The association between modified Nordic diet adherence and diabetic nephropathy among women with type 2 diabetes: a case-control study

Purpose A modified Nordic diet (MND) may improve various aspects of diabetic nephropathy (DN) risk factors. The present study aimed to investigate the relationship between MND adherence and DN. However, these findings are based on a case-control study; thus, causality cannot be inferred. The retrospective design may introduce recall bias and reverse causality cannot be ruled out. Design/methodology/approach This study included 204 women aged 30–65. Biochemical outcomes were collected from all participants. DN was defined as a urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/g. The authors collected biochemical and anthropometric data, while dietary intake (for MND score) and physical activity were assessed using a food frequency questionnaire and an international physical activity questionnaire, respectively. Findings High adherence to MND was associated with significantly improved markers of glycemic control (blood sugar, glycosylated hemoglobin (HbA1c)) and renal function (ACR). In the fully adjusted model, the odds of DN were 93% lower in the highest versus lowest adherence group (OR: 0.07; 95% CI: 0.02–0.19; p < 0.001). Originality/value Findings suggest that higher adherence to MND may be associated with lower odds of DN in women with type 2 diabetes mellitus (T2DM). However, due to the case-control design, causality cannot be inferred. Further research, particularly randomized controlled trials, is needed to confirm a potential causal link.