Abstract

Abstract Food security is a universal need assuring access to healthy diet in both developing and developed countries. The aim of this study was to investigate the association between factors related to food security and adherence to the Mediterranean diet in 5 Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) participating to the EU funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean diet and LIfestyle in Children and adolescents through behavIOUral change actionS). Data were retrieved from a survey involving 2011 parents of children and adolescents aged 6-17 years old. The KIDMED score was used to assess the level of adherence to the Mediterranean diet. Information regarding easiness to retrieve foods characteristic of the Mediterranean diet, working status, economic allowance, and place of living were collected. The association with adherence to the Mediterranean diet were investigated by performing logistic regressions. The analyses revealed that individuals living in rural areas and reporting difficulty to retrieve all food items explored were less likely to have higher adherence to the Mediterranean diet. Moreover, higher adherence was also associated with household income higher than €3,500. No associations with family status nor working situation were found. There were no evident differences across countries, although there was nearly an inverse trend toward lack of association between economic allowance and higher adherence to the Mediterranean diet in Italy. In conclusion, the progressive abandonment of traditional dietary patterns, such as the Mediterranean diet, may not just depend on a cultural shift toward unhealthier industrial alternatives, but also on family budget and easiness to retrieve food stuff. Key messages • Food security may play a role in adherence to the Mediterranean diet. • The food market may be responsible for changes in cultural culinary habits.

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