Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy.
Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy.
Eur J Public Health. 2019 Apr 1;29(2):328-335. doi: 10.1093/eurpub/cky127.
To evaluate the adherence to Mediterranean diet (MD) and its major socioeconomic and psychosocial determinants in a large sample of the Italian population, covering three main geographical areas of the Country (Southern, Central and Northern).
Data were obtained from the Italian Nutrition & Health Survey (INHES), including a total of 7, 430 participants (age >20) recruited from all over Italy (2010-13). Dietary information was collected by the European Food Propensity Questionnaire. Adherence to MD was assessed by using the MedDietScore based on 11 food groups. Associations were tested by multivariable logistic regression analysis (Odds ratio [OR] with 95% CI).
Adherence to MD was higher in Southern Italy as compared with the Northern (OR = 1.34; 95% CI 1.18-1.53), and was closely associated with adult age (OR= 2.40; 1.61-3.58 for those aged > 75 years as compared with 20-34 years) and higher educational level (OR = 1.77; 1.40-2.24 for post-secondary education as opposed to lowest educational attainment). Subjects reporting adverse life events and those with family-related stress were less likely to show an optimal adherence to MD (OR = 0.55; 0.46-0.67 and OR = 0.44; 0.28-0.69, for highest vs. lowest tertile, respectively) as compared with adequate controls. A number of eating behaviours were also inversely associated with MD, such as consuming higher amount of alcohol in the weekend than in week days.
Adherence to MD is strongly determined by age, geographical area and educational level. Psychosocial factors and several eating behaviours are also closely associated.
为了评估大量意大利人群对地中海饮食（MD）的依从性及其主要的社会经济和心理社会决定因素，涵盖了该国三个主要地理区域（南部、中部和北部）。
数据来自意大利营养与健康调查（INHES），共纳入 7430 名（年龄＞20 岁）来自意大利各地的参与者（2010-13 年）。通过欧洲食物倾向问卷收集饮食信息。采用基于 11 种食物组的 MedDietScore 评估 MD 的依从性。使用多变量逻辑回归分析（比值比 [OR]和 95%置信区间）检验相关性。
与北部相比，南部意大利人对 MD 的依从性更高（OR=1.34；95%CI 1.18-1.53），并与成人年龄（OR=2.40；75 岁以上人群与 20-34 岁人群相比）和更高的教育水平（OR=1.77；与最低教育程度相比，中学后教育与最高教育程度相比）密切相关。报告不良生活事件和家庭相关压力的受试者不太可能表现出对 MD 的最佳依从性（OR=0.55；0.46-0.67 和 OR=0.44；0.28-0.69，分别为最高与最低三分位）。一些饮食行为也与 MD 呈负相关，例如周末比工作日摄入更多的酒精。
MD 的依从性主要由年龄、地理区域和教育水平决定。心理社会因素和几种饮食行为也密切相关。
