FFQ require validation as part of epidemiological research of diet–disease relationships. Studies exploring associations between carbohydrate type and chronic diseases are rapidly increasing, but information on the validity of carbohydrate fractions, dietary glycaemic index (GI) and the glycaemic load (GL) estimated by FFQ is scarce. Likewise, the effects of subject characteristics on FFQ validity have been poorly documented. The present study evaluates the relative validity of an 131-item FFQ in relation to two 3 d food records (FR) performed 6 months apart focusing on the intake of carbohydrate fractions, dietary GI and the GL. Furthermore, we assessed the extent to which subjects' age, education and BMI explain differences between these methods. The study sample comprised 218 men and 292 women aged 25–74 years participating in a large population-based survey in Finland. Energy-adjusted Spearman's rank correlations ranged from 0·27 (sugars) to 0·70 (lactose) for men and from 0·37 (sugars) to 0·69 (lactose) for women. On average, 73 % of the subjects were categorised into the same or adjacent distribution quintile based on the two methods. In general, the FFQ overestimated the intakes compared with FR. Especially in women, FFQ validity for some nutrients was associated with the level of intake, subjects' age and, to a lesser extent, education but not BMI. In conclusion, the FFQ appears to be reasonably valid in the assessment of carbohydrate exposure variables, but the findings show a need for adjustment of diet–disease relationships for subjects' age and education.

Information on dietary adequacy is needed to assess food and nutrition security in a modern society, especially in the transition towards climate-friendly food systems. In this study, differences in the nutritional adequacy of diets among Finnish adults were evaluated in population groups of different education, income and urbanisation levels. The study used data from the FinDiet 2017 Survey (n = 1655, 18–74 years). Modelled usual intakes of foods and nutrients were evaluated relative to food-based dietary guidelines issued by the National Nutrition Council of Finland (FNNC) and with respect to nutrient adequacy following the Nordic Nutrition Recommendations and FNNC. For about half of the nutrients studied, intakes were found to be adequate. Intakes of protein, fat, saturated fatty acids and salt were estimated to be high. By contrast, inadequate intakes were seen in folate and vitamins A, D, B1, B2 and C in almost all groups studied. Groups with a higher education and income, groups that lived in urban areas and, in particular, women adhered more closely to recommended food consumption and nutrient intakes than others. However, major challenges posed by the Finnish diet are common to all groups studied, and only certain dietary features evaluated in view of nutritional adequacy are associated with socioeconomic differences.

Associations between sugar intake and the remaining diet are poorly described in modern food environments. We aimed at exploring associations of high naturally occurring and added sugar intakes with sociodemographic characteristics, intake of macronutrients, fibre and selected food groups. Our data comprised 4842 Finnish adults aged 25–74 years, who participated in the population-based DIetary, Lifestyle and Genetic determinants of Obesity and Metabolic syndrome (DILGOM) study. Diet was assessed by a validated 131-item FFQ. The food item disaggregation approach was used to estimate sucrose and fructose intakes from natural sources (naturally occurring sugar) and all other sources (added sugar). Sex-specific trends in macronutrient, fibre and food group intakes across sugar type quartiles were determined with general linear modelling adjusting for age, energy intake, leisure-time physical activity, smoking, education and BMI. Overall, results were similar across sexes. Young age was found to be a determinant of higher added sugar and lower naturally occurring sugar intakes (P < 0·0001). High added sugar intake was associated with low fibre intake (P < 0·0001) accompanied with lower fruit (P < 0·0001 women; P = 0·022 men) and vegetable consumption (P < 0·0001) and higher wheat consumption (P = 0·0003 women; P < 0·0001 men). Opposite results were found for naturally occurring sugar. Butter consumption increased by 28–32 % (P < 0·0001) when shifting from the lowest to the highest added sugar intake quartile, while a decrease of 26–38 % (P < 0·0001) was found for naturally occurring sugar. Therefore, the associations of sugar types with dietary carbohydrate and fat quality seem opposing. Proper adjustments with dietary variables are needed when studying independent relationships between sugar and health.

Objective: The shift towards plant-based diets with less meat and more legumes is a global target and requires an understanding of the consequences of dietary adequacy on the population level. Our aim was to model the impact of partial replacement of red and processed meat with legumes on nutrient intakes and population shares below dietary reference intakes.Design: Modelling study with three scenarios anchored in meat cut-offs: ≤ 70 g/d (Finnish dietary guideline); ≤ 50 g/d (Danish dietary guideline); ≤ 30 g/d (EAT-Lancet recommendation). In all subjects, the amount of meat in grams over the cut-off was replaced with the same amount of legumes. The SPADE method was used to model usual intake distributions. Meaningful differences in average intakes and in population shares below dietary reference intakes compared to the reference (FinDiet) were evaluated based on non-overlapping 95 % CI.Setting: Finnish national food consumption survey (FinDiet 2017).Subjects: Finnish adults (n 1655) aged18–74 years (47 % men).Results: The scenarios introduced increases in the average intakes of fibre, folate, K, Mg, Cu and Fe, and decreases in intakes of saturated fat, niacin, vitamin B₁₂, Se and Zn. Meaningful shifts of the usual intake distributions of fibre and folate towards improvement in intakes emerged already in ‘scenario 70 g’. Overall, distribution shifts towards a higher probability of inadequate intakes of the studied nutrients were not observed.Conclusions: These results support the public health message to partly replace meat with legumes and may benefit nutrition policy actions towards sustainable diets in the Nordic countries and beyond.

Background: The relationship between carbohydrate intake, dietary glycaemic index (GI) and load (GL), and obesity remains unsolved. Sugar intake and obesity represent a timely topic, but studies on sugar subcategories are scarce. We aimed to study whether total carbohydrate, sucrose, lactose, fibre, dietary GI, and GL are associated with obesity in 25–79-year-old Finns. Methods: Our pooled analysis included three cross-sectional population-based studies: the DILGOM Study ( n = 4842), the Helsinki Birth Cohort Study ( n =1979), and the Health 2000 Survey ( n = 5521). Diet was assessed by a validated food-frequency questionnaire, and anthropometric measurements were collected by standardised protocols. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression analysis. Results: In the model, which included sex, age, education, smoking, physical activity, and energy intake, the likelihood of being obese (body mass index ⩾ 30 kg/m²) appeared lower in the highest quartiles of total carbohydrate (OR 0.65; 95% CI 0.57–0.74; P for trend < 0.0001), sucrose (OR 0.53; 95% CI 0.47–0.61; P < 0.0001), and dietary GL (OR 0.64; 95% CI 0.56–0.73; P < 0.0001) compared to the lowest quartiles. In contrast, dietary GI did not associate with obesity. Fibre intake associated inversely with abdominal obesity (OR 0.80; 95% CI 0.71–0.90; P < 0.001). The inverse sucrose–obesity relationship appeared stronger in high fruit consumers compared to low fruit consumers ( P for interaction 0.02). Conclusions: Although most of the studied carbohydrate exposures were associated with a diminished likelihood of being obese, prospective studies are needed to assess temporal relations to support causal inference.

Purpose: Legumes are recommended as a sustainable alternative protein source to red and processed meat (RPM). We studied the effects of a partial substitution of RPM with non-soy legumes on nutrient intakes and status, anthropometric measurements, and biomarkers of cardiovascular diseases and type 2 diabetes risk in healthy working-age men. Methods: In a 6-week clinical trial, 102 men (mean age 38 years, range 21–61) were randomized to either the MEAT group, consuming 760 g/week of RPM (25% of total protein intake (TPI)) or the LEGUME group, consuming 200 g/week of RPM corresponding to the maximum of the Planetary Health Diet (5% of TPI) along with legume-based foods containing protein equivalent to 560 g/week of red meat (20% of TPI). TPI target was 18 E%. Four-day food records, blood, and 24-h urine samples were collected at baseline and endpoint. Results: At the endpoint, the LEGUME group had higher intakes of fiber (g/MJ, P = 0.006), polyunsaturated fatty acids (E%, P < 0.001), and iron (mg/MJ, P < 0.001) compared to the MEAT group, but lower intakes of saturated fatty acids (E%, P = 0.012) and vitamin B12 (µg/MJ, P < 0.001). The LEGUME group had lower vitamin B12 status (holotranscobalamin, P = 0.022), iodine status (24-h urinary iodine excretion, P = 0.041), total and LDL cholesterol (both P < 0.001), and BMI and weight (both P = 0.009). Conclusion: Implementing a moderate dietary shift by consuming more legumes and less RPM may beneficially affect biomarkers of cardiovascular diseases and weight in healthy working-age men while maintaining nutritional adequacy of iodine, iron, and vitamin B12 in the short term. Trial Registration Clinical trial registration ClinicalTrials.gov as NCT04599920 in October 2020.