Socio-demographic and lifestyle determinants of adherence to the Mediterranean diet in seemingly healthy Lebanese adults: a cross-sectional study

Abstract

Background: Mediterranean diet (MD) is a traditional dietary pattern mainly followed in the Mediterranean regions and is shown to have positive health impacts, decreasing morbidity and mortality of major chronic diseases. A global shifting from the MD was documented especially in the Mediterranean regions, including Lebanon. Multiple individual and environmental factors were found to impact adherence to MD. In Lebanon, there is a shortage of recent information about adherence to the MD and its associated factors. Objective: The objectives of this study are to 1) evaluate the level of adherence to the MD among Lebanese adults and 2) examine the associations between individual factors (socio-demographic and lifestyle) and MD adherence before and after adjustment for food environment at home and in stores factors. Methods: A cross-sectional study design was carried out during the month of July 2021 among a convenient sample of 326 Lebanese adults. The participants completed an online questionnaire composed of a) questions about socio-demographics, anthropometrics, and lifestyle behaviors; b) the 14-item Mediterranean Diet Adherence Screener (14-MEDAS); and c) the Perceived Nutrition Environment Measures Survey in the Mediterranean Context (NEMS-P-MED-AR). Results: The mean of the 14-MEDAS was 7.59 ± 2.22, thus the surveyed sample has a moderate adherence to the Mediterranean dietary pattern. Consumption of fruits, vegetables, legumes, and olive oil met the recommended Mediterranean diet intake among the majority of participants. Older age, having children, specializing in a health -related field and having regular physical exercise showed statistically significant associations with higher adherence to the Mediterranean diet. Results from multiple linear regression analyses showed that only older age and having a regular routine of physical activity were significantly associated with increased MD adherence. Conclusion: Public health interventions aiming to promote adherence to the Mediterranean diet shall target predominantly younger age groups of the Lebanese population and incorporate strategies to boost physical activity among target groups.