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Time Trends and Determinants of the Adherence to the Mediterranean Diet in Children and Adults

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Policies and Education for Health Promotion".

Deadline for manuscript submissions: closed (5 December 2022) | Viewed by 16186

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Special Issue Editors

Dr. Helmut Schröder

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Guest Editor

1. Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
2. CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III Madrid, 28029 Madrid, Spain
Interests: nutrition; obesity; physical activity; cardiovascular disease; epidemiology
Special Issues, Collections and Topics in MDPI journals

Dr. Santiago Felipe Gomez

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Guest Editor

1. Gasol Foundation, 08830 Sant Boi de Llobregat, Spain
2. GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, 25008 Lleida, Spain
Interests: childhood obesity; epidemiology; community-based interventions; family-based interventions

Special Issue Information

Dear Colleagues,

A healthy balanced diet is imperative for healthy physical and mental development in children and helps to prevent nutrition-related diseases. The Mediterranean diet traditionally includes abundant plant foods such as vegetables and fruits, cereal products, legumes, nuts and seeds. Dairy products are consumed daily in small quantities, some portions of poultry or fish are consumed weekly, and olive oil is the main source of fat intake. Several of these foods have been associated with a reduced risk of the incidence of chronic disease. Composite scores of adherence to the Mediterranean diet, which can best capture the synergy between these dietary components, have been associated with a lower risk of adverse health outcomes, with a greater magnitude than individual food components.

The aim of this Special Issue is to examine time trends and determinants of adherence to the Mediterranean diet. We welcome submissions of prospective and longitudinal data on determinants of adherence to the Mediterranean diet in addition to reviews (systematic reviews and meta-analyses) on this topic. Furthermore, reports on temporal trends of the Mediterranean diet are welcome.

Dr. Helmut Schröder
Dr. Santiago Felipe Gomez
Guest Editors

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Keywords

Mediterranean diet
secular trends
determinants
longitudinal study
systematic review
children
adolescents
adults

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Published Papers (4 papers)

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Research

16 pages, 1546 KiB

Open AccessEditor’s ChoiceArticle

Trends in Adherence to the Mediterranean Diet in Spanish Children and Adolescents across Two Decades

by Estefanía Herrera-Ramos, Laura Tomaino, Almudena Sánchez-Villegas, Lourdes Ribas-Barba, Santiago F. Gómez, Julia Wärnberg, Maddi Osés, Marcela González-Gross, Narcis Gusi, Susana Aznar, Elena Marín-Cascales, Miguel Ángel González-Valeiro, Nicolás Terrados, Josep A. Tur, Marta Segú, Montserrat Fitó, Clara Homs, Juan Carlos Benavente-Marín, Idoia Labayen, Augusto G. Zapico, Jesús Sánchez-Gómez, Fabio Jiménez-Zazo, Pedro Emilio Alcaraz-Ramón, Marta Sevilla-Sanchez, Susana Pulgar-Muñoz, Cristina Bouzas, Clara Sistac-Sorigué, Helmut Schröder and Lluis Serra-Majem Show full author list Hide full author list

Nutrients 2023, 15(10), 2348; https://doi.org/10.3390/nu15102348 - 17 May 2023

Cited by 15 | Viewed by 3671

Abstract

Unhealthy dietary habits determined during childhood may represent a risk factor to many of the chronic non-communicable diseases (NCDs) in adulthood. Mediterranean Diet (MD) adherence in children and adolescents (8–16 years) living in Spain was investigated using the KIDMED questionnaire in a comparative analysis of two cross-sectional nationwide representative studies: enKid (1998–2000, n = 1001) and PASOS (2019–2020, n = 3540). Taking into account the educational level of pupils, as well as the characteristics of the place of living, a significant association was found between a KIDMED score ≥ 8 (optimal MD adherence) and primary education as well as residency in an area of <50,000 inhabitants, while living in the southern regions was associated with non-optimal MD adherence (p < 0.001). Participants of the 2019–2020 study showed an increase in the consumption of dairy products (31.1% increase), pasta/rice (15.4% increase), olive oil (16.9% increase), and nuts (9.7% increase), as well as a decreased sweets and candies intake (12.6% reduction). In contrast, a significantly lower MD adherence was found when comparing the 2019–2020 (mean ± SE: 6.9 ± 0.04) and the 1998–2000 study (7.37 ± 0.08); p < 0.001), due to less consumption of fish (20.3% reduction), pulse (19.4% reduction), and fruits (14.9% reduction), and an increased intake of commercial goods/pastries or fast-food intake (both 19.4% increase). The lowest adherence was recorded for adolescents also in the most recent study, where 10.9% of them presented a KIDMED score ≤ 3. This study shows that eating habits are deteriorating among Spanish children and adolescents. Such findings point out the urgency of undertaking strong measures to promote the consumption of healthy, sustainable, and non-ultra-processed food, such as those available in an MD, not only at a scientific and academic level, but also at a governmental one. Full article

(This article belongs to the Special Issue Time Trends and Determinants of the Adherence to the Mediterranean Diet in Children and Adults)

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11 pages, 439 KiB

Open AccessArticle

Diet Quality Changes by Educational Level among Adults in Spain from 2017 to 2021

by Isabel Romero, Julia Díez, Isabel Del Cura, Manuel Franco, Pedro Gullón and on behalf of the Heart Healthy Hoods Study Group

Nutrients 2023, 15(4), 858; https://doi.org/10.3390/nu15040858 - 8 Feb 2023

Cited by 3 | Viewed by 2222

Abstract

Despite increasing attention on addressing socioeconomic disparities in diet quality, longitudinal studies are scarce. Furthermore, the effects of the COVID-19 pandemic on diet-related outcomes are yet to be fully understood. We examined changes in diet quality by educational level among adults in Madrid, Spain. We used data from recruitment (in 2017) and from 2021. At baseline, our sample included 1358 adults aged 40–75 years who were free of cardiovascular disease and completed a validated diet quality screener. Of them, 931 answered the survey in the follow-up visit in 2021. We used participants' diet quality index scores (range: 18–54; higher scores indicate better diet quality) as the dependent variable. As our independent variable, we assessed participants’ educational levels (low, medium, and high). We fitted a multinomial regression using the categories of educational level as the main predictor, adjusting for age, sex, country of origin, and household composition. During the study period, 78.0% of participants sustained their diet quality, 11.6% improved it, and 10.4% moved away from a healthier dietary pattern. In descriptive analyses, we observed an increase in diet quality among less-educated females. Unadjusted multinomial models showed that a lower educational level predicted both increases and decreases in diet quality over the period. Even though the median diet quality scores did not change significantly, we observed heterogeneous changes over the four years. Variability within diet, with some improving and some worsening, seems to have increased among participants with lower educational levels. Future studies should look at the determinants of change in these population subgroups. Full article

(This article belongs to the Special Issue Time Trends and Determinants of the Adherence to the Mediterranean Diet in Children and Adults)

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12 pages, 1016 KiB

Open AccessArticle

Mediterranean Diet Adherence in Community-Dwelling Older Adults in Spain: Social Determinants Related to the Family

by Rut Navarro-Martínez, Mayra Alejandra Mafla-España and Omar Cauli

Nutrients 2022, 14(23), 5141; https://doi.org/10.3390/nu14235141 - 2 Dec 2022

Cited by 7 | Viewed by 2513

Abstract

The Mediterranean diet (MD), a well-established quality diet model, and regular physical activity are associated with reducing the appearance or progression of several chronic diseases and reducing morbidity and mortality. However, reduction of these goals, adherence to the MD, and regular physical activity occur at all ages, including older individuals in Mediterranean countries such as Spain, where at least adherence to the MD is culturally rooted. Objective: To evaluate the degree of adherence to the MD and physical activity in older individuals. Methods: The sample comprises 679 older adults aged 60 and over who attended activities in municipal centers for older adults in Valencia. Adherence to the Mediterranean diet, frequency of physical activity, and anthropometric assessment were used. Results: High adherence (score ≥ 9) to MD was observed only in 23.7% of the study sample. Smoking habits or having meals in fast-food restaurants on a weekly basis were significantly (p < 0.05) associated with lower MD adherence. Age, BMI, marital status, and physical activity were not significantly associated with MD adherence. Physical activity was significantly (p < 0.05) lower in individuals who were divorced or widow/ers and in those taking care of their grandchildren several times a week. Conclusions: Adherence to the MD in a big Spanish city is low among older individuals. Socio-family factors seem to play a role. Public health and governmental strategies should reinforce adherence to the MD among older individuals as a gold standard for nutrition. Full article

(This article belongs to the Special Issue Time Trends and Determinants of the Adherence to the Mediterranean Diet in Children and Adults)

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12 pages, 310 KiB

Open AccessEditor’s ChoiceArticle

Adherence to Mediterranean Diet and NAFLD in Patients with Metabolic Syndrome: The FLIPAN Study

by Sofía Montemayor, Catalina M. Mascaró, Lucía Ugarriza, Miguel Casares, Isabel Llompart, Itziar Abete, María Ángeles Zulet, J. Alfredo Martínez, Josep A. Tur and Cristina Bouzas

Nutrients 2022, 14(15), 3186; https://doi.org/10.3390/nu14153186 - 3 Aug 2022

Cited by 33 | Viewed by 7181

Abstract

Unhealthy diet is an important factor in the progression of non-alcoholic fatty liver disease (NAFLD). Previous studies showed the benefits of a Mediterranean diet (MedDiet) on Metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and cardiovascular diseases, which usually have a pathophysiological relationship with NAFLD. To assess the effect of adherence to a MedDiet on NAFLD in MetS patients after lifestyle intervention, this multicentre (Mallorca and Navarra, Spain) prospective randomized trial, with personalized nutritional intervention based on a customized MedDiet, coupled with physical activity promotion was performed to prevent, and reverse NAFLD among patients with MetS. The current analysis included 138 patients aged 40 to 60 years old, Body Mass Index (BMI) 27–40 kg/m², diagnosed with NAFLD using MRI, and MetS according to the International Diabetes Federation (IDF). A validated food frequency questionnaire was used to assess dietary intake. Adherence to Mediterranean diet by means of a 17-item validated questionnaire, anthropometrics, physical activity, blood pressure, blood biochemical parameters, and intrahepatic fat contents (IFC) were measured. The independent variable used was changes in MedDiet adherence, categorized in tertiles after 6 months follow-up. Subjects with high adherence to the MedDiet showed higher decreases in BMI, body weight, WC, SBP, DBP, and IFC. An association between improvement in adherence to the MedDiet and amelioration of IFC after 6-month follow-up was observed. High adherence to the MedDiet is associated with better status of MetS features, and better values of IFC. Full article

(This article belongs to the Special Issue Time Trends and Determinants of the Adherence to the Mediterranean Diet in Children and Adults)

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