Mediterranean diet adherence, social capital and health related quality of life in the older adults of Crete, Greece: The MINOA study

BACKGROUND: Adherence to the Mediterranean Diet (MD), a sustainable dietary pattern with multiple benefits to health, environment, economy and society is decreasing even in the older adults in rural Crete; the prototype pattern from the 7 Country Study. OBJECTIVE: Investigate social and health related factors that may be perceived as barriers to adherence to the MD, among older adults, living in rural region of Crete, Greece. METHODS: Evaluate a) adherence to the Mediterranean dietary pattern using the MedDietScore b) dietary intake using theWater Balance Questionnaire (WBQ) c) social connections using the Social Capital Questionnaire including the Physical and Mental Component of Health (PCS and MCS, respectively) and d) health-related quality of life (HRQL) using the SF-36 Questionnaire, among older adults residing in the Municipality of Minoa; a Cretan rural area. A total of 436 older adults (>65 years, 58% men) were enrolled. RESULTS: Mean MedDietScore was moderate (31.9 +/- 3.6) and was found higher in males (32.9 +/- 3.4 vs 30.6 +/- 3.4; p < 0.001). Total social capital was 75 (68,80) with no significant differences between genders. The PCS was 45 (37,52) and the MCS 47 (40,54), males achieving a higher score (p < 0.0001 and p < 0.01 respectively). Results of linear regression, for adherence of the MD, showed sex (p < 0.0001), marital status (p = 0.039), "growing vegetables-fruits" (p = 0.014) and car ownership (p = 0.044), associated with MedDietScore. CONCLUSIONS: Older adults living in Crete, adhere moderately to the MD, with potential barriers being lower PCS and MCS and weak support provided by family and community structures as quantified by low scores in social capital and health-related quality of life.