Dr. Susana Sans Menendez
Low income is associated with poor adherence to a Mediterranean diet and a higher prevalence of obesity: cross-sectional results from the Moli-sani study. M. Bonaccio et al.BMJ Open 2012; 2: e00168
Since the Seven Countries study by Ancel Keys in the nineteen sixties, many other posterior studies have shown the beneficial effects of a Mediterranean diet not only on cardiovascular diseases, but also upon cancer, obesity and other conditions. In spite of this evidence other studies alarmingly show that a Mediterranean diet characterised by a high intake of fresh fruits, vegetables, fish, cereals, olive oil and moderate consumption of red wine is being progressively substituted by westernized diets high in saturated fats, meat and refined sugars, even in Mediterranean countries.
This cross-sectional study carried out in a region between Central and Southern Italy had the objective to look at the relation between income, education and socio-economic indicators and the degree of adherence to Mediterranean Diet in a sample of 13,262 subjects aged ≥35 years of the general population of Molise. The EPIC food frequency questionnaire and three parameters of Mediterranean Diet, two a priori and one a posterior, were used.
The odds of having the highest adherence to a Mediterranean diet clearly increased with household income, and with higher education independently of income level. Income was associated with dietary patterns in all categories of education. Prevalence of obesity was also higher in the lowest income and education groups.
These results concur with previous studies illustrating that higher quality diets are mainly consumed by better educated and affluent people and that lower education groups tend to have lower quality diets. Furthermore, it has been shown by another Spanish study that Mediterranean diet is more expensive to follow than other low quality diets.
Thus, issues of cost should be taken into account when counselling people, in order to maximise the opportunity to follow a healthy diet and policy action to reduce the cost of healthy food is needed to decrease these inequalities.
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