Ageing, women and health concerns are key drivers for Mediterranean diet adherence among Lebanese – study
The MedDiet is one of the most extensively studied eating patterns worldwide due to its reported beneficial impact on various health incomes, including cardiovascular disease (CVD), metabolic syndrome, type 2 diabetes, and obesity.
Previous meta-analyses and prospective studies have stated that even a small increase in MedDiet adherence score, typically by two points, results in a notable 10% reduction in CVD risk.
Several indexes have been developed to evaluate adherence to this dietary pattern, with the Lebanese Mediterranean Diet Score (LMDS) said to be a robust and straightforward measure to assess consumption of the Middle Eastern variant of MedDiet.
For instance, the LMDS incorporates foods, such as burghul, dried fruit and dairy products, that are emblematic of traditional Lebanese cuisine.
However, comprehensive studies involving the Lebanese population which analyse the correlation between adherence to MedDiet and CVD risk factors remain scarce.
To bridge this research gap, a cross-sectional study using a multistage cluster sample was conducted in Lebanon. It included data from 2,048 people aged 40 years and above.
Dietary practices were evaluated using the LMDS, with the score ranging from 0 to 64 (maximal adherence).
The results showed that older age, being female, being married, participating in regular physical activity, and having CVD and diabetes were significantly associated with higher LMDS scores.
Conversely, being a smoker, both current and previous, and higher psychological distress levels were significantly associated with lower adherence to the MedDiet.
Stratification analysis revealed that these associations remained consistent across subgroups defined by the presence or absence of diabetes, dyslipidemia, and CVD.
It was also found that people with CVD and dyslipidemia had slightly higher adherence to the MedDiet, compared to those without.
“Our findings suggest that demographic factors and health conditions play a significant role in influencing MedDiet uptake in Lebanon. These results contrast other cross-sectional studies indicating that MedDiet adherence is lower among CVD patients. Longitudinal studies are needed to explore additional factors affecting dietary adherence over time,” the researchers wrote.
In addition, the present study revealed moderate overall adherence to the MedDiet among participants.
This aligns with previous research involving 3,384 Lebanese university students, which demonstrated a similar moderate adherence, as well as two other Lebanese studies reporting moderate to high adherence among the general population.
“The moderate adherence observed in our study may be attributed to older individuals gravitating towards conventional eating patterns compared to younger ones, who may be exposed to novel and ‘trendy’ food products.
“Another possible explanation for our findings is that people improve their diet quality in response to receiving a CVD, diabetes, and/or dyslipidemia diagnosis. This is supported by a review reporting that nutritional counselling enhances cardiometabolic health in middle-aged and older adults.”
Take heart
The MedDiet was recognised by UNESCO as an Intangible Cultural Heritage in 2010.
Although it is characterised by the traditional eating habits of countries bordering the Mediterranean Sea, it manifests in various forms within and across those countries.
This dietary pattern emphasises a high consumption of plant-based foods, such as cereals and whole grains, fresh fruit and vegetables, legumes, nuts, and olive oil.
It also promotes low-to-moderate intake of fish and poultry, limited consumption of red meat, eggs and processed foods, and moderate wine consumption.
As such, its benefits are attributed to the high content of essential micronutrients, fibres and antioxidants from plant foods, particularly polyphenols and vitamins, and abundance of omega-3 polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs).
On the other hand, it restricts the intake of saturated and trans fats.
Numerous studies have linked the MedDiet with a reduced incidence of cardiovascular events and mortality.
“This diet favourably impacts blood pressure, body weight, glycaemic control, vascular inflammation, and arteriosclerosis. It may also improve glucose metabolism, insulin sensitivity, lipid profile, ultimately being protective against CVD, and reducing all-cause and cardiovascular-related mortality.
“Given the significant cardiovascular benefits associated with MedDiet, it should be promoted as a primary prevention strategy and not only as potentially secondary prevention. Besides better health outcomes, healthy eating choices at both individual and community levels can lead to enhanced quality of life, physical fitness, and mental well-being,” the researchers concluded.
Source: Nutrients
https://doi.org/10.3390/nu16152426
“Adherence to the Mediterranean Diet and Cardiovascular Risk Factors among the Lebanese Population: A Nationwide Cross-Sectional Post Hoc Study”
Authors: Rony M. Zeenny, et al
