Adherence to the Mediterranean Diet and the Consumption of Its Food Groups in a Sample of over 10,000 Italian Adults ^†

Abstract

Adherence to the Mediterranean diet (MD) has been shown to promote health and reduce the prevalence of several chronic diseases. However, to date, more and more countries in the Mediterranean basin seem to be moving away from their traditional eating habits, including Italy. Therefore, the aim of this study was to investigate adherence to the MD and the consumption of its food groups in a large sample of Italian adults. After the removal of duplicates, the study sample comprised 10,916 questionnaires, of which 7088 were completed by women (65%) and 3828 by men (35%). The dietary intake of each food group component in the questionnaire was estimated by multiplying the frequency by the portion size. The mean Medi-Lite score was 12 ± 2.5, suggesting a moderate level of MD adherence, with a significantly (p < 0.05) higher level of adherence observed in women and older subjects. The analysis of the consumption of the individual food groups showed a consumption behavior in line with the national dietary recommendations of fruit (342 g/day), pasta (96 g/day), white meat (302 g/week) and fish (296 g/week). On the other hand, a low consumption of vegetables (270 g/day), bread (85 g/day), legumes (233 g/week) and milk and dairy products (187 g/day) emerged. In addition, the consumption of red meat (209 g/week) was observed to be twice as high as the national guidelines. Subgroup analysis showed that women and the elderly consumed significantly (p < 0.001) more fruit, vegetables, and bread and less meat and meat products than did men and younger subjects. Upon a logistic regression analysis adjusted for possible confounding factors, women showed an increased probability (OR 1.34, 95%CI 1.22–1.46; p < 0.001) of being in the highest MD adherence tertile (i.e., Medi-Lite score > 11). Although the sample reported moderate adherence to MD, the consumption of some typically Mediterranean food groups such as vegetables, legumes and bread is still low, while the consumption of red meat is high.