Mediterranean Diet in Europe: how are mature adults and elderly moving closer to this diet pattern?

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BackgroundThe decrease in Mediterranean Diet (MD) adherence during the last decades in Europe has been linked with changes to modern lifestyles, and more recently, to the Great Recession. However, new national efforts to improve dietary habits through fiscal and regulatory policies, and the economic improvement of the second half of the past decade (pre-covid 19 pandemic) might have led to a reversal in this trend. Our goal was to analyze the changes in MD adherence between 2013 and 2019 among a sample of European mature adults and the elderly.MethodsUsing data from the Survey of Health, Ageing and Retirement in Europe (SHARE) for adults over 50 years old, we design a longitudinal cohort study with a sample of participants from waves 5 (2013) and 8 (2019/20). Logistic regressions were used to model the consumption of MD adherence, meat/fish, fruit/vegetables, legumes/eggs and dairy products as function of the year. We stratified the analyses by educational level and age groups and for transitions in economic status, employed, and self-perceived health.ResultsThere was in 2019/20 a significant increase in the MD adherence (10.8 v. 14.3%, OR = 1.377, P < 0.01). The rise is mainly related to the decrease of meat and fish (38.4 v. 30.5%, OR = 0,703, P < 0.01) and growth of legumes and eggs intake (36.3 v. 41.8%, OR = 1.260 P < 0.01). The results were consistent in all European regions and most sociodemographic groups. Younger people with higher income and education and overall better self-perceived health had a more prevalent rise in M.D adherence.ConclusionsOur analysis shows a generalized growth in MD's adherence amongst mature adults and elderly population across Europe. This rise was observed across most socioeconomic subpopulations and European countries, suggesting a shift to healthier diet patterns. Yet, MD adherence increase was more noticeable amongst more affluent, educated and healthy responders, which may further entrench diet and health inequalities.Key messages Mediterranean Diet adherence has been increasing among mature adults and the elderly in Europe (2013-2019).The rise in Mediterranean Diet adherence was more evident amongst more affluent, educated and healthy responders, which may further entrench diet and health inequalities.