Research uncovers dietary patterns influencing Mediterranean Diet adherence

By Vijay Kumar MalesuReviewed by Susha Cheriyedath, M.Sc.Dec 9 2024

Unveiling five unique consumer segments, this study sheds light on why many struggle to follow the world’s most evidence-based diet, highlighting cultural, financial, and behavioral barriers.

Study: From Olive Oil Lovers to Mediterranean Diet Lifestyle Followers: Consumption Pattern Segmentation in the Portuguese Context. Image Credit: Brian A Jackson / Shutterstock

In a recent study published in the journal Nutrients, researchers in Portugal investigated consumer segmentation based on olive oil consumption patterns and adherence to the Mediterranean Diet (MedDiet) while identifying barriers to its adoption.

Background

The scientific community has shifted focus toward understanding overall diet quality rather than single-nutrient-based approaches to examining diet-health relationships.

The MedDiet is renowned as the most evidence-based eating pattern for promoting health and longevity. Recognized by UNESCO as an Intangible Cultural Heritage, the MedDiet embodies not just nutritional guidelines but also historical and cultural practices that promote community well-being. However, traditional MedDiet patterns are being lost due to changes in dietary habits and lifestyle, even in Mediterranean countries.

Factors such as globalization, poverty, and increased consumption of processed foods are contributing to the decline. Despite these challenges, understanding consumer segmentation based on MedDiet adherence is crucial for tailoring effective policies and interventions.

Further research is needed to explore strategies that promote MedDiet adherence in diverse populations.

About the Study

Data were collected from a survey of the general Portuguese population using quota sampling to examine the evolution of MedDiet consumption patterns and strategies for promoting adherence. A total of 1,000 respondents participated, with representation across different socio-demographic variables, such as age, sex, and regional location.

The data were gathered in 2020 via a telephonic survey, which allowed for wide geographical and age group coverage. The sample consisted of 52% females and 48% males, with varying educational and financial backgrounds. The survey included demographic and MedDiet-related questions, as well as measures for body mass index (BMI) and food insecurity.

The evaluation instrument used was a semi-structured survey, primarily based on the Prevention with Mediterranean Diet (PREDIMED) questionnaire, which is widely recognized for assessing MedDiet adherence. The inclusion of demographic questions and obstacles to healthy eating provided a more nuanced understanding of dietary patterns.

The questionnaire was adapted to include questions on barriers to healthy eating and socio-demographic characteristics. Data were analyzed using descriptive statistics, factor analysis, and clustering techniques, including Principal Component Analysis (PCA) with Varimax rotation, the K-Means algorithm, and multinomial logistic regression (MLR).

These methods facilitated the segmentation of consumers based on their consumption patterns and identified significant factors influencing MedDiet adherence.

Statistical analysis was conducted using the Statistical Package for the Social Sciences (SPSS) software, with results considered significant at p < 0.05.

Study Results

In the study, 1,000 respondents participated, with 62% indicating they had heard of the MedDiet and 80% (about 50% of the total respondents) understanding what it entails. The most commonly recognized features of the MedDiet were the use of olive oil for cooking (77%), high consumption of fresh fruits and vegetables (68%), and a higher intake of fish and meat (41%).

Regarding adherence, 26% of the population scored ≥10 points on the PREDIMED test, which indicates high adherence. However, most respondents scored lower (<10 points), suggesting a lack of adherence to this health-promoting diet. The survey revealed significant gaps in the consumption of legumes (69%), vegetables (52%), fruits (61%), and oleaginous nuts (61%), indicating areas for targeted intervention.

Anthropometric measurements revealed a significant difference between genders, with women having an average BMI of 24.74 kg/m², compared to men’s 26.55 kg/m². Age and educational level were also significant factors influencing BMI, with older individuals and those with lower education having higher BMIs.

Additionally, those who adhered more strictly to the MedDiet had a lower average BMI, indicating a potential link between MedDiet adherence and healthier weight.

Factor and cluster analyses were performed to segment consumers based on their MedDiet consumption patterns. Factor analysis identified five key dietary components: low-fat diet, balanced diet, low-sugar diet, olive oil dominance, and Mediterranean style.

Using the K-Means algorithm, five distinct clusters were identified. These clusters included segments such as "MedDiet lifestyle followers," "Olive oil lovers," "Low-sugar diet foods seekers," "Healthy and balanced diet seekers," and "Low-fat diet foods seekers," each demonstrating different levels of adherence and consumption preferences.

Demographically, these segments varied in age, gender, education level, and financial situation, providing insights into the diverse barriers and motivators for MedDiet adherence.

Barriers to MedDiet adherence were also analyzed, revealing that while 92% of respondents use olive oil as the primary fat, the high cost of fish and olive oil and culinary difficulties were significant obstacles to adherence.

Additionally, perceptions that certain foods like bread and nuts are "fattening" contributed to lower consumption of these items. Logistic regression analysis confirmed that awareness of the MedDiet had the greatest impact on adherence, underscoring the importance of educational efforts to promote the diet.

Conclusions

To summarize, the MedDiet was recognized as the best overall diet in 2020 but has seen declining adherence due to modern lifestyles and environmental constraints.

In Portugal, factors like globalization, poverty, and processed food consumption contribute to this shift. The study highlights the importance of addressing both structural barriers, such as cost and accessibility, and personal perceptions, such as the belief that certain foods are fattening, to enhance adherence.

This study identifies five consumer segments based on MedDiet adherence: MedDiet lifestyle followers, olive oil lovers, low-sugar diet food seekers, healthy and balanced diet food seekers, and low-fat diet food seekers.

Findings show a strong inverse relationship between MedDiet adherence and obesity. Promoting the MedDiet requires tailored communication strategies that reflect the preferences and barriers specific to each consumer segment.