Adhering to a Mediterranean diet in a Mediterranean country: an excess cost for families?

2021 ◽  
pp. 1-24
Author(s):  
Ricardo Alves ◽  
Carla Lopes ◽  
Sara Rodrigues ◽  
Julian Perelman

Abstract Background: Adherence to the Mediterranean diet has been decreasing in southern Europe, which could be linked to several cultural or educational factors. Our aim is to evaluate the extent to which economic aspects may also play a role, exploring the relationship between food prices in Portugal and adherence to the Mediterranean diet. Methods: We evaluated data from the Portuguese National Food, Nutrition, and Physical Activity Survey (IAN-AF 2015-2016) (n=3,591). Diet expenditures were estimated by attributing a retail price to each food group and the diet was transposed into the Mediterranean Diet Score used in the literature. Prices were gathered from five supermarket chains (65% of the Portuguese market share). Linear regression models were used to assess the association between different adherence levels to the MD levels and dietary costs. Results: Greater adherence to the MD was associated with a 21.2% (p< 0.05) rise in total dietary cost, which accounts for more 0.59€ in mean daily costs when compared with low adherence. High adherence individuals (vs. low adherence) had higher absolute mean daily costs with fish (0.62€/+285.8%; p< 0.05), fruits (0.26€/+115.8%; p< 0.05), and vegetables (0.10€/+100.9%; p< 0.05). The analysis stratified by education and income level showed significantly higher mean daily diet cost only amongst higher income groups. Conclusions: Our findings suggest that greater adherence to the MD was positively and significantly associated with higher total dietary cost. Policies to improve population’s diet should take into consideration the cost of healthy foods, especially for large low- and middle-income families.

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1251 ◽  
Author(s):  
Yasmine S. Aridi ◽  
Jacqueline L. Walker ◽  
Eugeni Roura ◽  
Olivia R. L. Wright

The Mediterranean diet (MD) is linked to decreased risk of chronic disease, such as cardiovascular disease, obesity, hypertension, diabetes mellitus and cognitive disease. Given the health promoting aspects of this diet, we conducted a secondary analysis of data from the National Nutrition and Physical Activity Survey (NNPAS), which is the largest health study in Australia and the first nutrition-specific national-based study. The primary aim of this analysis was to determine the proportion of Australian adults adhering to the MD and to examine the association between adherence to the MD and markers of noncommunicable diseases, such as cardiovascular disease, diabetes mellitus and chronic kidney disease. Out of the 9435 participants included in the study (mean age = 48.6 ± 17.6 years), 65% were in the middle tertile of the MD score. Participants who were married, employed, of a high-socioeconomic level, nonsmokers, educated and had a healthy body mass index (BMI) and waist circumference were more likely to have higher adherence levels to the MD, which was associated with lower diastolic blood pressure (p < 0.05). Multivariate logistic regression analysis showed that, even after accounting for all possible confounders, higher adherence to the MD was associated with lower risk of dyslipidaemia, OR = 1.06 (1.01–1.10). In conclusion, this analysis is the first to assess adherence to the MD on a national level. Our results indicated that MD adherence may contribute to reducing the prevalence of dyslipidaemia, cerebrovascular disease and elevated blood pressure in a multi-ethnic, non-Mediterranean country.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
F Scazzina

Abstract More than five years since the global commitment to the 2030 Agenda for Sustainable Development, 690 million people lack sufficient food and economic projections suggest that the COVID-19 pandemic may add an additional 83 to 132 million people to the ranks of the undernourished. Meanwhile, 1.3 billion tons of food are wasted globally each year, utilizing 38% of total energy consumption in the global food system. Child and adult overweight and obesity are increasing in almost all countries, and on a global level the cost of a healthy diet is 60% higher than the cost of a nutrient adequate diet, and almost 5 times the cost of an energy sufficient diet. The Mediterranean Diet is one of the recognized models of healthy and sustainable diets. This model has proven to promote longevity and well-being, not only by considering specific food items and dietary patterns, but also taking into account the culture and the history of populations living in that region, as well as social aspects such as tradition and conviviality. Moreover, it is strongly tied to a gastronomic background that links health with enjoyment. This may be extremely important for the implementation of feasible programs for the prevention of chronic non communicable diseases. In fact, long lasting lifestyle changes are difficult to achieve and, although health motivations may lead to satisfactory dietary compliance in the short term, pleasure remains an important determinant of any dietary change that is intended to last. While keeping traditional dietary habits at European level, the main principles of the Mediterranean diet could be taken into account to identify key features that ensure both health benefits and sustainable impact on environment. Assessing the sustainability of these products can be an effective operational approach for preserving and promoting a Mediterranean-type dietary pattern in the European region.


2003 ◽  
Vol 73 (3) ◽  
pp. 221-225 ◽  
Author(s):  
Trichopoulou ◽  
Benetou ◽  
Lagiou ◽  
Gnardellis ◽  
Stacewicz-Sapunzakis ◽  
...  

In the context of the Greek segment of the European Prospective Investigation into Cancer and Nutrition (EPIC), we conducted a cross-sectional study to examine the effects of the intake of plant foods central in the traditional Mediterranean diet on plasma levels of alpha-carotene, beta-carotene, lycopene, beta-cryptoxanthin, and lutein-zeaxanthin. Study subjects were a random sample of 45 men and 68 women, aged 30–82 years, from the Greek EPIC cohort of 27953 volunteers. Linear regression models were fitted, with the carotenoid blood levels as dependent variables. Independent variables were selected food items, as well as body mass index, controlling for energy intake and a set of demographic factors. Body mass index was inversely associated with plasma levels of the studied carotenoids. The association was highly significant for alpha-carotene and beta-carotene, significant for lutein-zeaxanthin, and borderline significant (p ~ 0.07) for lycopene. Tomato intake was significantly positively associated with plasma lycopene, and beta-carotene. Other fruity vegetables and non-fruity vegetables were significantly positively associated, the former with a-carotene and the latter with both alpha- and beta-carotene plasma levels. Fruits showed a highly significant positive association with plasma beta-cryptoxanthin, as well as with beta-carotene. No association was found between the intake of olive oil or other added lipids and plasma carotenoids. We conclude that among the studied components of the Mediterranean diet, fruits and vegetables tend to increase levels of some carotenoids, but olive oil has no apparent effect.


2014 ◽  
Vol 18 (6) ◽  
pp. 959-967 ◽  
Author(s):  
Mercedes Sotos-Prieto ◽  
Belén Moreno-Franco ◽  
Jose M Ordovás ◽  
Montse León ◽  
Jose A Casasnovas ◽  
...  

AbstractObjectiveTo design and develop a questionnaire that can account for an individual’s adherence to a Mediterranean lifestyle including the assessment of diet and physical activity patterns, as well as social interaction.DesignThe Mediterranean Lifestyle (MEDLIFE) index was created based on the current Spanish Mediterranean food guide pyramid. MEDLIFE is a twenty-eight-item derived index consisting of questions about food consumption (fifteen items), traditional Mediterranean dietary habits (seven items) and physical activity, rest and social interaction habits (six items). Linear regression models and Spearman rank correlation were fitted to assess content validity and internal consistency.SettingA subset of participants in the Aragon Workers’ Health Study cohort (Zaragoza, Spain) provided the data for development of MEDLIFE.SubjectsParticipants (n 988) of the Aragon Workers’ Health Study cohort in Spain.ResultsMean MEDLIFE score was 11·3 (sd 2·6; range: 0–28), and the quintile distribution of MEDLIFE score showed a significant association with each of the individual items as well as with specific nutrients and lifestyle indicators (intra-validity). We also quantified MEDLIFE correspondence with previously reported diet quality indices and found significant correlations (ρ range: 0·44–0·53; P<0·001) for the Alternate Healthy Eating Index, the Alternate Mediterranean Diet Index and Mediterranean Diet Adherence Screener.ConclusionsMEDLIFE is the first index to include an overall assessment of lifestyle habits. It is expected to be a more holistic tool to measure adherence to the Mediterranean lifestyle in epidemiological studies.


2021 ◽  
Author(s):  
Alessia Rubini ◽  
Cristina Vilaplana Prieto ◽  
Marta Flor-Alemany ◽  
Lorena Yeguas-Rosa ◽  
Miriam Hernández-González ◽  
...  

Abstract BackgroundThe Mediterranean Diet (MD) is recognized as heart-healthy, but the economic cost associated with this type of diet has scarcely been studied.AimThe objective of the present study was to explore the cost and adherence of the low-income region population to the MD and its relationship with available incomes.MethodsA population-based study was carried out on 2,833 subjects between 25 and 79 years of age, 54% women, selected at random from the communities of Vegas Altas, La Siberia and La Serena in the province of Badajoz, Extremadura, Spain. The average cost of each product included in the MD and monthly expenditure were calculated. The expenditure was related to the degree of adherence to the MD (the Panagiotakos Index) and to the incomes of the participants.ResultsThe monthly median cost was 203.6 euros (IQR 154.04-265.37). Food-related expenditure was higher among the male population (p<0.001) of between 45 and 54 years of age (p<0.013) and living in urban areas (p<0.001). A positive correlation between food-related expenditure and the MD adherence was found. Expenditure represents 15% of total incomes, ranging from 11% for the group with a low MD adherence to 17% for the group with a high MD adherence.Conclusions The monthly cost of the MD was positively correlated with the degree of adherence to this dietary pattern, and is similar to that of other regions of Spain with higher per capita income, which entails a greater expenditure for equal adherence to the MD.


Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3841
Author(s):  
Miguel Seral-Cortes ◽  
Sergio Sabroso-Lasa ◽  
Pilar De Miguel-Etayo ◽  
Marcela Gonzalez-Gross ◽  
Eva Gesteiro ◽  
...  

Obesity and metabolic syndrome (MetS) are worldwide major health challenges. The Mediterranean diet (MD) is associated with a better cardiometabolic profile, but these beneficial effects may be influenced by genetic variations, modulating the predisposition to obesity or MetS. The aim was to assess whether interaction effects occur between an obesity genetic risk score (obesity-GRS) and the MD on adiposity and MetS in European adolescents. Multiple linear regression models were used to assess the interaction effects of an obesity-GRS and the MD on adiposity and MetS and its components. Interaction effects between the MD on adiposity and MetS were observed in both sex groups (p < 0.05). However, those interaction effects were only expressed in a certain number of adolescents, when a limited number of risk alleles were present. Regarding adiposity, a total of 51.1% males and 98.7% females had lower body mass index (BMI) as a result of higher MD adherence. Concerning MetS, only 9.9% of males with higher MD adherence had lower MetS scores. However, the same effect was observed in 95.2% of females. In conclusion, obesity-related genotypes could modulate the relationship between MD adherence and adiposity and MetS in European adolescents; the interaction effect was higher in females than in males.


Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1875 ◽  
Author(s):  
Andrea Romanos-Nanclares ◽  
Itziar Zazpe ◽  
Susana Santiago ◽  
Lucía Marín ◽  
Anaïs Rico-Campà ◽  
...  

Parental nutrition knowledge and attitudes play a fundamental role in their children’s food knowledge. However, little is known about their influence on their children’s diet quality and micronutrient intake. Thus, we aimed to assess the association of parental nutrition knowledge and healthy-eating attitudes with their children’s adherence to the Mediterranean dietary pattern and micronutrient adequacy. Parental healthy-eating attitudes and knowledge of the quality of their child’s diet as well as anthropometric, lifestyle, and nutrient intake characteristics were recorded with a basal questionnaire that included a 140-item-food frequency-questionnaire. A total of 287 pre-school children were included in the analyses. Intake adequacy was defined using the Estimated Average Requirements (EAR) cut-off point method. We developed a parental nutrition knowledge and healthy-eating attitudes scores and evaluated whether they were independently associated with 1) children’s inadequate intake (probability of failing to meet ≥3 EAR) of micronutrients, using logistic regression analyses, and 2) children’s diet quality (adherence to the Mediterranean Diet according to a Mediterranean Diet Quality Index for children and adolescents, the KIDMED index), using multiple linear regression models. A higher score in the parental healthy-eating attitudes score was associated with lower risk of failing to meet ≥3 EAR compared with the reference category (odds ratio (OR): 0.3; 95% confidence interval (CI) 0.12–0.95; p for trend: 0.037) and a higher adherence to the Mediterranean diet in the most adjusted model (β coefficient: 0.34; 95% CI 0.01–0.67; p for trend: 0.045). Our results suggest a positive association of parental healthy-eating attitudes with nutritional adequacy and diet quality in a sample of Spanish preschoolers. Public health strategies should focus on encouraging parental healthy-eating attitudes rather than simply educating parents on what to feed their children, recognizing the important influence of parental behavior on children’s practices.


2008 ◽  
Vol 11 (2) ◽  
pp. 214-217 ◽  
Author(s):  
Marta Rossi ◽  
Eva Negri ◽  
Cristina Bosetti ◽  
Luigino Dal Maso ◽  
Renato Talamini ◽  
...  

AbstractObjectiveThe Mediterranean diet is rich in fat and starch, and hence may be related to overweight. We therefore investigated the relationship between adherence to a Mediterranean diet and body mass index (BMI) and waist-to-hip ratio (WHR).Design and settingData were obtained from the control group of a network of case–control studies on cancer conducted in major teaching and general hospitals in four Italian areas between 1991 and 2002. An interviewer-administered validated 78-item food-frequency questionnaire was used to obtain information on the subjects’ habitual diet. Information on socio-economic factors, lifestyle habits and anthropometric measures was also collected. A Mediterranean diet score (MDS) was derived on the basis of eight characteristics of the Mediterranean diet.SubjectsSubjects were 6619 patients (3090 men, 3529 women) admitted to hospital for a wide spectrum of acute, non-neoplastic conditions, unrelated to known risk factors for cancer and long-term modifications of diet.ResultsIn multiple linear regression models adjusted for age, study centre, education, tobacco smoking, occupational physical activity and total energy intake, the MDS was not related to BMI (β = 0.05 for men and −0.04 for women) or WHR (β = 0.000 and 0.001, respectively) in both sexes.ConclusionsAdherence to the major characteristics of the Mediterranean diet is unrelated to BMI and WHR, confirming previous data from Greece and Spain.


2020 ◽  
pp. 1-8
Author(s):  
Kennya Beatriz Siqueira ◽  
Cristiano AV Borges ◽  
Mirella L Binoti ◽  
Amanda F Pilati ◽  
Paulo HF da Silva ◽  
...  

Abstract Objective: Affordable nutrition refers to the relation between nutrient density of foods and their monetary cost. There are limited data on affordable nutrition in low- and middle-income countries. The present study aimed to develop a nutrient density score and nutrient affordability metrics for 377 most consumed foods in Brazil. Design: The foods were aggregated into seven major food groups and four NOVA food categories. Nutrient composition data were obtained from the Brazilian Institute of Geography and Statistics. Food prices were obtained from retailer websites and were converted to prices per 100 g and 418 kJ. The Nutrient Rich Food (NRF8.2) score was based on protein, fiber, vitamins A, C and E, Ca, Fe and K. Nutrients to limit were sugar and Na. Affordability was measured as kcal/R$ and nutrients/R$. Results: Grains, fats and sweets were more energy dense and had lower NRF8.2 scores than dairy, vegetables and fruits. Grains, fats and sweets were the lowest cost sources of energy. Vegetables and fruits, beans, nuts and seeds and eggs and dairy were the lowest cost sources of multiple nutrients. Ultra-processed foods (48 % of total) had higher energy density and lower NRF8.2 scores than did unprocessed foods. In Brazil, fruits, vegetables and dairy products offered the most nutrients per real. Conclusions: Analysis of the relationship between nutrient density of foods and their cost can help identify locally available foods that are nutrient rich, affordable and culturally acceptable. Achieving high nutrient density at an affordable cost should be the goal of Brazil’s food systems.


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