Associations of adherence to the New Nordic Diet with risk of preeclampsia and preterm delivery in the Norwegian Mother and Child Cohort Study (MoBa) (European Journal of Epidemiology)

Elisabet R. Hillesund • Nina C. Øverby • Stephanie M. Engel • Kari Klungsøyr • Quaker E. Harmon • Margaretha Haugen • Elling Bere

Affiliations:

Elisabet R. Hillesund • Elling Bere • Nina C. Øverby

Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway

Quaker E. Harmon

Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA

Stephanie M. Engel

Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

Kari Klungsøyr

Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway

Margaretha Haugen

Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo, Norway

Corresponding author:

Elisabet Rudjord Hillesund, Institute of Public Health, Sports and Nutrition, University of Agder, Serviceboks 422, 4604 Kristiansand, Norway. Tel: +47 38141285; Fax: +47 38141301; E-mail:

Supplementary Table 1 Weekly frequency of food and drink consumption according to adherence to a New Nordic Diet (NND) during pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Median (25th, 75th percentile). N= 72,072.1

Food items / Low NND adherence
n=19,349 / Medium NND adherence
n=25,544 / High NND adherence
n=27,179
Median / (25th, 75th) / Median / (25th, 75th) / Median / (25th, 75th)
Bread total (slices) / 37 / (28, 49) / 41 / (30, 51) / 44 / (33, 56)
-Bread (white and semi) / 23 / (9, 35) / 18 / (4, 34) / 7 / (2, 28)
-Wholegrain bread / 7 / (2, 21) / 16 / (5, 32) / 28 / (14, 42)
Oatmeal porridge / 0.0 / (0.0, 0.0) / 0.0 / (0.0, 0.6) / 0.3 / (0.0, 0.6)
Vegetables total / 9.9 / (6.7, 14.0) / 14.2 / (10.0, 19.9) / 20.3 / (14.9, 27.5)
- Root vegetables / 3.3 / (2.0, 4.7) / 4.8 / (3.1, 7.3) / 7.3 / (5.3, 10.3)
- Cabbages / 1.3 / (0.7, 1.8) / 1.8 / (1.2, 3.0) / 3.1 / (2.1, 4.7)
Fruits and berries total2 / 10.0 / (6.0, 16.3) / 14.4 / (9.0, 22.0) / 19.9 / (13.6, 28.5)
- Nordic fruits (apples, pears, plums and strawberries) / 3.0 / (1.5, 5.0) / 5.0 / (2.4, 8.0) / 7.7 / (4.8, 11.0)
Potatoes / 1.5 / (0.7, 3.5) / 1.5 / (1.5, 3.5) / 3.5 / (1.5, 3.5)
Rice and/or pasta / 3.0 / (1.8, 3.0) / 3.0 / (1.8, 3.0) / 3.0 / (2.2, 3.0)
Fish and seafood / 1.0 / (0.5, 1.5) / 1.3 / (0.8, 2.0) / 2.0 / (1.3, 2.8)
Game / 0.0 / (0.0, 0.3) / 0.0 / (0.0, 0.3) / 0.3 / (0.0, 0.5)
Unsweetened milk (all)3 / 7.0 / (1.3, 17.5) / 7.3 / (2.1, 17.5) / 17.5 / (5.0, 19.0)
Fermented milk and yoghurt / 1.5 / (0.5, 4.3) / 2.1 / (0.6, 5.6) / 3.5 / (1.3, 7.0)
Water, fresh/carbonated / 27 / (18, 46) / 34 / (19, 50) / 46 / (32, 57)
Fruit juices / 7.0 / (2.1, 14.0) / 6.1 / (2.1, 11.0) / 6.1 / (2.1, 11.0)
Sugar sweetened beverages / 3.5 / (0.9, 8.5) / 2.0 / (0.6, 6.1) / 1.5 / (0.5, 3.8)
Artificially sweetened beverages / 1.5 / (0.0, 7.0) / 0.8 / (0.0, 5.0) / 0.6 / (0.0, 3.0)
Coffee / 0.5 / (0.0, 4.8) / 0.9 / (0.0, 7.0) / 1.5 / (0.0, 7.6)
Cakes / 2.0 / (1.2, 3.1) / 2.2 / (1.3, 3.5) / 2.5 / (1.4, 3.7)
Desserts / 1.5 / (0.9, 2.4) / 1.8 / (1.0, 2.7) / 2.1 / (1.4, 3.2)
Sweets / 4.1 / (2.3, 6.8) / 3.9 / (2.2, 6.4) / 3.9 / (2.2, 6.2)
Salty snacks / 2.0 / (1.2, 3.0) / 1.8 / (1.2, 2.8) / 1.8 / (1.0. 2.7)

1 P for trend <0.01 across NND-adherence for all food items listed (Chi-Square Test)

2One portion of fruit is equivalent to one piece of fruit or a similar amount (1/2 grapefruit, 8-10 grapes etc.)

3 One unit of drink is equivalent to 2.5 dl

Supplementary Table 2 Comparison of energy intake, macronutrient distribution, and nutrient density according to New Nordic Diet adherence in the Norwegian Mother and Child Cohort Study (MoBa) (supplements not included)1. Median (25th, 75th centile) N=72,072.

Nutrients / Low NND adherence
(n=19,349)
Median / (25th, 75th) / Medium NND adherence
(n=25,544)
Median / (25th, 75th) / High NND adherence
(n=27,179)
Median / (25th, 75th)
Energy (MJ/d) / 8.7 / (7.3, 10.4) / 9.2 / (7.8, 10.9) / 10.0 / (8.5, 11.8)
Protein (E%) / 14.9 / (13.5, 16.3) / 15.4 / (14.1, 16.8) / 15.7 / (14.5, 17.0)
Total fat (E%) / 31.7 / (28.5, 34.8) / 31.4 / (28.3, 34.4) / 30.8 / (27.9, 33.9)
- SFA (E%) / 12.2 / (10.9, 13.7) / 12.0 / (10.7, 13.4) / 11.7 / (10.4, 13.0)
- MUFA (E%) / 10.1 / (8.9, 11.2) / 10.0 / (8.9, 11.2) / 9.9 / (8.8, 11.1)
- PUFA (E%) / 5.6 / (4.7, 6.8) / 5.6 / (4.8, 6.8) / 5.6 / (4.8, 6.7)
Carbohydrate (E%) / 53.8 / (50.5, 57.2) / 53.7 / (50.6, 56.8) / 53.9 / (51.0, 56.8)
- added sugar (E%) / 11.2 / (8.1, 15.1) / 9.9 / (7.2, 13.0) / 8.9 / (6.7, 11.1)
Dietary fiber (g/10 MJ) / 28 / (24, 32) / 31 / (27, 35) / 35 / (30, 39)
Beta carotene µg/10 MJ / 1656 / (1248, 2238) / 2079 / (1548, 3077) / 2880 / (2007, 4257)
Vitamin D µg/10 MJ / 2.9 / (2.0, 4.0) / 3.3 / (2.3, 4.4) / 3.6 / (2.6, 4.8)
Vitamin E mg/10 MJ / 9.3 / (7.9, 11.0) / 9.9 / (8.5, 11.7) / 10.6 / (9.1, 12.6)
Folate µg/10 MJ / 249 / (213, 293) / 273 / (237, 317) / 301 / (263, 346)
Vitamin C mg/10 MJ / 143 / (99, 200) / 154 / (110, 209) / 169 / (127, 224)
Calcium mg/10 MJ / 963 / (785, 1168) / 1037 / (859, 1243) / 1104 / (933, 1296)
Phosphorus mg/10 MJ / 1628 / (1464, 1812) / 1737 / (1572, 1922) / 1834 / (1672, 2013)
Sodium mg/10 MJ / 3143 / (2812, 3480) / 3177 / (2855, 3504) / 3175 / (2872, 3484)
Potassium mg/10 MJ / 3778 / (3378, 4199) / 4103 / (3713, 4532) / 4430 / (4032, 4877)
Sodium/Potassium/10MJ / 0.96 / (0.75, 1.21) / 0.84 / (0.67, 1.05) / 0.72 / (0.57, 0.89)
Magnesium mg/10 MJ / 381 / (348, 414) / 409 / (378, 443) / 438 / (407, 473)
Zinc mg/10 MJ / 11.2 / (10.0, 12.3) / 11.6 / (10.5, 12.8) / 12.1 / (11.0, 13.2)
Iron mg/10 MJ / 10.8 / (9.6, 12.1) / 11.5 / (10.3, 12.8) / 12.1 / (10.9, 13.5)
Selenium µg/10 MJ / 53 / (45, 61) / 56 / (49, 64) / 58 / (51,66)

1P for trend <0.01 for energy intake and all nutrients listed (Kruskal-Wallis test)