A Generation Shift in Mediterranean Diet Adherence and Its Association with Biological Markers and Health in Dalmatia, Croatia

Abstract

Previous studies have confirmed the beneficial effect of a Mediterranean diet in mitigating health issues related to cardiovascular disease, diabetes and obesity. However, rapid changes in the traditional way of life and the “westernization” of the diet in Mediterranean populations, especially in younger generations, has led to progressive abandonment of healthy dietary patterns. In order to investigate the generation shift in dietary patterns and lifestyle habits in the Mediterranean part of Croatia, we compared two cohorts of 610 women (266 pregnant and 344 non-pregnant) from the same region, but from different age groups. The MDSS score was derived from food frequency questionnaires. The results showed that the young, reproductively active generation (pregnant women) in Dalmatia, Croatia, although having a higher education and socioeconomic status, exhibits a more adverse eating behaviour (lower adherence to the Mediterranean diet) and lifestyle (excessive smoking in pregnancy) than the older population from the same region. Lower MDSS scores across aggregated age groups in both cohorts showed significant association with higher blood lipid levels and higher smoking frequency. In conclusion, Mediterranean diet adherence is associated with biological markers (age, lipid profile) and lifestyle (smoking) in our study, with a more adverse trend observed in the younger generation.

Adherence to the Mediterranean Diet: Impact of Geographical Location of the Observations

“…An interesting “generation shift” from a Mediterranean diet pattern to a more “westernized” type of diet has also been observed in Dalmatia, the Mediterranean coastal part of Croatia, highlighting that younger women, although having a higher education and socioeconomic status, showed a lower adherence to the Mediterranean diet (assessed by the Mediterranean Diet Serving Score [ 61 ], Table 2 ) and a healthier lifestyle than older women from the same region [ 17 ].…”

“…In this context, it is important to emphasize that, in order to be most effective, nutritional guidelines need to be developed according to several specific factors, such as local cultural, ethnic and traditional features, and geographic and socioeconomic components, as well as to the availability of specific local food products [ 9 ]. Among these features, the geographical location (i.e., a specific country, different areas in a country, such as seaside or mountainside or plains far from both, and specific latitude and climate, including climate changes, as well as the related social features) appears to be a crucial factor that may affect to a large extent the actual applicability of the Mediterranean diet or some of its principles as well as the actual adherence to it [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. An additional dynamic component affecting personal nutritional choices, also regarding adherence to the Mediterranean diet and its principles, is the individual life-long trajectory of food preference and nutrition habits and awareness, including feeding behavior aspects [ 19 ].…”

“…In the past, this aspect has been associated with local traditions and ethnic features and therefore remained rather stable over time within a specific population. However, over the last decades, due to the exponential diffusion of multiple communication media, the modifications of such traditional nutrition habits have been more frequent, leading to either a nutritional transition to unhealthy habits, especially in younger subjects [ 17 , 20 , 21 , 22 ] and in selected areas such as the Middle Eastern and North African (MENA) region [ 12 ], or a greater awareness of the health advantages of a good adherence to the Mediterranean diet, especially in middle/older age subjects, with improved nutrition patterns during their lifetime [ 23 ]. Thus, the epidemiological and experimental observations reporting adherence to the Mediterranean diet and its impact on health issues should also take into consideration another component: the time-related longitudinal changes within a specific population.…”

The influence on fish and seafood consumption, and the attitudes and reasons for its consumption in the Croatian population

“…This study found that two-thirds of participants consumed fish and seafood two or more times a week, and three-fifths of participants had a diet that moderately and highly adhered to the Mediterranean diet, which represents important information and a prospective beneficial foundation for good health. The results showing a substantial proportion of participants with a diet moderately to highly adhering to MD is affirmative, since previous Croatian studies showed the MD diminishing, especially among younger populations (Kolčić et al, 2016;Kendel Jovanović et al, 2020;Šarac et al, 2021). Despite the well-known health benefits of fish and seafood consumption, mainly due to the content of omega-3 fatty acids, there is a potential health risk of fish and seafood consumption.…”

High Compliance to Mediterranean Diet Associates with Lower Platelet Activation and Liver Collagen Deposition in Patients with Nonalcoholic Fatty Liver Disease

“…This finding is in agreement with that observed in other Italian study populations [ 56 ]. The trend of Mediterranean youth to prefer Western dietary habits was widely discussed in the literature in the last years [ 57 , 58 ] and was summarized in a systematic review [ 59 ]. This has been related to the more frequent habits to have launch away from home because of work [ 57 ].…”