Background and aims: The Mediterranean diet is reportedly a healthy eating pattern with protective effects on chronic diseases. The aim of this study was to assess the relationship between adherence to the Mediterranean diet and anthropometric and metabolic variables in a rural setting in southern Italy, in the context of a health screening initiative.
Methods and results: Five hundred and twenty-two healthy participants from the "Alto Molise" region in southern Italy were studied. Blood pressure, glucose, and total cholesterol were measured using automatic devices. Food intake was evaluated with a semi-quantitative food-frequency questionnaire, and the Mediterranean adequacy index (MAI) was calculated. The median value of MAI in the population studied was 3.0 (1.5-5.4) in men and 2.4 (1.2-5.1) in women. In women, the stronger contributors to MAI were dairy products (42.5%), sweets (29.3%) and meat (19.4%), while in men they were cereals (39.1%), meat (18.6%), dairy products (16.9%) and sweets (16.1%). In multiple linear regression analysis MAI was positively associated with age in both sexes (P=0.0044 in men and P=0.0054 in women) and with systolic blood pressure in women (P=0.012). After stratification of women by age, systolic blood pressure was significantly associated with MAI only in older persons (P=0.040) but not at younger ages (interaction effect P<0.0001).
Conclusions: Adherence to the Mediterranean diet depends on age, possibly because in younger people the traditional Mediterranean style diet is decreasing, even in rural areas of southern Italy. Age also influences the association between MAI and metabolic variables such as systolic blood pressure in women.