Department of Food and Drug, University of Parma, Parco Area delle Scienze, 27/A, 43124 Parma, Italy.
Jožef Stefan Institute (JSI), Jamova 39, 1000 Ljubljana, Slovenia.
Nutrients. 2024 Jul 25;16(15):2405. doi: 10.3390/nu16152405.
Given the global decline in adherence to the Mediterranean Diet (MD), even within its native region, it is key to identify the factors influencing this trend to mitigate the negative health outcomes associated with westernized diets. To this end, 4025 individuals (49.6% women, 42.6 ± 14.2 y/o) from Greece, Italy, Morocco, Slovenia, and Tunisia remotely completed a series of measures assessing motives, attitudes, and psychosocial factors related to MD adherence, which was evaluated using the MEDAS questionnaire. The results suggested medium-to-low adherence across all countries, with the highest adherence in Italy and Morocco and the lowest in Slovenia. Structural equation modeling revealed that positive attitudes toward the healthiness of food were the strongest predictors of adherence, whereas picky eating was a significant negative predictor in all countries except Greece. Adherence to the MD was positively influenced by health motivations in Morocco and weight control in Slovenia and Greece, while sensory appeal negatively influenced adherence in Italy. Additionally, price and convenience were significant barriers in Tunisia and Greece, whereas a preference for local and seasonal foods promoted adherence in Morocco and Greece. Overall, our findings underscore the need for country-specific interventions and policies that address distinct local factors and motivations to ease favorable shifts in dietary patterns toward MD principles.
鉴于地中海饮食（MD）在全球范围内的遵从率下降，甚至在其发源地也是如此，因此确定影响这一趋势的因素对于减轻与西式饮食相关的负面健康后果至关重要。为此，来自希腊、意大利、摩洛哥、斯洛文尼亚和突尼斯的 4025 名个体（49.6%为女性，42.6±14.2 岁）远程完成了一系列评估与 MD 遵从性相关的动机、态度和心理社会因素的措施，使用 MEDAS 问卷进行评估。结果表明，所有国家的 MD 遵从率都处于中等至低水平，意大利和摩洛哥的遵从率最高，斯洛文尼亚的遵从率最低。结构方程模型显示，对食物健康的积极态度是 MD 遵从性的最强预测因素，而挑食在除希腊之外的所有国家都是 MD 遵从性的显著负向预测因素。摩洛哥的健康动机和斯洛文尼亚及希腊的体重控制对 MD 的遵从性有积极影响，而意大利的感官吸引力对 MD 的遵从性有负面影响。此外，价格和便利性在突尼斯和希腊是重要的障碍，而对当地和季节性食物的偏好则促进了摩洛哥和希腊的 MD 遵从性。总体而言，我们的研究结果强调了需要针对特定国家的干预措施和政策，以解决不同的地方因素和动机，促进向 MD 原则的有利饮食模式转变。
