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Literature Review #2 (Paleo Diet)

March 5, 2013

Research in the Disciplines: Nutrition and Exercise Science

Professor Wimick


APA Citation:

Johansson, Ingegerd., Nillson, Lena Maria,. Stegmayr, Birgitta., Boman, Kurt., Hallmans, Goran,.     Winkvist, Anna,. (2012). Associations among 25-year trends in diet, cholesterol and BMI from 140,000 observations in men and women in Northern Sweden. Retrieved from


The results of a study done in Northern Sweden studying the 25-year diet of a population and the correlations between diet and food eaten with health benefits and disadvantages.



Ingegerd Johansson is a  Professor of Odontology at Umea University.


Key Terms and Concepts:

Diet-The food a person consumes.

Fat- Lipid made from 2 kinds of smaller molecules: glycerol and fatty acids

Cholesterol-Waxy steroid of fat.

BMI-Body Mass Index (A weight-to-height ratio,)

FFQ– Northern Sweden Food Frequency Questionnaire

CVD-Cardio Vascular Disease

CDD-Coronary Heart Disease

VIP– Vasterbotten Intervention Program (made for better health of its people)

MONICA Project– Multinational Monitoring of Trends and Determinants in Cardio Vascular Diseases)


“In 1986, mean reported fat intake, adjusted for age and BMI, was 39.2% of the mens total reported energy intake (E%). Carbohydrates made up 45.9 E% and protein 13.6 E%. For women the corresponding levels were 35.5 E%, 49.2 E%, and 14.3 E% for fat, carbohydrates, and protein, respectively, in the same year. . . Thus, in 2010 men got 39.9% and women 37.7% of their total energy from fat. . . In the same period reciprocal trend shifts were seen for reported carbohydrate intake. The fraction of energy originating from protein was virtually unchanged over the 25-year period (pg. 5).

Meaning/Significance:  This quote explains how the studied population went from a low-fat, high carbohydrate diet to a high-fat, low carbohydrate diet. We would see this as an unhealthy choice because Americans have been told to reduce fat consumption for decades, despite our obesity rates continuing to rise. This quote is significant because hopefully, it will teach us to look at fat differently in the country, that it may not be the enemy, and to look at nutrition in a broader and more scientific view. We should also learn that eliminating or decreasing one single macro-nutrient may not be the only thing we should be advocating when trying to make a population healthy, it is a combination of changes that will lead to the best health in a nation. It is also interesting to note that men, compared to women, ate a larger percentage of their calories from fat, while women ate a larger percentage of their calories from carbohydrates; this observation could lead to more correlations being drawn between the two populations since 25 years of a little difference can prove to make a big difference later on.


“There is strong support for protective effects of dietary foods/factors in relation to cholesterol levels and coronary heart disease; such positive foods are fish, vegetables, nuts, and the “Mediterranean diet”. Harmful dietary factors include trans fatty acids, foods with high glycaemic index, and “Western diet” patterns. (pg. 9)”

Meaning/Significance:  This quote shows how the “Mediterranean diet”, the diet that the people living next to the Mediterranean sea consume, leads to better prevention from high cholesterol levels and coronary heart disease compared to the prevention provided from the “Western diet”, the diet that most Americans are advised to eat. Thus, we Americans should lower our consumption of trans fatty acids as well as foods with high glycaemic indexes and increase our consumption of the positive foods that the “Mediterranean diet” advocates. It is important to note that a change in diet may have unnoticeable effects on an individual, but a change in diet in a nation can bring out the true results behind a diet with more reliable statistics.


 “Evaluations of 14 randomized trials of statins have concluded that a reduction of LDL cholesterol by 1 mmol/L leads to a 12% reduction in all-cause mortality and 19% reduction in CHD mortality. Hence, not surprisingly, the promising decline in CHD has been attributed mainly to healthful changes in blood cholesterol, triglycerides, smoking and hypertension. . . The long-term deleterious effects of a high blood cholesterol level seem to be neglected in the population and media, and the interest is centered on diets that promise rapid weight loss. . . [High fat diets,] Initially beneficial and thereafter deleterious changes in blood cholesterol paralleled these trends in food selection, whereas a claimed weight reduction by high-fat diets was not seen in the most recent years. In contrast, BMI increased continuously over the 25-year period (pg. 11).”

Meaning/Significance: As with the last quote, reducing cholesterol (LDL) by 1 mmol/L leads to higher prevention from mortality. Our nation should take it upon itself to help reduce everyone’s LDL cholesterol to prevent more mortalities of its population. Unfortunately, in the second part of the quote, people seem to care more about easy and fast ways to lose weight rather than focusing their efforts and resources towards their long-term health and wellbeing. The significance in this observation may reveal another problem that we must uncover in our societies outside of diet, the problem of choosing physical subjective based appearance over objective health and mortality prevention. It is also important to note that people who ate the high fat diet seemed to have benefited for some period, and then showed opposite results for another period of time all while their BMI continued to rise. Though the two may or may not be correlated, it is important to know that other factors may have affected the results of each correlation.



  • If the diet of a person is not the only thing that correlates with beneficial and deleterious effects upon their health, what other factors should be taken into consideration when determining one’s health and chances of mortality?
  • What outside influences are causing people to choose their weight over their health?
  • What other factors may be causing an increase in BMI and blood cholesterol other than diet?
  • What other factors may be causing the “Western diet” to have higher cholesterol levels than the “Mediterranean diet”, and what other factors may be causing the “Mediterranean diet” to be more successful than the “Western diet”?

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