Results from the Italian Moli-sani study suggest that the Mediterranean diet, once so typical in this region of Europe, is now too expensive for many people.
People with lower incomes were also more likely to be obese than those with higher incomes, add the researchers, perhaps due to consuming a poorer quality diet.
"We sought to see whether the increasing cost of the main food products and the progressive impoverishment of people could contribute to the obesity pandemic which has been affecting the countries of the Mediterranean area during the recent years, including Italy," explained lead author Marialaura Bonaccio (Fondazione di Ricerca e Cura "Giovanni Paolo II," Campobasso, Italy) in a press statement.
As reported in the BMJ Open, the investigators analyzed data collected from 13,262 individuals taking part in the Moli-sani study (mean age 53 years) on dietary intake and demographic factors, as well as socioeconomic status. Adherence to the Mediterranean diet was assessed according to the Mediterranean score elaborated by Trichopolou (MDS) and the novel Italian Mediterranean Index (IMI).
When people in the highest income bracket (> € 40,000; US$ 52,303 per year net income) were compared with those in the lowest (< € 10,000; US$ 13,075 per year net income), the team found that they were 54% or 72% more likely to stick to a Mediterranean dietary pattern according to the MDS or IMI, respectively.
"We found that low-income people showed the poorest adherence to Mediterranean diet as compared to those in the uppermost group of income," said study author Licia Iacoviello, also from the Fondazione di Ricerca e Cura "Giovanni Paolo II."
"This means a less healthy diet for the poorest, who are more likely to get prepackaged or junk food, often cheaper than the fresh foods of the Mediterranean tradition," she added.
Similarly, people in the lowest income group had a higher prevalence of obesity than those in the highest, at 36% versus 20%.
Of note, income seemed to be the prime determinant of dietary patterns regardless of education level, although in general people with higher incomes also had higher levels of education.
Co-author Giovanni de Gaetano, from the same Institute in Campobasso, said that it is concerning that they observed such a strong difference in diet in groups of people with a relatively small difference in income and from quite a homogenous area.
"This is a very serious issue which should foster a discussion on healthy food accessibility in terms of economic costs among those appointed to guarantee the rights to health to everybody, independently from socioeconomic status," he concluded.
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