AimTo assess the adherence to the Mediterranean diet in the population of Dalmatia in southern Croatia.MethodsA cross-sectional study was performed within the 10 001 Dalmatians cohort, encompassing 2768 participants from Korčula and Vis islands and the City of Split, who were recruited during 2011-2014. Using the data obtained from food frequency questionnaire we calculated the Mediterranean Diet Serving Score (MDSS). Multivariate logistic regression was used to identify the characteristics associated with the adherence to the Mediterranean diet, with age, sex, place of residence, education attainment, smoking, and physical activity as covariates.ResultsThe median MDSS score was 11 out of 24 points (interquartile range 8-13), with the highest score recorded on the island of Vis. Participants reported a dietary pattern that had high compliance with the Mediterranean diet guidelines for consumption of cereals (87% met the criteria), potatoes (73%), olive oil (69%), and fish (61%), moderate for consumption of fruit (54%) and vegetables (31%), and low for consumption of nuts (6%). Overall, only 23% of the participants were classified as being adherent to the Mediterranean diet, with a particularly low percentage among younger participants (12%) compared to the older ones (34%). Men were less likely to show good adherence (odds ratio 0.52, 95% confidence interval 0.42-0.65).ConclusionThis study revealed rather poor compliance with the current recommendations on the Mediterranean diet composition in the population of Dalmatia. Public health intervention is especially needed in younger age groups and in men, who show the greatest departure from traditional Mediterranean diet and lifestyle.

Nuts are often considered beneficial for health, yet few studies have examined determinants of their intake and the associations between nut consumption and various cardiovascular disease risk factors. The aim of this study was to identify factors associated with nut intake in a Mediterranean population, in Croatia, and to investigate the association of nut intake and various cardiovascular risk factors. Methods: Subjects from the Island of Vis, Island of Korčula and the City of Split were included in this cross-sectional study (n = 4416 in total; 4011 without known cardiovascular disease). Survey responses, medical records and clinically relevant measurements were utilized. Multivariate ordinal and logistic regression models were used in the analysis, adjusting for known confounding factors. Results: As low as 5% of all subjects reported daily, and 11% reported weekly, nut consumption. The characteristics associated with more frequent nut intake were female gender (Odds ratio (OR) = 1.39; 95% confidence interval (CI) 1.19–1.62), highest level of education (1.42; 1.15–1.76) and material status (1.58; 1.29–1.93), smoking abstinence (1.21; 1.04–1.42 in never-smokers and 1.22; 1.02–1.46 in ex-smokers), Mediterranean diet adherence (1.87; 1.62–2.15), and absence of central obesity (1.29; 1.09–1.53), absence of diabetes (1.30; 1.02–1.66) and metabolic syndrome (1.17; 1.01–1.36). Subjects who consumed nuts had more favorable waist-to-height (overall p = 0.036) and waist-to-hip ratios (0.033), lesser odds of elevated fibrinogen (p < 0.001 in both weekly and monthly nut consumers) and reduced high-density lipoprotein (HDL) cholesterol (p = 0.026), compared to non-consumers. Conclusions: It appears that frequent nut consumption is an integral part of a healthy lifestyle and better socioeconomic status. A beneficial association of nut intake with cardiovascular risk factors was confirmed in this study.

Purpose The impact of eating habits on mental health is gaining more attention recently. The purpose of this paper is to investigate the association between mental distress and the Mediterranean diet (MD) in a community-dwelling adult population of Dalmatia, Croatia. Design/methodology/approach Participants from the “10,001 Dalmatians” study from the Island of Korcula and the City of Split were included (n=3,392). Lifestyle habits were investigated using a self-administered questionnaire, while mental distress was evaluated using the General Health Questionnaire-30 (GHQ-30) in a cross-sectional design. MD compliance was assessed using the Mediterranean Diet Serving Score. Multivariate linear regression analysis was used in the analysis. Findings MD compliance was associated with lesser mental distress (ß=−1.96, 95% CI −2.75, −1.17; p<0.001). Inverse association was found between mental distress and higher intake of fruits (ß=−0.64; 95% CI −0.89, −0.39; p<0.001), vegetables (ß=−0.39; 95% CI −0.65, −0.13; p=0.003), olive oil (ß=−0.30; 95% CI −0.56, −0.04; p=0.022) and legumes (ß=−0.83; 95% CI −1.66, 0.00; p=0.049). Mental distress was more intense in women, older participants, those with worse material status, subjects with previously diagnosed chronic diseases and in current smokers. Originality/value This study suggests beneficial association of MD and overall mental health, offering important implications for public health provisions. Since the literature search did not reveal any previous study on the association between the MD and GHQ-based mental distress in the general population, this study delivers interesting results and fills this knowledge gap.

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