn a lot from these actions, not only as individuals, but also as a community.