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Article

The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia

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Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia
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NUTRITIUS—Nutrition Counseling, Primorska 30, 20000 Dubrovnik, Croatia
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Department of Economics, University of Foggia, 71121 Foggia, Italy
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Department of Cardiac Surgery, University Hospital of Split, 21000 Split, Croatia
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Department for Social Medicine, Division for Health Promotion, Public Health Institute of Dubrovnik Neretva County, Dr. A. Šercera 4a, pp 58, 20001 Dubrovnik, Croatia
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MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH8 9YL, UK
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Algebra LAB, Algebra University College, Ilica 242, 10000 Zagreb, Croatia
*
Author to whom correspondence should be addressed.
Academic Editor: Daniela Bonofiglio
Nutrients 2021, 13(11), 3802; https://doi.org/10.3390/nu13113802
Received: 15 September 2021 / Revised: 23 October 2021 / Accepted: 25 October 2021 / Published: 26 October 2021
The Mediterranean diet (MD) is one of the most healthful dietary patterns, beneficial for humans and the environment. However, the MD has recently exhibited a declining trend, especially in younger and less affluent people. This study investigated the association between socioeconomic indicators and adherence to the MD in 4671 adult subjects from Dalmatia, Croatia (age range 18–98 years; 61.9% were women). Additionally, in the follow-up we examined the change in adherence to the MD and in BMI (subsample, N = 1342; 62.5% were women; mean follow-up time of 5.8 years). The adherence to the MD was based on the Mediterranean Diet Serving Score (range 0–24 points, cut-off value ≥ 14 points), with a prevalence in the overall sample of 28.5%. Higher odds of adherence to the MD were recorded in women, older subjects, and those with higher level of objective material status, while it was less likely in the period after economic crisis of 2007–2008. Additionally, we detected no change in adherence to the MD in the follow-up subsample (−8.5%, p = 0.056), but there was an increase in BMI (+6.5%, p < 0.001). We recorded an increase in adherence for nuts (+127.5%), sweets (+112.6%), red meat (+56.4%), and wine (+50.0%), unlike the reduction in adherence for vegetables (−35.1%), fish (−23.4%), white meat (−11.6%), cereals (−10.9%), and dairy products (−9.6%). Similar results were obtained across all quartiles of objective material status. Over time, the absolute change in the MD score was positively associated with female gender, age, higher education, and moderate physical activity, but it was negatively associated with adherence to the MD at baseline. BMI change was positively associated with female gender, and negatively with initial BMI, initial adherence to the MD, and MD change. Our findings point towards a less than ideal adherence to the MD in the general population of southern Croatia, and identify important characteristics associated with adherence change over time, informing necessary interventions aimed at increasing MD uptake. View Full-Text
Keywords: Mediterranean diet; adherence; BMI; socioeconomic status Mediterranean diet; adherence; BMI; socioeconomic status
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MDPI and ACS Style

Pribisalić, A.; Popović, R.; Salvatore, F.P.; Vatavuk, M.; Mašanović, M.; Hayward, C.; Polašek, O.; Kolčić, I. The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia. Nutrients 2021, 13, 3802. https://doi.org/10.3390/nu13113802

AMA Style

Pribisalić A, Popović R, Salvatore FP, Vatavuk M, Mašanović M, Hayward C, Polašek O, Kolčić I. The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia. Nutrients. 2021; 13(11):3802. https://doi.org/10.3390/nu13113802

Chicago/Turabian Style

Pribisalić, Ajka, Romana Popović, Fiorella P. Salvatore, Maja Vatavuk, Marija Mašanović, Caroline Hayward, Ozren Polašek, and Ivana Kolčić. 2021. "The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia" Nutrients 13, no. 11: 3802. https://doi.org/10.3390/nu13113802

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