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

  • Francesca Denoth
  • Marco Scalese
  • Valeria Siciliano
  • Laura Di Renzo
  • Antonino De Lorenzo
  • Sabrina Molinaro
Original Article



(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.


Eating 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


Confidence interval


Composite international diagnostic interview, short form


Chronic kidney disease


National Research Council (Italy)


Cardiovascular disease


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


Mediterranean diet


Multinational MONItoring of trends and determinants in CArdiovascular disease project


Odds ratio


Physical activity


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.

Ethical approval

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.

Informed consent

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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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Francesca Denoth
    • 1
    • 2
  • Marco Scalese
    • 1
  • Valeria Siciliano
    • 1
  • Laura Di Renzo
    • 2
  • Antonino De Lorenzo
    • 2
  • Sabrina Molinaro
    • 1
  1. 1.Institute of Clinical PhysiologyCNR (Italian National Research Council)PisaItaly
  2. 2.Section of Clinical Nutrition and Nutrigenomic, Faculty of Medicine and Surgery, Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly

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