Nutrition behaviour and compliance with the Mediterranean diet pyramid recommendations: an Italian survey-based study
- 3 Downloads
Adopting a Mediterranean-like dietary pattern may help in preventing several chronic diseases. We assessed the eating behaviour and compliance with the Mediterranean diet pyramid recommendations in Italy.
This is a cross-sectional study conducted in subjects aged ≥ 20 years. A 14-question survey based on the updated Mediterranean diet pyramid was launched online from April 2015 to November 2016. At test completion, a personalized pyramid displaying the possible deficiencies and/or excesses was generated, that could be the basis to plan diet and lifestyle modifications.
Overall, 27,540 subjects completed the survey: the proportion of females (75.6%), younger subjects (20.7%) and people with a University degree (33.1%) resembled those of the Italian population of Internet users rather than of the general population. 37.8% of participants declared a sedentary lifestyle, including 29.6% of those aged 20–29 years. A lower-than-recommended intake of all food categories included in the Mediterranean diet pyramid, along with excess of sweets, red and processed meats, emerged, that may affect health in the long term. Low adherence to recommendations was observed especially among females and older people. Notably, a discrepancy surfaced between the responders’ perceived and actual behaviour toward the regular consumption of fruits and vegetables (81.8% vs 22.7–32.8%, respectively).
The nutritional habits and lifestyle of Italian participants are poorly adherent to the Mediterranean diet recommendations. The personalized pyramid tool may help in raising the awareness of individuals and their families on where to intervene, possibly with the support of healthcare professionals, to improve their behaviour.
Level of evidence
Level V, cross-sectional descriptive study.
KeywordsCompliance Food pyramid Italy Lifestyle Mediterranean diet Nutrition
The authors would like to thank all participants who completed the online test. We also thank Scientific Committee members and contributors of Curare la Salute: Luigi Canciani, Alessandro Fornaro. Marcello Giovannini, Elisa Paganini, Annarosa Racca, Paolo Vintani. We thank Pfizer Consumer Healthcare, and especially Antonio Limitone, Ornella Parma and Domenico Giorgio Cassarà for supporting “Curare la salute”. Editorial support was provided by Edra spa, and unconditionally funded by Pfizer Consumer Healthcare.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Participation was voluntary and anonymous and completing the survey was accepted as consent by the participants.
- 7.Zappalà G, Buscemi S, Mulè S et al (2018) High adherence to Mediterranean diet, but not individual foods or nutrients, is associated with lower likelihood of being obese in a Mediterranean cohort. Eat Weight Disord EWD 23:605–614. https://doi.org/10.1007/s40519-017-0454-1 CrossRefPubMedGoogle Scholar
- 11.Vitale M, Masulli M, Calabrese I et al (2018) Impact of a Mediterranean dietary pattern and its components on cardiovascular risk factors, glucose control, and body weight in people with type 2 diabetes: a real-life study. Nutrients. https://doi.org/10.3390/nu10081067 CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Jennings A, Cashman KD, Gillings R et al (2018) A Mediterranean-like dietary pattern with vitamin D3 (10 µg/day) supplements reduced the rate of bone loss in older Europeans with osteoporosis at baseline: results of a 1-y randomized controlled trial. Am J Clin Nutr. https://doi.org/10.1093/ajcn/nqy122 CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Renzella J, Townsend N, Jewel J et al (2018) What national and subnational interventions and policies based on Mediterranean and Nordic diets are recommended or implemented in the WHO European Region, and is there evidence of effectiveness in reducing noncommunicable diseases? http://www.euro.who.int/__data/assets/pdf_file/0011/365285/hen-58-eng.pdf?ua=1. Accessed 14 Oct 2019
- 30.SINU—Società Italiana di Nutrizione Umana. https://sinu.it/. Accessed 14 Oct 2019
- 31.Aspetti della vita quotidiana (2016). https://www.istat.it/it/archivio/186843. Accessed 26 Sep 2019
- 32.Istat.it| Multiscopo sulle famiglie (2018) Aspetti della vita quotidiana—parte generale. https://www.istat.it/it/archivio/217037. Accessed 14 Oct 2019
- 34.EUPATI (2017) Fattori di rischio per la salute: fumo, obesità, alcol e sedentarietà. https://www.istat.it/it/archivio/202040. Accessed 26 Sep 2019
- 39.International Agency for Research on Cancer, International Agency for Research on Cancer (1988) Alcohol drinking: views and experts opinions of an IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, which met in Lyon 13–20 Oct. 1987. Lyon. https://monographs.iarc.fr/wpcontent/uploads/2018/06/mono98.pdf. Accessed 14 Oct 2019
- 57.Weaver CM, Alexander DD, Boushey CJ et al (2016) Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int J (Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA) 27:367–376. https://doi.org/10.1007/s00198-015-3386-5 CrossRefGoogle Scholar
- 59.Kahwati LC, Weber RP, Pan H et al (2018) Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults: evidence report and systematic review for the us preventive services task force. JAMA 319:1600–1612. https://doi.org/10.1001/jama.2017.21640 CrossRefPubMedGoogle Scholar