Individual and food environment determinants of Mediterranean diet adherence among Lebanese adults: a cross-sectional study

Background: Many studies revealed positive health impacts of the Mediterranean diet (MD) especially on metabolic disorders. Conversely, information about determinants of adherence to the MD are limited. This study aims to examine the individual and environmental determinants of MD adherence among adults in Lebanon. Methods: A cross-sectional study was carried out during July 2021 among a convenient sample of 326 Lebanese adults. Data from participants were collected via an online survey developed by study researchers, that is composed of 3 well-structured questionnaires: a) background questionnaire; b) Perceived Nutrition Environment Measures Survey in the Mediterranean Context (NEMS-P-MED), and c) 14-item Mediterranean Diet Adherence Screener (14-MEDAS). Results: Mean MD score in the total sample was 7.59±2.22, reflecting moderate-to-fair MD adherence. Older age and having a regular routine of physical activity emerged as significant independent determinants of better MD adherence. Equally, availability of whole wheat pasta, rice or flour and fish at home and perceived importance of availability of easy to cook foods at food stores showed significant positive association, while healthy food availability, and in- store characteristics had no association with MD adherence score. Conclusion: Future public health interventions aiming at promoting MD adherence among young adults in Lebanon shall take account of availability of healthy food at home alongside individual factors such as meal preparation skills and regular physical activity.

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