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The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia.

ABSTRACT: The Mediterranean diet (MD) is one of the most healthful dietary patterns, beneficial for humans and the environment. However, the MD has recently exhibited a declining trend, especially in younger and less affluent people. This study investigated the association between socioeconomic indicators and adherence to the MD in 4671 adult subjects from Dalmatia, Croatia (age range 18-98 years; 61.9% were women). Additionally, in the follow-up we examined the change in adherence to the MD and in BMI (subsample, N = 1342; 62.5% were women; mean follow-up time of 5.8 years). The adherence to the MD was based on the Mediterranean Diet Serving Score (range 0-24 points, cut-off value ≥ 14 points), with a prevalence in the overall sample of 28.5%. Higher odds of adherence to the MD were recorded in women, older subjects, and those with higher level of objective material status, while it was less likely in the period after economic crisis of 2007-2008. Additionally, we detected no change in adherence to the MD in the follow-up subsample (-8.5%, p = 0.056), but there was an increase in BMI (+6.5%, p < 0.001). We recorded an increase in adherence for nuts (+127.5%), sweets (+112.6%), red meat (+56.4%), and wine (+50.0%), unlike the reduction in adherence for vegetables (-35.1%), fish (-23.4%), white meat (-11.6%), cereals (-10.9%), and dairy products (-9.6%). Similar results were obtained across all quartiles of objective material status. Over time, the absolute change in the MD score was positively associated with female gender, age, higher education, and moderate physical activity, but it was negatively associated with adherence to the MD at baseline. BMI change was positively associated with female gender, and negatively with initial BMI, initial adherence to the MD, and MD change. Our findings point towards a less than ideal adherence to the MD in the general population of southern Croatia, and identify important characteristics associated with adherence change over time, informing necessary interventions aimed at increasing MD uptake.

SUBMITTER: Pribisalic A

PROVIDER: S-EPMC8624926 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:There is increasing evidence for the interaction between gut microbiome, diet, and health. It is known that dysbiosis is related to disease and that most of the times this imbalances in gut microbial populations can be promoted through diet. Western dietary habits, which are characterized by high intakes of calories, animal proteins, saturated fats, and simple sugars have been linked with higher risk of obesity, diabetes, cancer, and cardiovascular disease. However, little is known about the impact of dietary patterns, dietary components, and nutrients on gut microbiota in healthy people. The aim of our study is to determine the effect of nutrient compounds as well as adherence to a dietary pattern, as the Mediterranean diet (MD) on the gut microbiome of healthy adults. Consequently, gut microbiota composition in healthy individuals, may be used as a potential biomarker to identify nutritional habits as well as risk of disease related to these habits. Dietary information from healthy volunteers (n = 27) was recorded using the Food Frequency Questionnaire. Adherence to the MD was measured using the PREDIMED test. Microbiota composition and diversity were obtained by 16S rRNA gene sequencing and specific quantitative polymerase chain reaction. Microbial metabolic activity was determined by quantification of short chain fatty acids (SCFA) on high performance liquid chromatography (HPLC). The results indicated that a higher ratio of Firmicutes-Bacteroidetes was related to lower adherence to the MD, and greater presence of Bacteroidetes was associated with lower animal protein intake. High consumption of animal protein, saturated fats, and sugars affected gut microbiota diversity. A significant higher presence of Christensenellaceae was found in normal-weight individuals compared to those who were overweight. This was also the case in volunteers with greater adherence to the MD compared to those with lower adherence. Butyricimonas, Desulfovibrio, and Oscillospira genera were associated with a BMI <25 and the genus Catenibacterium with a higher PREDIMED score. Higher bifidobacterial counts, and higher total SCFA were related to greater consumption of plant-based nutrients, such as vegetable proteins and polysaccharides. Better adherence to the MD was associated with significantly higher levels of total SCFA. Consequently, diet and specific dietary components could affect microbiota composition, diversity, and activity, which may have an effect on host metabolism by increasing the risk of Western diseases.

Project description:OBJECTIVE:The aim of this review was to evaluate the conceptual suitability, applicability and psychometric properties of scores used internationally to measure adherence to the Mediterranean diet (MD). DESIGN:This was a systematic review to identify original articles that examined some aspects of the conceptual suitability, applicability or psychometric properties of the MD adherence score. Electronic searches were carried out on the international databases MEDLINE, Scopus, Web of Science and EMBASE (from January 1980 to 31 December 2015). ELIGIBILITY CRITERIA FOR SELECTING STUDIES:The study included original articles that examined some aspects of the conceptual suitability, applicability or psychometric properties of the MD adherence score. The studies where MD adherence scores were administered but did not bring forward any evidence about their performance related to conceptual suitability, applicability or psychometric properties were excluded. DATA EXTRACTION:Information relating to the scales was extracted in accordance with the quality criteria defined by the Scientific Advisory Committee of the Medical Outcomes Trust for measurement of health results and the quality criteria recommended by Terwee: (1) conceptual, (2) applicability and (3) psychometric properties. Three authors independently extracted information from eligible studies. RESULTS:Twenty-seven studies were identified as meeting the inclusion criteria, yielding 28 MD adherence scores. The results showed that evidence is scarce and that very few scores fulfilled the applicability parameters and psychometric quality. The scores developed by Panagiotakos et al, Buckland et al and Sotos-Prieto et al showed the highest levels of evidence. CONCLUSIONS:Scores measuring adherence to MD are useful tools for identifying the dietary patterns of a given population. However, further information is required regarding existing scores. In addition, new instruments with greater conceptual and methodological rigour should be developed and evaluated for their psychometric properties.

Project description:With the increase in life expectancy, expectation of a longer healthy life is also increasing. Importance of consumption of certain foods is confirmed to have a strong effect on quality of life. One of the healthiest dietary patterns consistently associated with a range of beneficial health outcomes is the Mediterranean diet (MD). The aim of this study was to assess MD adherence in the population over 50 years of age, in Europe, with special reference to Croatia, and to assess regional differences and investigate the association with health-related indicators (disease incidence, body mass index (BMI), grip strength measure, control, autonomy, self-realization, and pleasure scale (CASP-12)). This research uses data from the SHARE project for the population over 50 years of age. The frequency of individual responses was analyzed (frequencies, cross tables, and appropriate tests of significance, depending on the data set), and logistic regression was used to connect adherence to the Mediterranean diet with health indicators. The results of the study indicate a positive correlation between adherence to the principles of the Mediterranean diet with CASP and self-perception of health, which the followers of the MD pattern predominantly rate as "very good" or "excellent" (37.05%) what is significantly different (p < 0.05) from individuals which do not follow the patterns of MD (21.55%). The regression models indicate significant changes in the measure of maximum grip strength also among MD followers (ORMEDIUM = 1.449; ORHIGH = 1.293). Data for EU countries are also classified by regions (Central and Eastern; Northern, Southern and Western Europe), additionally allocating Croatia, and the trends in meat, fish and egg consumption showed the greatest differences for Croatian participants (39.6% twice a week) versus participants from four European regions. Data for Croatia deviates from the European average also in terms of the proportion of overweight and obese persons in all observed age groups, of which the largest proportion is in the 50-64 age group (normal BMI: only 30.3%). This study extended the currently available literature covering 27 European countries, placing the findings in a wider geographical context. The Mediterranean diet has once again proven to be an important factor related to health-related behavior. The presented results are extremely important for public health services, indicating possible critical factors in preserving the health of the population over 50 years old.

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The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia.

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