title: A traditional Sami diet score as a determinant of mortality in a general northern Swedish population.
abstract: OBJECTIVE
  To examine the relationship between "traditional Sami" dietary pattern and mortality in a general northern Swedish population.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  We examined 77,319 subjects from the Västerbotten Intervention Program (VIP) cohort. A traditional Sami diet score was constructed by adding 1 point for intake above the median level of red meat, fatty fish, total fat, berries and boiled coffee, and 1 point for intake below the median of vegetables, bread and fibre. Hazard ratios (HR) for mortality were calculated by Cox regression.
  
  
  RESULTS
  Increasing traditional Sami diet scores were associated with slightly elevated all-cause mortality in men [Multivariate HR per 1-point increase in score 1.04 (95% CI 1.01-1.07), p=0.018], but not for women [Multivariate HR 1.03 (95% CI 0.99-1.07), p=0.130]. This increased risk was approximately equally attributable to cardiovascular disease and cancer, though somewhat more apparent for cardiovascular disease mortality in men free from diabetes, hypertension and obesity at baseline [Multivariate HR 1.10 (95% CI 1.01-1.20), p=0.023].
  
  
  CONCLUSIONS
  A weak increased all-cause mortality was observed in men with higher traditional Sami diet scores. However, due to the complexity in defining a "traditional Sami" diet, and the limitations of our questionnaire for this purpose, the study should be considered exploratory, a first attempt to relate a "traditional Sami" dietary pattern to health endpoints. Further investigation of cohorts with more detailed information on dietary and lifestyle items relevant for traditional Sami culture is warranted.
authors.affiliation: Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden. lena.nilsson@nutrires.umu.se
authors.forename: Lena Maria
authors.initials: LM
authors.lastname: Nilsson
authors.forename: Anna
authors.initials: A
authors.lastname: Winkvist
authors.forename: Magritt
authors.initials: M
authors.lastname: Brustad
authors.forename: Jan-Håkan
authors.initials: JH
authors.lastname: Jansson
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Johansson
authors.forename: Per
authors.initials: P
authors.lastname: Lenner
authors.forename: Bernt
authors.initials: B
authors.lastname: Lindahl
authors.forename: Bethany
authors.initials: B
authors.lastname: Van Guelpen
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D004032:Diet / Q000208:ethnology*; D004034:Diet Surveys; D005006:Ethnicity; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008017:Life Expectancy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000401:mortality; D044382:Population Groups / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology