Table 1
Participant characteristics among modified Nordic diet adherence tertiles.
Variables
|
Modified Nordic diet adherence
|
P value*
|
P value**
|
Low
(n=73)
|
Medium
(n=160)
|
High
(n=171)
|
Quantitative variables ¥
Demography
|
|
|
|
|
|
Age(year)
|
36.42 ± 9.51
|
35.85 ± 9.10
|
37.54 ± 8.89
|
0.23
|
0.01Ψ
|
Weight(kg)
|
78.40 ± 11.17
|
81.52 ± 12.86
|
82.32 ± 12.41
|
0.07
|
0.46
|
Height(cm)
|
160.10 ± 5.70
|
161.56 ± 5.87
|
161.38 ± 5.90
|
0.18
|
0.91
|
PA(METs h/week)
|
605.21 ± 498.31
|
805.34 ± 610.36
|
1434.82 ± 1498.56
|
0.001 a
|
<0.001Ψ
|
Body Composition
|
|
|
|
|
|
BMI(kg/m²)
|
30.81 ± 4.58
|
31.16 ± 4.40
|
31.54 ± 4.06
|
0.45
|
0.86Ψ
|
Fat percentage (%) #
|
42.25 ± 5.38
|
42.49 ± 5.48
|
41.94 ± 5.49
|
0.65
|
0.58
|
BFM (kg) #
|
33.71 ± 8.45
|
34.96 ± 9.27
|
34.96 ± 8.38
|
0.55
|
0.23
|
FFM (kg) #
|
45.20 ± 4.75
|
46.36 ± 5.79
|
47.25 ± 5.93
|
0.03 b
|
0.51
|
FFMI #
|
17.59 ± 1.52
|
17.73 ± 1.57
|
18.89 ± 10.11
|
0.20
|
0.17
|
FMI #
|
13.24 ± 3.52
|
13.48 ± 3.55
|
13.48 ± 3.18
|
0.87
|
0.28
|
WHR #
|
0.93 ± 0.04
|
1.50 ± 7.19
|
0.93 ± 0.05
|
0.47
|
0.58
|
WC (cm) #
|
98.20 ± 9.59
|
99.62 ± 10.56
|
100.19 ± 9.80
|
0.37
|
0.68
|
RMR (kcal/day)
|
1538.91 ± 274.98
|
1595.30 ± 255.25
|
1570.56 ± 258.23
|
0.43
|
0.73
|
RMR per kg
|
19.88 ± 3.60
|
19.77 ± 2.97
|
19.34 ± 3.01
|
0.43
|
0.99
|
RMR per BSA
|
848.52 ± 138.63
|
856.48 ± 103.07
|
845.48 ± 113.55
|
0.74
|
0.79
|
RQ
|
0.86 ± 0.03
|
0.85 ± 0.04
|
0.85 ± 0.04
|
0.58
|
0.206
|
Blood pressure
|
|
|
|
|
|
SBP (mmHg)
|
109.46 ± 12.46
|
109.95 ± 15.58
|
113.28 ± 14.86
|
0.13
|
0.34
|
DBP (mmHg)
|
78.86 ± 10.32
|
77.25 ± 10.29
|
77.42 ± 10.56
|
0.64
|
0.14
|
Blood Parameters
|
|
|
|
|
|
FBS (mg/dl)
|
87.45 ± 11.26
|
87.36 ± 9.84
|
87.60 ± 8.99
|
0.98
|
0.78
|
Tolal cholesterol (mg/dl)
|
190.62 ± 36.95
|
180.88 ± 35.46
|
186.91 ± 35.53
|
0.28
|
0.83
|
TG (mg/dl)
|
106.50 ± 47.84
|
121.10 ± 65.88
|
127.94 ± 76.91
|
0.23
|
0.23
|
HDL (mg/dl)
|
46.57 ± 10.05
|
46.32 ± 9.83
|
46.78 ± 11.88
|
0.95
|
0.27
|
LDL (mg/dl)
|
91.45 ± 22.22
|
95.33 ± 24.25
|
96.52 ± 24.67
|
0.51
|
0.28
|
AST (U/L)
|
16.95 ± 5.21
|
18.01 ± 7.77
|
18.45 ± 8.41
|
0.56
|
0.86
|
ALT (U/L)
|
16.95 ± 8.22
|
20.07 ± 12.90
|
19.88 ± 15.82
|
0.44
|
0.90
|
hs. CRP (mg/l)
|
6.00 ± 5.58
|
3.80 ± 4.72
|
4.29 ± 4.15
|
0.05 c
|
0.04
|
Qualitative variables €
|
|
|
|
|
|
Marital status (n)
Single
Married
|
21 (19.3)
51 (17.8)
|
47 (43.1)
112 (39.2)
|
41 (37.6)
123 (43)
|
0.62
|
0.76
|
Education
Illiterate
Diploma
Bachelor and higher
|
0 (0)
11 (22.4)
61 (17.8)
|
3 (75)
20 (40.8)
136 (39.8)
|
1 (25)
18 (36.7)
145 (42.4)
|
0.54
|
0.75
|
ES
Poor
Moderate
Good
|
8 (34.8)
43 (41.7)
38 (40.9)
|
8 (34.8)
31 (30.1)
18 (19.4)
|
7 (30.4)
29 (28.2)
37 (39.8)
|
0.26
|
0.09
|
¥: Data are presented as Mean ± SD. €: Data are presented as n (%). Ψ: Put out the collinear variable from general linear models (GLM) as confounders.
#: BMI considered as collinear and this variable adjusted for age, physical activity and total energy intake.
Modified Nordic diet score classification: 0-1 point for low adherence, 2-3 points for medium adherence and 4-6 points for high adherence.
Abbreviations: PA: physical activity; BMI: body mass index; BFM: body fat mass; FFM: fat free mass; FFMI: fat free mass index; FMI: fat mass index; WHR: waist to hip ratio; WC: waist circumference; RMR: resting metabolic rate; RQ: respiratory quotient; SBP: systolic blood pressure; DBP: diastolic blood pressure; TG: triglyceride; HDL: high-density lipoprotein; LDL: low-density lipoprotein; AST: aspartate aminotransferase; ALT: Alanine aminotransferase; hs_CRP: high sensitivity C-reactive protein; ES: economic status.
*P values resulted from ANOVA analysis. P value < 0.05 is significant.
**P values presented resulted from ANCOVA analysis and were adjusted for age, BMI, energy and physical activity.
a: association between low tertile and high tertile; medium tertile and high tertile of modified Nordic diet adherence, resulted by Tukey analysis.
b: association between low tertile and high tertile of modified Nordic diet adherence, resulted by Tukey analysis.
c: association between low tertile and medium tertile of modified Nordic diet adherence, resulted by Tukey analysis.
Table 2
Distribution of variables among RMR/kg status.
Variables
|
RMR/kg
|
P value*
|
P value**
|
Hypometabolic
(RMR < 20 (kcal/day/kg))
|
Normal
(RMR > 20 (kcal/day/kg))
|
Quantitative variables ¥
|
|
|
|
|
Age(year)
|
37.82 ± 7.71
|
34.94 ± 8.66
|
0.005
|
0.04 Ψ
|
Weight(kg)
|
84.85 ± 14.00
|
76.77 ± 9.18
|
<0.001
|
0.32
|
Height(cm)
|
160.85 ± 6.01
|
161.99 ± 5.83
|
0.12
|
0.25
|
PA(METs h/week)
|
1145.82 ± 1759.29
|
1310.58 ± 2519.97
|
0.54
|
0.60 Ψ
|
Body Composition
|
|
|
|
|
BMI(kg/m²)
|
32.77 ± 4.64
|
29.26 ± 3.27
|
<0.001
|
<0.001 Ψ
|
Fat percentage (%) #
|
43.81 ± 4.98
|
39.39 ± 5.31
|
<0.001
|
0.01
|
BFM (kg) #
|
37.63 ± 9.54
|
30.56 ± 6.24
|
<0.001
|
0.24
|
FFM (kg) #
|
47.31 ± 6.01
|
46.05 ± 5.02
|
0.07
|
0.09
|
FFMI #
|
19.25 ± 11.51
|
17.53 ± 1.31
|
0.10
|
0.30
|
FMI #
|
14.54 ± 3.56
|
11.74 ± 2.56
|
<0.001
|
0.06
|
WHR #
|
0.93 ± 0.04
|
1.50 ± 7.19
|
0.93 ± 0.05
|
0.15
|
WC (cm) #
|
102.87 ± 10.44
|
95.03 ± 7.93
|
<0.001
|
0.35
|
RMR (kcal/day)
|
1453.16 ± 254.70
|
1701.42 ± 209.97
|
<0.001
|
<0.001
|
RMR per BSA
|
766.19 ± 87.92
|
938.49 ± 79.33
|
<0.001
|
<0.001
|
RQ
|
0.84 ± 0.041
|
0.86 ± 0.040
|
0.005
|
0.01
|
Blood pressure
|
|
|
|
|
SBP (mmHg)
|
111.85 ± 14.41
|
111 ± 13.36
|
0.63
|
0.03
|
DBP (mmHg)
|
77.51 ± 9.03
|
78.01 ± 10.08
|
0.68
|
0.04
|
Blood Parameters
|
|
|
|
|
FBS (mg/dl)
|
88.47 ± 9.77
|
86.86 ± 9.07
|
0.21
|
0.42
|
Total cholesterol (mg/dl)
|
188.59 ± 34.09
|
182.32 ± 36.01
|
0.19
|
0.54
|
TG (mg/dl)
|
127.10 ± 73.17
|
117.77 ± 70.31
|
0.34
|
0.46
|
HDL (mg/dl)
|
46.51 ± 11.54
|
47.90 ± 10.85
|
0.36
|
0.88
|
LDL (mg/dl)
|
98.88 ± 25.23
|
91.07 ± 22.03
|
0.01
|
0.21
|
AST (µKat/L)
|
17.60 ± 7.72
|
18.33 ± 7.48
|
0.48
|
0.06
|
ALT (µKat/L)
|
19.22 ± 13.75
|
19.26 ± 12.74
|
0.98
|
0.15
|
hs. CRP (mg/l)
|
4.99 ± 4.70
|
3.69 ± 4.57
|
0.04
|
0.70
|
Qualitative variables €
|
|
|
|
|
Marital status (n)
Single
Married
|
35 (56.5)
131 (57.5)
|
27 (43.5)
97 (42.5)
|
1.00
|
0.81
|
Education
Illiterate
Diploma
Bachelor and higher
|
2 (66.7)
26 (65)
138 (55.9)
|
1 (33.3)
14 (35)
109 (44.1)
|
0.52
|
0.85
|
ES
Poor
Moderate
Good
|
16 (53.3)
75 (57.7)
67 (57.8)
|
14 (46.7)
55 (42.3)
49 (42.2)
|
0.90
|
0.68
|
¥: Data are presented as Mean ± SD. €: Data are presented as n (%).Ψ: Put out the collinear variable from general linear models (GLM) as confounders.
#: BMI considered as collinear and this variable adjusted for age, physical activity and total energy intake.
Abbreviations: PA: physical activity; BMI: body mass index; BFM: body fat mass; FFM: fat free mass; FFMI: fat free mass index; FMI: fat mass index; WHR: waist to hip ratio; WC: waist circumference; RMR: resting metabolic rate; RQ: respiratory quotient; SBP: systolic blood pressure; DBP: diastolic blood pressure; TG: triglyceride; HDL: high-density lipoprotein; LDL: low-density lipoprotein; AST: aspartate aminotransferase; ALT: Alanine aminotransferase; hs_CRP: high sensitivity C-reactive protein; ES: economic status.
* P values resulted from T-test analysis. P value < 0.05 is significant.
**P values presented resulted from ANCOVA analysis and were adjusted for age, BMI, energy and physical activity.
Table 3
Dietary intakes of participants in different tertiles of modified Nordic diet adherence.
Variables
|
Modified Nordic diet adherence
|
P value*
|
P value**
|
Low
(n=73)
|
Medium
(n=160)
|
High
(n=171)
|
Energy (kcal/d)
|
2080.39 ± 632.61
|
2514.71 ± 767.23
|
3008.79 ± 741.26
|
<0.001
|
-
|
Carbohydrate (g/d)
|
289.23 ± 96.02
|
351.16 ± 113.78
|
432.45 ± 117.97
|
<0.001
|
0.03
|
Protein (g/d)
|
67.68 ± 21.36
|
84.65 ± 27.09
|
108.96 ± 29.79
|
<0.001
|
<0.001
|
Fat (g/d)
|
77.17 ± 29.25
|
93.54 ± 36.86
|
105.04 ± 32.44
|
<0.001
|
0.003
|
Trans fatty acid (g/d)
|
0.0005 ± 0.001
|
0.0006 ± 0.002
|
0.0010 ± 0.002
|
0.25
|
0.22
|
SFA (g/d)
|
23.36 ± 9.88
|
27.45 ± 11.41
|
31.70 ± 11.43
|
<0.001
|
0.04
|
Cholesterol (mg/d)
|
215.65 ± 103.32
|
254.54 ± 110.55
|
296.07 ± 110.92
|
<0.001
|
0.38
|
PUFA (g/d)
|
16.42 ± 9.19
|
20.21 ± 10.16
|
21.63 ± 8.68
|
0.001
|
0.08
|
Dietary fiber (g/d)
|
36.43 ± 18.81
|
43.30 ± 20.17
|
56.47 ± 20.07
|
<0.001
|
0.01
|
Sodium(mg/d)
|
3691.58 ± 1746.51
|
4412.66 ± 1657.03
|
4919.27 ± 1734.17
|
<0.001
|
0.41
|
Potassium (mg/d)
|
3056.18 ± 1075.04
|
4066.22 ± 1398.84
|
5630.65 ± 1565.56
|
<0.001
|
<0.001
|
Iron (mg/d)
|
19.85 ± 13.96
|
25.77 ± 21.35
|
30.13 ± 22.36
|
0.002
|
0.88
|
Calcium (mg/d)
|
1023.96 ± 438.88
|
1164.02 ± 486.77
|
1487.57 ± 542.75
|
<0.001
|
0.09
|
Magnesium (mg/d)
|
329.84 ± 106.28
|
441.70 ± 140.36
|
577.46 ± 162.80
|
<0.001
|
<0.001
|
Zinc (mg/d)
|
9.92 ± 3.41
|
12.47 ± 4.25
|
15.97 ± 4.71
|
<0.001
|
<0.001
|
Copper (mg/d)
|
1.47 ± 0.53
|
1.84 ± 0.58
|
2.45 ± 0.74
|
<0.001
|
<0.001
|
Vitamins
|
|
|
|
|
|
C (mg/d)
|
123.25 ± 82.52
|
163.25 ± 112.56
|
243.98 ± 110.39
|
<0.001
|
<0.001
|
D(mcg/d)
|
1.49 ± 1.38
|
1.75 ± 1.27
|
2.38 ± 1.78
|
<0.001
|
0.03
|
E (mg/d)
|
13.66 ± 8.497
|
17.55 ± 9.88
|
18.01 ± 8.05
|
0.002
|
0.39
|
B1 (mg/d)
|
1.76 ± 0.57
|
2.03 ± 0.73
|
2.42 ± 0.69
|
<0.001
|
0.23
|
B2 (mg/d)
|
1.81 ± 0.73
|
2.10 ± 0.80
|
2.66 ± 0.83
|
<0.001
|
0.05
|
B3 (mg/d)
|
19.67 ± 6.75
|
24.64 ± 8.69
|
31.18 ± 10.42
|
<0.001
|
0.001
|
B6 (mg/d)
|
1.57 ± 0.44
|
1.99 ± 0.62
|
2.69 ± 0.68
|
<0.001
|
<0.001
|
B9 (mcg/d)
|
493.29 ± 147.10
|
580.66 ± 183.01
|
719.04 ± 172.36
|
<0.001
|
<0.001
|
B12 (mcg/d)
|
3.61 ± 2.70
|
3.97 ± 1.99
|
5.06 ± 2.64
|
<0.001
|
0.49
|
K (mcg/d)
|
177.30 ± 177.38
|
258.47 ± 270.48
|
366.74 ± 332.56
|
<0.001
|
0.002
|
Modified Nordic diet components
|
|
|
|
|
|
Fish (g/d)
|
5.89 ± 10.36
|
9.13 ± 8.31
|
15.15 ± 14.51
|
<0.001
|
<0.001
|
Apples, pears/high antioxidant fruits (g/d)
|
63.30 ± 44.32
|
111.09 ± 84.17
|
179.31 ± 117.23
|
<0.001
|
<0.001
|
Root vegetables (g/d)
|
45.21 ± 22.20
|
66.78 ± 40.66
|
118.46 ± 58.89
|
<0.001
|
<0.001
|
Cabbages (g/d)
|
147.83 ± 97.48
|
251.56 ± 205.44
|
412.25 ± 199.80
|
<0.001
|
<0.001
|
Rye/ wholegrain breads (g/d)
|
22.51 ± 25.68
|
62.68 ± 69.10
|
77.78 ± 88.40
|
<0.001
|
0.002
|
Oatmeal (g/d)
|
28.62 ± 15.61
|
45.15 ± 34.36
|
77.09 ± 53.50
|
<0.001
|
<0.001
|
All values are presented as mean and SE. Abbreviations: SFA: saturated fatty acids; PUFA: poly-unsaturated fatty acids.
*P values resulted from ANOVA analysis. P value < 0.05 is significant.
**P values presented resulted from ANCOVA analysis and were adjusted for energy (kcal).
Table 4
Association between adherences to modified Nordic diet and RMR/kg status in the crude and adjusted model.
Variables
|
Modified Nordic diet adherence
|
P trend
|
Low
(n=73)
|
Medium
(n=160)
|
High
(n=171)
|
Crude
P value
|
1
0.95
|
0.97 (0.47-2.00)
0.95
|
0.91 (0.45-1.83)
0.80
|
0.78
|
Model 1
P value
|
1
0.77
|
1.37 (0.53-3.51)
0.50
|
1.39 (0.52-3.71)
0.50
|
0.57
|
Model 2
P value
|
1
0.15
|
2.42 (0.82-7.12)
0.10
|
3.15 (0.97-10.15)
0.05
|
0.07
|
All values are presented as odds ratio (OR) and 95% Confidence intervals (95% CI).
Model 1: Adjusted for age, BMI, energy and physical activity.
Model 2: Adjusted for age, BMI, energy, physical activity, education, marriage, smoking, diet resistance, age at onset of obesity and economic status.
P value < 0.05 is significant.
The lowest tertile of modified Nordic diet adherence considered as a reference group.
RMR/kg > 20 (kcal/day/kg) was included in linear regression as RMR status.