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Objective: To compare temporal trends, over a 20-year period, in dietary habits between a county (Vasterbotten) with a CVD prevention programme and a county (Norrbotten) without such a programme.

Design: Cross-sectional data from the Northern Sweden MONICA study (survey period 1994, 1999, 2004, 2009 and 2014). Dietary habits were assessed by a semi-quantitative FFQ.

Setting: Counties of Norrbotten and Vasterbotten, Northern Sweden.

Participants: Five thousand four hundred Swedish adults (mean age 56 center dot 9 years; 51 center dot 2 % women) from Vasterbotten (47 %) and Norrbotten (53 %).

Results: No differences in temporal trend for estimated percentage of energy intake from total carbohydrates, total fat, total protein and alcohol were observed between the counties (P (for interaction) >= 0 center dot 33). There were no between-county difference in temporal trends for overall diet quality (assessed by the Healthy Diet Score; P (for interaction) = 0 center dot 36). Nor were there any between-county differences for the intake of whole grain products, fruits, vegetables, fish, sweetened beverages or fried potatoes (P (for interaction) >= 0 center dot 09). Consumption of meat (P (for interaction) = 0 center dot 05) increased to a greater extent in Norrbotten from 2009 and onwards, mainly in men (sex-specific analyses, P (for interaction) = 0 center dot 04). Men in Vasterbotten decreased their intake of sweets to a greater extent than men in Norrbotten (P (for interaction) < 0 center dot 01).

Conclusions: Over a 20-year period in northern Sweden, only small differences in dietary habits were observed in favour of a county with a CVD prevention programme compared with a county without such a programme.