Diet and Health Issues of
Sweden
By: Candice Carlson
10/10/11
Nutrition 3420, 2011
Overview
• Background
• Traditional Dietary Practices
• Dietary Analysis Results
• Special Occasions
• Traditional Health Care Practices
• Diet and Health Issues
• Communication
Background Information on Sweden
• Capital: Stockholm
• Scandinavian countries
include: Sweden, Norway,
Denmark, Finland, and
Iceland.
• Fourth Largest Country in
Europe
• Swedish’s diet is one of
the world’s most
innovative.
– Simple and hearty.
IKEA, 2007
Background
• Vikings (800-1050 a.d.)
– Embarked on raids
– Invaded lands(British
Isles, France)
– Teas from France, honey
cakes form Germany,
and sauces and soups
from France
• Yellow=generosity.
• Blue=truth, loyalty.
Notaker, 2009
Timeline
• 12,000 B.C.- Reindeer hunted in Scandinavia.
• 9000 B.C.-Elk hunted
• 4000 B.C.-Stone Age, introduction of
agriculture and animal husbandry.
• 1800 B.C.-Bronze Age, a lot of fishing and seal
hunting.
• 1-400 a.d.- High quality kitchenware and
tableware pottery made.
Notaker, 2009
Timeline
• 800-1000 a.d.-Viking Age
– Preserved meat and fish, porridge, gruels, and
curds are dietary staples.
• 1000-1100 - Christian Laws established
– Can not consume horse meat
• 1538- Ostkaka (Cheesecake) was brought up
for the first time in Sweden.
• 1600-1700-Strong alcohol more common
Notaker, 2009
Timeline
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•
•
•
1650- First Swedish cookbook printed.
1710-1720- First coffee house.
1800-1850- Coffee is a daily drink.
1903- The first Vegetarian Society in Sweden
was founded.
• 1973- First McDonalds opened in Sweden.
• 2000- Opened a cookbook museum.
Notaker, 2009
Dala Horse History
•
•
•
•
•
•
Created by woodcutters and
soldiers.
Men spent time away from family.
– Carved little horses for
children.
In 1716, King Charles XII declared
war.
– Winter, lack of food and
warmth
– Soldiers traded these for food.
Known for armies survival.
Used as decorations, trucks, house
signs, city letterhead. Popular
souvenir, Swedish handicraft.
Unofficial symbol of Sweden.
Ross, 2008
Traditional Dietary Practices
• 3 meals a day
• Staple food: potatoes,
wheat, rye, barley, and oats
• Fish, lamb, beef, pork, veal,
chicken, eggs, dairy
products (cream, cheese),
preserved meats (sausage,
ham, bacon)
Jacob & Ashkenazi, 2007
• Knäckebröd
– Hard bread
– Eaten at every meal
Typical dishes
• Herring Dishes: fried, fermented, marinated,
pickled.
• Salmon dishes
• Crayfish
• Meatballs
• Vegetable dishes: stuffed cabbage, creamed
cauliflower, potato, anchovy casserole.
• Sweets: baked apples, dried fruit cream,
cinnamon rolls, Lacy Meringue cake, sweet Easter
bun with whipped cream and marzipan.
Jacob & Ashkenazi, 2007
Herring
• Specialty
– Feeds Swedes in abundance
– Large part of export economy
• Baltic Herring: Staple of Swedish diet
–
–
–
–
–
Easy to catch, large in numbers
Preserve in salt or ferment
Year round delicacy
High in nutrients and fatty acids
Requires 80 g (3 oz) of salted herring to get necessary
protein.
Ross, 2008
Proctor & Roland, 2009
Herring
• Fishing for herring
– Autumn and spring
• Once caught, if not served fresh it’s gutted
and cured in brine
– Stored in large barrels for months
• Ready to be eaten
– Soaked in water or milk to remove excess salt
• Served raw, cooked or pickled
– Also can be grilled, fried, smoked, baked
Ross, 2008
Surströmming
• Sour herring
– Delicacy in Northern Sweden
– Acquired taste (fermented herring)
• Fish are caught in the Spring
– Fermented in tins for 6 months
– Time gases build up and the tins bulge into the size of
a soccer ball.
• Sold on Surströmming Premiere
– 3rd Thursday in August
– Sold for 2 to 3 weeks until supplies run out
– Traditionally eat when first leaves fall from trees
Moss, 2008
Proctor & Roland, 2009
Surströmming
• When the tins open the
scent releases
– Restaurants won’t open on
premises because of smell.
– Traditionally eaten outdoors
– Served in square shaped
bread (tunnbröd) with boiled
potatoes, chopped onions,
sour cream and milk or beer
(aquavit) to drink
• Aquavit
– “Water of life”
– liquor
– Distillation of potatoes
Ross, 2008
Proctor & Reland, 2009
Swedish Delicacies
Swedish Meatballs
Served with boiled potatoes, gravy, and
lingonberry jam
IKEA, 2007
Jansson’s Frestelse
Swedish casserole made with potatoes,
onions, bread crumbs, butter, cream, and
anchovies
Traditional Dietary Practices
• Smörgåsbord: buffet of hot
and cold dishes (fish, meat,
vegetables, salad)
• Stage One: Salted fish
• Stage Two: All other fish
• Stage Three: cold cuts of
ham, sausage, liver paste
• Stage Four: Hot dishes
• Stage Five: Dessert
Notaker, 2009
Kittler & Sucher, 2008
Etiquette
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•
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•
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Fork in left hand, knife in right hand
Only bread is eaten with hands
Sandwiches are eaten with fork and knife
Pass dishes to left
If not eating, hands are placed on the table
resting on the edge.
• Wine is appreciated as a gift for the hostess
Kittler & Sucher, 2008
Family Meal
• Hot meal eaten at home in the company of
family members.
– High regard for family meals
• Most Scandinavians eat most of their meals at
home (50%).
• Eating at home is common during weekends
– Friday, Saturday, and Sunday nights
– Meal eaten around kitchen or dining room table
– 19-30% eat at sofa, coffee table, or armchair
Notaker, 2009
Family Meal
• Eating with friends isn’t very common.
– Young eat more with friends then elderly
• Important element in building family unit
– Women feel it maintains cohesiveness in the unit
– Organize the day in a way that makes a family
meal possible.
Notaker, 2009
Breakfast
• Limit to coffee or juice
• Few eat traditional porridge
• Main grain product is bread
– Butter, margarine, vegetable spread, jams, cheese
spreads, caviar.
• Sausage, boiled or cured ham and liver paste.
• Many eat packaged cereal and yogurt
• Eggs are rare, typically served on Sunday
• Eaten at home on an individual basis.
Notaker, 2009
Coffee
• Swedes drink a lot of
coffee.
• Worlds second highest
drinkers of coffee.
• Coffee break- mid
morning and mid
afternoon
– Coffee or tea with
cinnamon bun
Jacob & Ashkenazi, 2007
Lunch
• Many Swedes eat out for
lunch.
• Foreign food are popular
– Mexican, Thai, Chinese,
American fast food.
• Pizzerias are common
– Swedish style
– Seafood and salad on top.
Jacob & Ashkenazi, 2008
Notaker, 2009
Dinner
• Swedes have two hot meals a day
• Hot meal consists of:
– Main dish (meat)
– Staple (Potatoes, rice, pasta)
– Second staple (bread)
– Side dish (vegetables)
– Hot and cold sauces and condiments
Kittler & Sucher, 2009
Notaker, 2009
Proper Meal
• Consists of meat, potatoes, and one or more
vegetable side dishes and sauces
1.
2.
3.
4.
5.
Main Dish (center)- meat, fish, or vegetable
Staple- consists of potatoes, rice, pasta
Side dish- Vegetable (Raw or cooked)
Accompaniments (hot and cold sauces)
Bread
• Proper meal made from scratch
Notaker, 2009
Current common dishes
1) Falun sausage (boiled)
-Specialty
-beef, pork, veal
2) Spaghetti with meat
sauce
3) Pizza
Usually drink milk, beer,
or wine
Kittler & Sucher, 2008
Diet Analysis
Name: Lucy
Height: 5 ft. 7 in.
Weight 130 lbs, active
• Breakfast:
• Dinner
1 pancake
2 oz. sausage
1 T. Jam
1 T. butter
1 slice bread
4 pieces pickled herring
7 oz. cabbage
1.5 c. mashed potatoes
1 slice bread
• Lunch:
3 oz. salmon
1 cup mashed potatoes
1.5 cup salad
2 T. salad dressing
1 slice bread
• Snacks
1 cinnamon bun
1 slice bread
0.5 cup cucumbers
• Drinks
Coffee, milk, pear juice, apple juice
Diet Analysis, 2009
Diet Analysis Results My Pyramid
Goal*
Actual
% Goal
Grains
9.0 oz. eq.
tips
6.5 oz. eq.
71.7%
Vegetables
3.5 cup eq.
tips
3.7 cup eq.
105.2%
Fruits
2.0 cup eq.
tips
1.6 cup eq.
82.2%
Dairy
3.0 cup eq.
tips
2 cup eq.
66.7%
Protein
Foods
Empty
Calories
6.5 oz. eq.
tips
9.2 oz. eq.
140.8%
694.3
169.3%
410.0
Results are based on a 2479 calorie diet
Diet Analysis, 2009
Macronutrient Ranges
Carbs 46%, Protein 14%, Fat 40%
Diet Analysis, 2009
Dietary Analysis Fat
and Cholesterol
Results
Saturated fat: 15%
Monounsaturated fat:
11%
Polyunsaturated fat:
5%
Unspecified 8%
Fat Breakdown
16
14
12
10
8
6
4
2
Cholesterol: 229 mg
Dietary Analysis, 2009
0
Fat Breakdown
Dietary Analysis Results Vitamins and
Minerals
• Vitamins: Vitamin A (89%), Vitamin E (40%), and Folate (59%) were
deficient
• Minerals: Iron (60%), Magnesium (94%), Potassium (77%), and Zinc
(88%) were deficient
• Omega 6 was short at 92%.
• Sodium was excessive: 396%
• Consumed 2576 calories based on a 2479 calorie diet
Diet Analysis, 2009
Dietary Analysis Results Vitamins and
Minerals
% DRI
100
90
80
70
60
50
40
30
20
10
0
% DRI
Diet Analysis, 2009
Sources of Nutrients
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Carbohydrates and fiber: bread, potatoes
Protein: salmon
Fat: sausage, milk, butter
SUFA: milk, butter, cinnamon bun
MUFA: sausage, herring
PUFA: salad dressing, pancakes
Vitamin C: pear juice
B Vitamins: bread, potatoes, herring, salmon, milk
Sodium: sausage, potatoes, salad dressing, cabbage,
herring cucumbers, bread
Diet Analysis, 2009
Fruits and Vegetables
• Swedish are close to meeting daily recommended intake of
fruits and vegetables.
• Highest consumption in Sweden
• Vegetables-39 times a month
• 1/3 eat vegetables two times daily
• Fruit-37 times a month
• Consumption due to eating habits
– Hot meals are accompanied by salad
• Diet high in fat and sugar
Simunaneimi, Anderson, Nydahl, 2009
Notaker, 2009
Solutions
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Eat more fruits and vegetables
Eat more whole wheat bread
More fish
Boil or bake potatoes
Reduce sugar, fat, salt,
Reduce fatty potato, fatty dairy and fatty meat
products
Notaker, 2009
Easter
• Easter is one of the
biggest Swedish
festivals.
• Eggs top the menu.
– Eggs served in every
form.
– Accompanied with
pickled herring.
• Children dress up as
Easter witches.
IKEA, 2007
Walpurgis Night
• April 30th
• Celebrate arrival of Spring
– Big Bonfires
– Male voice choirs
• One of the World’s most
choral countries.
• Feast is followed.
– Jansson’s Temptation
– Served with crisp bread,
cheese, beer, Swedish
vodka
IKEA, 2007
Midsummer
• End of June
• Evening before celebration
– Girls pick 7 flowers and dream
of the man to be hers.
• Dance Games
• Food
– Fish, boiled new potatoes, wild
strawberries are common for
Sweden
– Matjes herring, pickled herring,
new potatoes cooked in dill,
chives, soured cream, crisp
bread, cheese, beer, Swedish
Vodka
IKEA, 2007
Saint Lucia
• December 13th
• Christian girl who died for
her faith (Lucia)
• Eldest daughter
– Head wreath, candles, long
white robe
• Serve parents in bed
– St. Lucia buns (Lussekatter)
and coffee while in bed.
• Lucia choir show is
followed.
• Schools and businesses
closed
IKEA, 2007
Christmas Eve
• Father Christmas comes on December 24th.
• Traditional Dinner (Smörgåsbord)
– Consists of 20 to 30 dishes
– Centerpiece is Christmas ham.
– Pickled herring, lutfisk, meatballs, chipolatas,
potatoes, meatballs, peas, bread, cheese, beer, and
Swedish Vodka.
– Desserts are rice pudding, saffron buns, ginger
biscuits, nuts, dried fruit.
• Presents are brought by Jultomten (Tomten).
IKEA, 2007
Kittler & Sucher, 2008
Health Practices and Beliefs
• Information is limited
• Sweden massage (therapeutic)
– found in the United States
– Technique using 5 key strokes.
– May promote healing, enhance circulation, and
provide a sense of relaxation.
• Swede’s are enthusiastic about tradition
– Many are Christian
– Evangelical Lutheran church
Kittler & Sucher, 2008
Obesity and Weight Issues
• Increasing amount of people overweight
• Problem since the 1960’s
• Overweight children
– 25% overweight
– 3% obese
• Women working outside of the home
– More fast food
– Child-care Providers
– Greater risk for heart disease, diabetes, cancer,
stroke.
Garerno, Lenner, & Strandvik, 2007
Lagiou, Sandin, Weiderpass, Lagiou, Mucci, Trichopoulous & Adami,2007
Notaker 2009
Wallstrom, Bjartell, Gullburg, Olsson & Wirfalt, 2009
Counseling
• Low context
– Analytical
• Comfortable with silence
• Maintain direct eye contact
• Handshakes when being greeted
• Avoid discussion of illness until needed.
– Sickness may be considered a weakness
(physical, moral).
Kittler & Sucher, 2008
Summary
• Sweden’s diet is simple and hearty.
• Staple foods consist of potatoes, wheat, rye, fish
(herring), beef, pork, dairy products.
• Delicacies include; Herring (Baltic), Swedish Meatballs,
Jansson’s Frestelse, and Surströmming.
• Diet is high in fat and sugar with high fruit and
vegetable intake.
• Enthusiastic about tradition.
• Special Occasions include: Easter, Walpurgis Night,
Midsummer, Saint Lucia, and Christmas Eve.
• Obesity and weight issues are prevalent in Sweden.
References
•
Diet Analysis Plus 9.0 Online, 9th Edition (2009). Belmont: Wadsworth.
•
Garerno, M., Lenner, R., & Strandvik, B. (2007). Swedish pre-school children eat
too much junk food and sucrose. Acta Paediatrica, 96(2), 266-272.
•
IKEA. (2007). Ikea’s real Swedish food book. Inter IKEA Systems.
•
Jacob, J., & Ashkenazi, M. (2009). The world cookbook for students. (Vol. 5, pp. 2832). Wesport: Greenwood Press.
•
Kittler, P. G., & Sucher, K. P. (2008). In Food and culture: fifth edition (pp. 194-199).
Belmont:Thomson Wadsworth.
•
Lagiou, P., Sandin, S., Weiderpass, E., Lagiou, A., Mucci, L., Trichopoulous D., &
Adami H. (2007). Low carbohydrate-high protein diet and mortality in a
cohort of swedish women. Journal of Internal Medicine, 261(4), 366-374.
References
•
Notaker, H. (2009). Food culture in scandinavia. (p. 81, 109, 151, 181). Westport:
Greenwood Press.
•
Proctor, J., & Roland, N. (2009). The rough guide to sweden. (5 ed.).
•
Ross, Z. (2008). Travellers sweden. (2 ed.). Italy: Thomas Cook Publishing.
•
Simunaniemi, A., Andersson, A., & Nydahl, M. (2009). Fruit and vegetable
consumption close to recommendations. A partly web based nationwide
dietary survey in swedish adults. Food and Nutrition Research, 53, 1-9.
•
Wallstrom , P., Bjartell, A., Gullberg, B., Olsson, H., & Wirfalt, E. (2009). A
prospective swedish study on body size, body composition, diabetes, and
prostate cancer risk. British Journal of Cancer, 100(11), 1799-1805.