Investigating factors that influence adoption of and adherence to Mediterranean style diet in healthy adults who live in England.

Abstract

Aim: This project aimed to investigate the factors (barriers & facilitators) that influence adoption of and adherence to Mediterranean style diet (MedDiet) in adults aged 18 years old and above who live in England. For the purposes of the study, a Systematic Literature Review (SLR) and a pilot anonymous cross-sectional online questionnaire study have been conducted. The SLR informed the content of the questionnaire study. Results: Of 3.971 retrieved articles, 10 studies fulfilled our inclusion criteria and were included in the SLR. Eight influencing factors were identified and categorized into themes: financial factors, cognitive factors, sociocultural factors, motivational factors, health and lifestyle factors, accessibility & availability factors, hedonic factors and demographic factors. The SLR results informed the content of the anonymous online cross-sectional questionnaire study. The questionnaire survey was launched online in April 2020 and it was disseminated through social media (Facebook, twitter and BU research blog). Potential participants were asked to complete the eligibility criteria, before getting redirected into the MEDAS (Mediterranean Diet Adherence Screener) score measurement section. Firstly, the questionnaire assessed current MEDAS score of each participant. Secondly, the factors associated with adoption of or adherence to Mediterranean style diet were scored based on a seven- point Likert scale, and finally, various participants' demographic and lifestyle characteristics were collected. The total MEDAS score was found to be below moderate level (5.8 ± 2.7). British citizens’ MEDAS scores had significant positive correlations with the influence of family members and their upbringing (r = 0.35, p = 0.03) and their smoking habits (r = 0.37, p = 0.02). Conclusions: Worldwide various factors related to adoption of and adherence to MedDiet was documented to have an impact into the consumption of the Mediterranean dietary pattern among adults outside Mediterranean regions. Our synthesis of previous findings from various studies provided insights into the factors that could influence adoption of and adherence to MedDiet in healthy adults globally. Moreover, our questionnaire study findings confirmed that two factors had statistical significant impact on Mediterranean diet adoption in our sample of British citizens. Concerning adherence related factors our results were not significant, but might show tendency and bigger study (larger sample) needed to elucidate the statistical significance of these results. If our findings are confirmed in future studies, nutrition professionals can consider the development of nutritional interventions based on MedDiet’s influencing factors.