Labros S. Sidossis

Textbook of Lifestyle Medicine


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carbon dioxide production and, thus, carbon footprint. In order for a food to be characterized as “typical” of the Nordic diet, it has to fulfill a list of criteria, such as being produced within the Nordic countries without employing external energy sources, being related to Nordic dietary tradition (such as dark bread, root vegetables, and fish), being superior in terms of health effects compared to other foods of the same food group, and being consumed as food and not only in small amounts as dietary supplement, such as spices.

      A detailed description of the Nordic dietary model and a sample menu plan can be found in Appendix B.9.

      Take‐Home Messages

       The Nordic diet is a plant‐based diet and refers to the dietary pattern recently developed in the Nordic region.

       Compared to the Mediterranean and the DASH diets, the Nordic diet differs in the type of recommended oil and the vegetable and fruit choices.

       The Nordic diet has been proven to have favorable health effects in controlling weight status and blood glucose and in reducing cardio‐metabolic and inflammatory markers.

       A food is characterized as “typical” of the Nordic diet if it fulfills a list of criteria, such as being produced within the Nordic countries, being related to Nordic dietary tradition, superior in terms of health effects compared to other foods of the same food group, and consumed as food and not as dietary supplement.

      Self‐Assessment Questions

      1 What are the main characteristics of the Nordic diet?

      2 What are the main differences of the Nordic diet compared to the Mediterranean and DASH diets?

      3 When is a food characterized as typical of the Nordic diet?

      Various aspects of the traditional Asian diet are followed by most Asian countries, including Bangladesh, Cambodia, China, India, Indonesian, Japan, Laos, Malaysia, Mongolia, Myanmar, Nepal, North Korea, South Korea, Philippines, Singapore, Sri Lanka, Taiwan, Thailand, and Vietnam. Although there are differences between countries, they all have many common food groups or items characteristic of the region.

       Key Point

      The Asian diet is primarily characterized by high consumption of rice, foods of plant origin (e.g., soy products), fish and seafood, and fruits and vegetables.

      The illustration of these guidelines resembles the traditional Japanese spinning top toy, i.e., a turned‐upside‐down cone with separated layers displaying different foods. This illustration incorporates the number of servings for each food category.

Schematic illustration of the Asian diet pyramid.

      © 2018 Oldways Preservation & Exchange Trust.

Schematic illustration of the Japanese food guide spinning top.

      Source: Reprinted from Yoshiike et al. (2007).

      The Japanese dietary guidelines emphasize the planning of a regular meal schedule for the establishment of a healthy rhythm, eating well‐balanced meals, including staple foods, grains, vegetables and fruits, dairies, beans, and seafood, as well as enjoying both main meals and snacks. Furthermore, it highlights the avoidance of excessive amounts of salt and fat. Lifestyle recommendations are also included, such as managing body weight by controlling energy intake and being active and monitoring caloric intake. Finally, Japanese guidelines highlight the benefits of following the local dietary culture, avoiding food waste, and adopting suitable culinary practices and storage methods.

       Key Point

      Japanese guidelines highlight the benefits of following the local dietary culture, avoiding food waste, and adopting suitable culinary practices and storage methods.

      Back in the 1950s, the Seven Countries Study, led by Ancel Keys, aiming to chart the incidence of CHD among seven countries (US, Japan, Italy, Greece, the Netherlands, Finland, Yugoslavia), underlined the effectiveness of the traditional Japanese diet in reducing CHD risk, as the Asian cohort demonstrated the lowest CHD incidence. The researchers from the Seven Countries Study concluded that the Asian diet was most effective in lowering CHD rates, although compared to the Greek cohort, Japanese showed more strokes due to the high sodium intake in Japan and higher stomach cancer rates due to traditional food preservation methods. Nevertheless, several studies have documented the beneficial role of specific dietary components of the Asian diet on various health outcomes.

       Key Point

      The researchers from the Seven Countries Study concluded that the Asian diet was most effective in lowering CHD rates.

      The base of the pagoda is filled with cereals, such as rice, corn, bread, noodles, and crackers, as well as tubers.