TABLE 5.
HRs and 95% CIs for total mortality, and characteristics, of women participating in the Västerbotten Intervention Programme during 1990–2016, classified into 4 groups according to their diet quality calculated by the nutrient density score NRF11.3 and climate impact1
| Women (n = 49,124) | |||||||
|---|---|---|---|---|---|---|---|
| HNutr/LClim (n total = 12,997; n cases = 865) | P | HNutr/HClim (n total = 11,566; n cases = 570) | P | LNutr/LClim (n total = 11,564; n cases = 895) | P | LNutr/HClim, reference group (n total = 12,997; n cases = 744) | |
| HR mortality2 (95% CI), basic model | 0.81 (0.73, 0.89) | <0.001 | 0.81 (0.72, 0.90) | <0.001 | 0.92 (0.84, 1.02) | 0.096 | 1.00 |
| HR mortality3 (95% CI), model 1 | 0.88 (0.80, 0.97) | 0.013 | 0.87 (0.78, 0.97) | 0.012 | 0.97 (0.88, 1.07) | 0.541 | 1.00 |
| HR mortality4 (95% CI), model 2 | 0.87 (0.79, 0.96) | 0.008 | 0.87 (0.78, 0.97) | 0.011 | 0.96 (0.87, 1.06) | 0.439 | 1.00 |
| Age,5 y | 47.2 ± 8.0 | 48.3 ± 8.0 | 47.7 ± 8.0 | 48.3 ± 8.0 | |||
| Systolic blood pressure,5 mm Hg | 123.8 ± 18.1 | 123.9 ± 17.6 | 123.2 ± 18.4 | 123.9 ± 18.0 | |||
| Diastolic blood pressure,5 mm Hg | 76.9 ± 10.4 | 77.1 ± 10.3 | 76.6 ± 10.7 | 77.3 ± 10.7 | |||
| Serum cholesterol,5 mmol/L | 5.5 ± 1.2 | 5.4 ± 1.1 | 5.5 ± 1.2 | 5.5 ± 1.2 | |||
| Fasting blood glucose (capillary),5 mmol/L | 5.4 ± 0.9 | 5.4 ± 0.9 | 5.4 ± 0.8 | 5.4 ± 0.9 | |||
| 2-h blood glucose,5 mmol/L | 6.8 ± 1.5 | 6.9 ± 1.5 | 6.8 ± 1.5 | 6.9 ± 1.5 | |||
| BMI,5 kg/m2 | 25.5 ± 4.4 | 26.1 ± 4.7 | 25.1 ± 4.6 | 25.8 ± 4.9 | |||
| Underweight, <18.5 | 1.0 | 0.7 | 1.5 | 1.1 | |||
| Normal, 18.5–25.0 | 53.8 | 46.4 | 57.3 | 49.2 | |||
| Overweight, >25.0–30.0 | 31.3 | 34.8 | 28.4 | 32.3 | |||
| Obese, >30.0 | 13.8 | 18.2 | 12.8 | 17.5 | |||
| Physical activity | |||||||
| Inactive | 14.8 | 16.2 | 19.6 | 19.9 | |||
| Moderately inactive | 31.4 | 28.4 | 32.7 | 30.1 | |||
| Moderately active | 27.8 | 26.5 | 28.0 | 28.4 | |||
| Active | 25.6 | 28.5 | 19.2 | 21.1 | |||
| Level of education | |||||||
| Basic level, 9 y | 37.3 | 30.5 | 42.2 | 32.2 | |||
| High school | 26.1 | 28.5 | 28.3 | 32.9 | |||
| University | 35.8 | 40.3 | 28.7 | 34.1 | |||
| Smoking | |||||||
| Currently smoking | 17.7 | 18.6 | 22.7 | 23.3 | |||
| Have smoked | 29.6 | 31.7 | 25.6 | 28.1 | |||
| Never smoked | 51.9 | 48.9 | 50.7 | 47.8 | |||
| Climate impact per day and 2000 kcal, kg CO2e | 2.6 [2.3–2.8] | 3.5 [3.2–3.9] | 2.6 [2.3–2.8] | 3.5 [3.2–4.1] | |||
| Energy-adjusted climate impact per year, tonnes CO2e | 0.9 [0.8–1.0] | 1.3 [1.2–1.4] | 0.9 [0.9–1.0] | 1.3 [1.2–1.5] | |||
| Nutrient density score per day and 2000 kcal6 | 7.7 [7.3–8.2] | 7.7 [7.2–8.1] | 6.3 [5.8–6.7] | 6.2 [5.7–6.6] | |||
Values are means ± SDs, medians [IQRs], or percentages unless otherwise indicated. HRs, 95% CIs, and P values estimated by Cox proportional hazards regression. NRF11.3 is based on the NRF index. Qualitative nutrients in NRF11.3 are protein, fiber, iron, potassium, calcium, magnesium, vitamin A, vitamin C, vitamin E, vitamin D, and folate, and disqualitative nutrients are sodium, saturated fat, and added sugars. All qualitative nutrients in NRF11.3 are capped at the DRI, except for fiber which has no recommended upper limits. All group differences were P < 0.05 and mostly P < 0.001, except for 2-h blood glucose (P = 0.111), tested using 1-factor ANOVA, the Kruskal–Wallis test, and chi-square test. CO2e, carbon dioxide equivalents; HNutr/HClim, higher nutrient density/higher climate impact; HNutr/LClim, higher nutrient density/lower climate impact; LNutr/HClim, lower nutrient density/higher climate impact; LNutr/LClim, lower nutrient density/lower climate impact; NRF index, Nutrient Rich Foods index.
Basic model adjusted for age and age squared.
Model 1 adjusted for age, age squared, BMI, physical activity, educational level, and smoking status.
Model 2 adjusted for age, age squared, BMI, physical activity, educational level, smoking status, and year of participation.
Adjusted for age and year of study participation.
Calculated by NRF11.3 with capping.