The nutrition transition in Spain: a European Mediterranean country

Abstract

Background: Mediterranean diets are felt to be healthful diets linked with reduced mortality from diet-related noncommunicable diseases. Objective: To examine trends in diet, activity, obesity and diet-related noncommunicable diseases for Spain and compare these with other European countries, particularly those from the Mediterranean area. Design: A combination of large-scale primary and secondary nationally representative data analysis are used. Data: Nationally representative data on household food consumption, physical activity, adult obesity, and cause of death are combined with regionally representative adolescent obesity data, obtained in the last four decades. Comparative diet and obesity data come from nationally representative comparable data, obtained during the same period. Results: The Spanish diet has shifted toward a very high level of fat intake, high fruit and dairy intake and moderate vegetable intake. Dairy and fruit intakes were the highest in Europe, as was the proportion of energy from fat, when we compared with the available data. Adult overweight and obesity trends show a marked increase in the past decade to levels as high as Italy and far above France. Overweight for children aged 6 -7 is above that of even the USA, while adolescent overweight levels are among the highest in the world. Cardiovascular disease mortality is low, as with Italy and France, and the cancer mortality rate is lower than Italy and France. Conclusions: We have observed that, in Spain, relatively high obesity prevalences and dairy intake levels are related to much lower levels of cardiovascular disease and cancer mortality than are found in other European countries. This unique Spanish dietary and obesity pattern should be further explored in order to clarify the causal links.

Population dietary habits and physical activity modification with age

“…Interestingly, dietary vitamin C intake was more than five times higher in the former than in the latter. This difference is consistent with the high consumption of fruits and vegetables in Spain, which is one of the highest in Europe (EPIC group of Spain, 1999;Moreno et al, 2002). In the present study, there were significantly higher intakes and nutrient densities of vitamin C and folate in aged men than young men.…”

“…Again, the cross-sectional design of the study may have resulted in the above-mentioned selection bias. An alternative or complementary reason may stem from the fact that the aged group preserved the most typical dietary characteristics in spite of the dietary changes that have occurred during the last 50 y in Spain (Moreno et al, 2002).…”

Influence of dietary pattern on the development of overweight in a Chinese population

“…The traditional Chinese diet has many similarities with the Mediterranean diet, with the exception of low dairy products and wine consumption, such that a Mediterranean diet score may be applied (Woo et al, 2001), and potential health benefits have been discussed . Recent studies have addressed the impact of nonadherence to the Mediterranean dietary pattern on the development of overweight and obesity, such that the rising prevalence of obesity in Mediterranean regions has been attributed to a nutrition transition away from traditional diets (Moreno et al, 2002). Adherence to the traditional Mediterranean diet pattern was found to reduce the risk of obesity after controlling for confounding factors such as socioeconomic status and physical activity in a Spanish study (Schroder et al, 2004), and similar observations had been made for the Greek population (Wahlqvist et al, 1999).…”

“…Recent studies have addressed concerns that nonadherence to the Mediterranean diet may predispose to the development of overweight and obesity in view of the rising prevalence in Mediterranean countries (Wahlqvist et al, 1999;Notarbartolo and Barbagallo, 2001;Moreno et al, 2002;Serra-Majem et al, 2003;Schroder et al, 2004;Trichopoulou et al, 2005). The traditional Chinese diet has many similarities with the Mediterranean diet, such that the Mediterranean diet score when applied to Chinese dietary patterns is comparable to the score from Mediterranean populations (Woo et al, 2001).…”

Western and Mediterranean dietary patterns among Balearic Islands’ adolescents: socio-economic and lifestyle determinants

“…Recent nutritional surveys carried out in Spain also confirmed a progressive departure from the traditional Mediterranean diet towards a Western dietary pattern, mainly in young generations (5)(6)(7)(8)(9)(10)(11) . Because there is evidence that nutritional behaviours track from adolescence into adulthood, the promotion of healthy nutrition during adolescence has the potential to confer significant long-term health benefits (1) .…”