The results of a large study published in the Bmj Open by Italian scientists, at the Fondazione di ricerca e cura Giovanni Paolo II – Catholic University of Campobasso, who analyzed data on 13,000 subjects enrolled in the Moli-sani Project

Recently the Mediterranean diet has achieved lots of distinctions, from the inclusion by the UNESCO in the Olympus of the World heritage list to a long series of dedicated congresses and meetings held everywhere in the globe with the aim of promoting its healthy properties against the most threatening diseases such as cardiovascular disease and tumors. So the Mediterranean diet is an international star acclaimed by the scientific community as the best dietary paradigm. And yet this eating model seems to creak under the burden of the economic crisis scaring the food trolley of millions of families worldwide.

The alarm was raised by a team of Italian scientists from the Research Laboratories at the Fondazione di ricerca e cura Giovanni Paolo II – Catholic University of Campobasso who published in the British Medical Journal, BMJ Open, the results of a study on 13,000 subjects.

“Our hypothesis comes from a pretty simple observation. – argues Marialaura Bonaccio first author of the study – We sought to see whether the increasing cost of the main food products and the progressive impoverishment of people could contribute to the obesity pandemic which has been affecting the countries of the Mediterranean area during the recent years, including Italy”.

Researchers analyzed information on over 13,000 people, a sub-sample of the widest epidemiological Moli-sani Project. Since 2005 this project has been recruiting about 25,000 adult subjects from the Molise region aiming to investigate the relationship between genetic and environmental factors in the onset of chronic disease such as cardiovascular disease and tumors. The authors explored the association between income and dietary habits of participants, evaluated according to specific scores of adherence to Mediterranean diet.

“We found that low-income people showed the poorest adherence to Mediterranean diet as compared to those in the uppermost group of income – says Licia Iacoviello, chairperson of the Moli-sani Project– In particular, high-income people have 72% odds of being in the top category of adherence to Mediterranean diet. This means a less healthy diet for the poorest, who are more likely to get prepackaged or junk food, often cheaper than the fresh foods of the Mediterranean tradition. In the lowest-income category we have recorded a higher prevalence of obesity as well. Low-income people report 36 % of obesity compared to 20% in the uppermost income class”.

“Obviously we have considered all the possible confounding factors which may bias the observed effects – the authors say –The educational level, for instance, has a huge role in determining health status, as showed by previous studies. That is why we have further divided our population according to educational level but in this case too income appears to influence people’s food choices”.

“An interesting aspect of our study – argues Giovanni de Gaetano, director of the Research Laboratories at the centre of Campobasso – is that the income categories considered were not so different from each another. We are talking about relatively small economic differences, from 10,000 Euros to over 40,000 Euros net per year. Yet, also in a quite homogenous region as Molise we could observe substantial differences in dietary habits and consequent health outcomes. This is a very serious issue which shall foster a discussion on healthy food accessibility in terms of economic costs within those appointed to guarantee the rights to health to everybody, independently from socioeconomic status. Keep on gaining proofs on the beneficial effect of Mediterranean diet is no longer the only task. We have to be sure that everyone has the chance to take advantage from it”.
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The Moli-sani Project is an observational, prospective study brought about by the Research Laboratories of the Fondazione di Ricerca e Cura “Giovanni Paolo II” in Campobasso, Italy, and supported by the the Cuore Sano Association. Started in March 2005, the study has randomly recruited 25,000 adult citizens living in the Molise region, in order to investigate environmental and genetic factors implicated in cardiovascular disease and tumors. The Moli-sani study is changing the face of a whole Italian region by turning it into a large scientific laboratory.

The Cuore Sano Association is a no-profit organization aiming to support the activities related to the Moli-sani project.

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Americo Bonanni
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Catholic University - Campobasso