Nordic Nutrition Recommendations and risk of myocardial infarction and stroke: a prospective cohort study

Sjöblom, Linnea; Hantikainen, Essi; Bellocco, Rino; Ye, Weimin; Adami, Hans-Olov; Trolle Lagerros, Ylva; Bonn, Stephanie Erika

doi:10.1007/s00394-024-03337-7

Table 3 Incidence rates and hazard ratios of myocardial infarction and stroke for the adherence to the Nordic Nutrition Recommendations 2023 (NNR₂₀₂₃)

From: Nordic Nutrition Recommendations and risk of myocardial infarction and stroke: a prospective cohort study

Total sample	No. of cases	Person-years	Model^a		Model^b
Total sample	No. of cases	Person-years	HR	(95% CI)	HR	(95% CI)
Myocardial infarction
NNR₂₀₂₃-score (range 0–9)	1649	623,206	0.84	(0.77 to 0.90)	0.86	(0.78 to 0.95)
NNR₂₀₂₃ categories
Low (< 6.3)	599	157,172	1.00	(Reference)	1.00	(Reference)
Moderate (6.3– 7.2)	840	318,310	0.93	(0.83 to 1.04)	1.00	(0.88 to 1.13)
High (> 7.2)	210	147,725	0.69	(0.58 to 0.81)	0.72	(0.59 to 0.87)
P for linear trend			< 0.01		0.01
Stroke
NNR₂₀₂₃-score (range 0–9)	2071	621,798	0.91	(0.85 to 0.98)	0.94	(0.87 to 1.03)
NNR₂₀₂₃ categories
Low (< 6.3)	691	156,814	1.00	(Reference)	1.00	(Reference)
Moderate (6.3–7.2)	1003	318,223	0.83	(0.75 to 0.92)	0.88	(0.78 to 0.99)
High (> 7.2)	377	146,760	0.89	(0.78 to 1.01)	0.95	(0.81 to 1.11)
P for linear trend			0.02		0.31
Female
Myocardial infarction
NNR₂₀₂₃-score (range 0–9)	737	418,638	0.75	(0.67 to 0.84)	0.77	0.67 to 0.89)
NNR₂₀₂₃ categories
Low (< 6.3)	158	68,693	1.00	(Reference)	1.00	(Reference)
Moderate (6.3–7.2)	436	219,821	0.78	(0.65 to 0.93)	0.79	(0.64 to 0.99)
High (> 7.2)	143	130,124	0.58	(0.46 to 0.72)	0.59	(0.45 to 0.78)
P for linear trend			< 0.01		< 0.01
Stroke
NNR₂₀₂₃-score (range 0–9)	1149	416,343	0.92	(0.83 to 1.01)	0.98	(0.87 to 1.10)
NNR₂₀₂₃ categories
Low (< 6.3)	224	68,195	1.00	(Reference)	1.00	(Reference)
Moderate (6.3–7.2)	624	219,003	0.78	(0.67 to 0.91)	0.84	(0.70 to 1.01)
High (> 7.2)	301	129,145	0.86	(0.72 to 1.02)	0.96	(0.78 to 1.18)
P for linear trend			0.17		0.92
Male
Myocardial infarction
NNR₂₀₂₃-score (range 0–9)	912	204,568	0.92	(0.83 to 1.02)	0.97	(0.85 to 1.10)
NNR₂₀₂₃ categories
Low (< 6.3)	441	88,478	1.00	(Reference)	1.00	(Reference)
Moderate (6.3–7.2)	404	98,489	0.99	(0.87 to 1.14)	1.09	(0.93 to 1.28)
High (> 7.2)	67	17,600	0.84	(0.65 to 1.08)	0.86	(0.64 to 1.17)
P for linear trend			0.33		1.00
Stroke
NNR₂₀₂₃-score (range 0–9)	922	205,455	0.91	(0.82 to 1.02)	0.91	(0.81 to 1.04)
NNR₂₀₂₃ categories
Low (< 6.3)	467	88,620	1.00	(Reference)	1.00	(Reference)
Moderate (6.3–7.2)	379	99,220	0.87	(0.76 to 0.996)	0.90	(0.77 to 1.06)
High (> 7.2)	76	17,616	0.89	(0.70 to 1.14)	0.90	(0.68 to 1.18)
P for linear trend			0.07		0.21

HR Hazards ratio; CI confidence interval, PY Person-years
^aAdjusted for age (years) and sex (female/male, not in stratified analysis) at enrollment
^bAdjusted for age (years), sex (female/male, not in stratified analysis), body mass index (kg/m²), level of education (≤ 13 years, > 13 years), smoking status (never, former, current), physical activity (METh/day), total daily energy intake (kcal/day), hypertension (yes/no), diabetes (yes/no), and lipid disturbance (yes/no)

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