National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029, Madrid, Spain.
Department of Preventive Medicine and Public Health, Autonomous University of Madrid, Madrid, Spain.
Eur J Nutr. 2024 Apr;63(3):881-891. doi: 10.1007/s00394-023-03318-2. Epub 2024 Jan 13.
The objective is to evaluate the association between various indicators of alcohol consumption and the degree of adherence to the Mediterranean diet among the Spanish adult population.
A cross-sectional study including 44,834 participants ≥ 15 years of age from the 2017 National Health Survey and the 2020 European Health Survey in Spain. Alcohol patterns were defined based on (1) average intake: individuals were classified as low risk (1-20 g/day in men and 1-10 g/day in women) and high risk (> 20 g/day in men or > 10 g/day in women), (2) binge drinking, and (3) alcoholic beverage preference. Non-adherence to the Mediterranean diet was defined as scoring < 7 points on an adapted Mediterranean Diet Adherence Screener index (range 0-10). Odds ratios (OR) were estimated using logistic regression models adjusted for relevant covariates.
Compared to non-drinkers, low and high-risk drinkers were more likely to report non-adherence to the Mediterranean diet: ORs 1.35 (95% CI 1.23; 1.49) and 1.54 (95% CI 1.34; 1.76), respectively. Similarly, reports of binge drinking less than once a month was associated with higher likelihood of non-adherence (OR 1.17; 95% CI 1.04; 1.31). Individuals reporting no preference for a specific beverage and those with a preference for beer or for spirits had lower adherence: ORs 1.18 (95% CI 1.05; 1.33), 1.31 (95% CI 1.17; 1.46), and 1.72 (95% CI 1.17; 2.54), respectively, while a preference for wine showed no association (OR 1.01; 95% CI 0.90; 1.13).
Alcohol consumption, even in low amounts, is associated with lower adherence to the Mediterranean diet. Therefore, alcoholic beverages should not be included in measures that define the Mediterranean diet.
评估西班牙成年人群中各种饮酒指标与地中海饮食依从度之间的关联。
这是一项横断面研究，纳入了 2017 年全国健康调查和 2020 年西班牙欧洲健康调查中≥15 岁的 44834 名参与者。根据（1）平均摄入量：将个体分为低风险（男性 1-20 克/天，女性 1-10 克/天）和高风险（男性>20 克/天或女性>10 克/天），（2） binge drinking 和（3）酒精饮料偏好来定义饮酒模式。不遵守地中海饮食定义为适应地中海饮食依从性筛查指数（范围 0-10）得分<7 分。使用调整了相关协变量的逻辑回归模型估计比值比（OR）。
与不饮酒者相比，低风险和高风险饮酒者更有可能报告不遵守地中海饮食：比值比（OR）分别为 1.35（95%可信区间 1.23；1.49）和 1.54（95%可信区间 1.34；1.76）。同样，每月 binge drinking 少于一次也与不遵守地中海饮食的可能性增加相关（OR 1.17；95%可信区间 1.04；1.31）。报告不偏好特定饮料以及偏好啤酒或烈酒的个体的依从性较低：比值比（OR）分别为 1.18（95%可信区间 1.05；1.33）、1.31（95%可信区间 1.17；1.46）和 1.72（95%可信区间 1.17；2.54），而偏好葡萄酒与无关联（OR 1.01；95%可信区间 0.90；1.13）。
即使饮酒量较低，也与地中海饮食的依从性较低有关。因此，酒精饮料不应包含在定义地中海饮食的措施中。
