Clustering eating habits: frequent consumption of different dietary patterns among the Italian general population in the association with obesity, physical activity, sociocultural characteristics and psychological factors
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(a) To identify clusters of eating patterns among the Italian population aged 15–64 years, focusing on typical Mediterranean diet (Med-diet) items consumption; (b) to examine the distribution of eating habits, as identified clusters, among age classes and genders; (c) evaluate the impact of: belonging to a specific eating cluster, level of physical activity (PA), sociocultural and psychological factors, as elements determining weight abnormalities.
Data for this cross-sectional study were collected using self-reporting questionnaires administered to a sample of 33,127 subjects participating in the Italian population survey on alcohol and other drugs (IPSAD®2011). The cluster analysis was performed on a subsample (n = 5278 subjects) which provided information on eating habits, and adapted to identify categories of eating patterns. Stepwise multinomial regression analysis was performed to evaluate the associations between weight categories and eating clusters, adjusted for the following background variables: PA levels, sociocultural and psychological factors.
Three clusters were identified: “Mediterranean-like”, “Western-like” and “low fruit/vegetables”. Frequent consumption of Med-diet patterns was more common among females and elderly. The relationship between overweight/obesity and male gender, educational level, PA, depression and eating disorders (p < 0.05) was confirmed. Belonging to a cluster other than “Mediterranean-like” was significantly associated with obesity.
The low consumption of Med-diet patterns among youth, and the frequent association of sociocultural, psychological issues and inappropriate lifestyle with overweight/obesity, highlight the need for an interdisciplinary approach including market policies, to promote a wider awareness of the Mediterranean eating habit benefits in combination with an appropriate lifestyle.
KeywordsEating habits Dietary patterns Obesity Overweight Population survey Cluster analysis
List of abbreviation
Akaike information criterion
Bayesian information criteria
Body mass index
The name of the questionnaire is an acronym of its four questions:
Have you ever felt you needed to cut down on your drinking? (cut down)
Have people annoyed you by criticizing your drinking? (annoyed)
Have you ever felt guilty about drinking? (guilty)
Have you ever felt you needed a drink first thing in the morning to steady your nerves or to get rid of a hangover? (eye-opener)
Coronary heart disease
Composite international diagnostic interview, short form
Chronic kidney disease
National Research Council (Italy)
Diagnostic and statistical manual of mental disorders, version IV
Eating attitude test, 26 items version
European Monitoring Centre for Drug and Drug Addiction
Fruit and vegetables
Institute of Clinical Physiology
Italian Mediterranean organic diet
Italian population survey on alcohol and other drugs
Multiple correspondence analysis
Multinational MONItoring of trends and determinants in CArdiovascular disease project
Statistical Package for Social Science software
Rapid stress assessment scale
World Health Organization
The authors would like to thank Prof. Michael Liebman for his valuable suggestions and helpful comments to the manuscript. The authors would like to thank Dr. Elisa Benedetti for the valuable help.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedure performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
As IPSAD® is an anonymous survey, signed consent form is not necessary because the fact that participants complete and return the survey questionnaire provides a passive consent.
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