From Liking to Following: The Role of Food Preferences, Taste Perception, and Lifestyle Factors in Adherence to the Mediterranean Diet Among Young Individuals

Background and aims: The Mediterranean diet (MedDiet) is a healthy dietary pattern associated with reduced risk of chronic diseases. However, adherence is declining, particularly among younger populations. Therefore, it is crucial to identify the main aspects that affect its adherence, particularly food preferences and sensory function, which have received insufficient attention. Our aims were to investigate the impact of socio-demographic and lifestyle factors on adherence to the MedDiet among young individuals; to assess the association of taste preferences and food liking with MedDiet adherence; and to evaluate the associations between taste perception modalities, taste and food preferences, and adherence. Methods: A cross-sectional study on young adults (aged 20.5 +/- 4.7 years) in a Mediterranean country (n = 879) was carried out. Demographic characteristics, clinical characteristics, anthropometric characteristics, lifestyle characteristics, MedDiet adherence, taste preferences, and food preferences were assessed. Taste perception for bitter, salty, sweet, sour, and umami was determined by rating different concentrations of prototypical tastants. We computed a total taste perception score and three scores to combine food preferences. Results: We identified several socio-demographic and lifestyle factors associated with adherence to the MedDiet, as well as food preferences, taste preferences, and taste perception determinants. Food preferences were significantly associated with total adherence to the MedDiet. Higher preference for olive oil, oranges, broccoli, fish, and legumes was associated with higher MedDiet adherence (p < 0.05 for all). Conversely, higher preference for sweet foods, red meat, and butter was associated with lower adherence (p < 0.05 for all). The combined positive score for food preference was strongly associated with higher MedDiet adherence (p = 1.4 x 10(-23)) in the multivariate adjusted model. The combined negative food preference score was inversely associated (p = 1.9 x 10(-8)). Likewise, taste preferences were significantly associated with adherence to the MedDiet (strong inverse association for sweet taste preference and direct association for bitter taste preference; both p < 0.001). Moreover, bitter taste perception was inversely associated with adherence to the MedDiet and with bitter foods (p < 0.05). In conclusion, future precision nutrition studies should measure food liking and taste preferences, which are crucial determinants of MedDiet adherence, especially in young people.