NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal.
Comprehensive Health Research Center (CHRC), Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal.
Eur J Public Health. 2022 Aug 1;32(4):600-605. doi: 10.1093/eurpub/ckac070.
The decreasing adherence in Mediterranean Diet (M.D.) during the last decades has been attributed to social, cultural and economic factors. However, recent efforts to improve dietary habits and the economic improvement might be reversing this trend. We analyze the changes in M.D. adherence between 2013 and 2019 among a sample of European mature adults and the elderly.
Using data from the Survey of Health, Ageing and Retirement in Europe for adults over 50 years old, we designed a longitudinal cohort study with a sample of participants from waves 5 (2013) and 8 (2019/20). Logistic regressions were used to model the consumption of M.D. adherence as a function of the year. We then stratified the analyses by education, age and transitions in economic status, employment and self-perceived health.
There was in 2019/20 a significant increase in the M.D. adherence (10.8% vs. 14.3%, OR = 1.367, P < 0.01). The rise was mainly related to the decrease of meat and fish (38.4% vs. 30.5%, OR = 0.703, P < 0.01) and growth of legumes and eggs intake (36.3% vs. 41.8%, OR = 1.260 P < 0.01). The results were consistent in all European regions and most sociodemographic groups. Younger people with higher income and education had a greater rise in adherence.
Our analysis shows a generalized growth in adherence to the M.D. across most socioeconomic subpopulations and countries in Europe, suggesting a shift to healthier diet patterns. The more noticeable increase among affluent, educated and healthy respondents, may further entrench dietary and health inequalities.
过去几十年来，地中海饮食（Mediterranean Diet，M.D.）的依从性下降归因于社会、文化和经济因素。然而，最近改善饮食习惯和经济改善的努力可能正在扭转这一趋势。我们分析了欧洲成年和老年人样本中 M.D. 依从性在 2013 年至 2019 年间的变化。
利用来自欧洲健康、老龄化和退休调查（Survey of Health, Ageing and Retirement in Europe）的数据，我们对 50 岁以上成年人的样本进行了一项纵向队列研究，参与者来自第 5 波（2013 年）和第 8 波（2019/20 年）。使用逻辑回归模型将 M.D. 依从性的消费作为年份的函数进行建模。然后，我们按教育程度、年龄以及经济状况、就业和自我感知健康的变化对分析进行分层。
2019/20 年，M.D. 依从性显著增加（10.8%比 14.3%，OR=1.367，P<0.01）。这一增长主要与肉类和鱼类摄入量的减少（38.4%比 30.5%，OR=0.703，P<0.01）和豆类和蛋类摄入量的增加（36.3%比 41.8%，OR=1.260，P<0.01）有关。结果在欧洲所有地区和大多数社会人口群体中都是一致的。收入和教育程度较高的年轻人依从性上升幅度更大。
我们的分析表明，欧洲大多数社会经济亚人群和国家的 M.D. 依从性普遍增长，表明饮食模式向更健康的方向转变。在富裕、受过教育和健康的受访者中，这种增长更为明显，可能进一步加剧饮食和健康方面的不平等。
